facebook tracking Other musculoskeletal system and connective tissue operating room procedures with complications cost in New York: 14 hospitals compared (DRG 516)

Other musculoskeletal system and connective tissue operating room procedures with complications in New York

What 14 hospitals in New York charged and were paid for a Medicare hospital stay for other musculoskeletal system and connective tissue operating room procedures with complications (DRG 516), from 2024 Medicare claims.

DRG 516 Inpatient 2024 Medicare data
Average charge $144,498 Hospital list price billed
Average payment $25,244 Medicare + patient + other payers
Medicare paid $20,346 Average per stay
State rank #32 of 33 1 = lowest average payment

Hospitals in New York billed an average of $144,498 for other musculoskeletal system and connective tissue operating room procedures with complications, about 5.7 times the average total payment of $25,244. That payment is 33% above the U.S. average of $18,981.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $25,244Billed $144,498

About 17¢ was paid for every $1 hospitals in New York billed for this stay.

New York hospitals: other musculoskeletal system and connective tissue operating room procedures with complications

Every New York hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
New York-Presbyterian HospitalNew York 56 $126,602 $25,753 $21,494
NYU Hospitals CenterNew York 39 $194,207 $27,373 $23,906
University HospitalStony Brook 24 $133,431 $28,055 $20,598
Mount Sinai HospitalNew York 18 $129,792 $32,974 $20,906
Montefiore Medical CenterBronx 17 $203,148 $31,848 $20,907
Westchester Medical CenterValhalla 17 $311,260 $26,571 $20,528
St Francis Hospital, RoslynRoslyn 16 $135,457 $17,536 $16,161
John T Mather Memorial Hospital of Port JeffersonPort Jefferson 14 $97,206 $20,298 $17,464
Albany Medical Center HospitalAlbany 13 $80,980 $22,506 $18,309
Lenox Hill HospitalNew York 13 $119,864 $24,408 $20,937
University Hospital S U N Y Health Science CenterSyracuse 13 $89,069 $22,406 $18,638
Hospital for Special SurgeryNew York 12 $92,883 $23,344 $19,772
Good Samaritan Hospital Medical CenterWest Islip 11 $105,600 $18,680 $17,422
White Plains Hospital CtrWhite Plains 11 $97,449 $17,792 $16,308
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Lowest and highest payments in New York

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Highest

Mount Sinai HospitalNew York, NY$32,974
Montefiore Medical CenterBronx, NY$31,848
University HospitalStony Brook, NY$28,055
NYU Hospitals CenterNew York, NY$27,373
Westchester Medical CenterValhalla, NY$26,571

Other musculoskeletal system and connective tissue operating room procedures with complications in other states

Questions

How much does other musculoskeletal system and connective tissue operating room procedures with complications cost in New York?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with complications (DRG 516) at 14 hospitals in New York was billed at $144,498 on average, while the average total payment was $25,244, of which Medicare paid $20,346. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in New York, average charges were 5.7 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.