Other musculoskeletal system and connective tissue operating room procedures with major complications
What 64 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515), from 2024 Medicare claims.
Average charge
$163,859
Hospital list price billed
Average payment
$28,741
Medicare + patient + other payers
Medicare paid
$25,138
Average per stay
Volume
1,005
Medicare hospital stays
Hospitals in the U.S. billed an average of $163,859 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 5.7 times the average total payment of $28,741.
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 $28,741Billed $163,859
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Cjw Medical CenterRichmond, VA | $20,689 |
|---|---|
| Deaconess Hospital INCEvansville, IN | $21,388 |
| Henrico Doctors' HospitalRichmond, VA | $21,604 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $22,036 |
| Saint Francis Hospital, INCTulsa, OK | $23,568 |
| Baptist Medical CenterJacksonville, FL | $24,432 |
| Riverside Methodist HospitalColumbus, OH | $24,992 |
| South Shore HospitalSouth Weymouth, MA | $27,087 |
| Methodist Hospital,TheHouston, TX | $27,474 |
| Adventhealth OrlandoOrlando, FL | $35,432 |
Highest
| NYU Hospitals CenterNew York, NY | $45,444 |
|---|---|
| Massachusetts General HospitalBoston, MA | $38,319 |
| Adventhealth OrlandoOrlando, FL | $35,432 |
| Methodist Hospital,TheHouston, TX | $27,474 |
| South Shore HospitalSouth Weymouth, MA | $27,087 |
| Riverside Methodist HospitalColumbus, OH | $24,992 |
| Baptist Medical CenterJacksonville, FL | $24,432 |
| Saint Francis Hospital, INCTulsa, OK | $23,568 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $22,036 |
| Henrico Doctors' HospitalRichmond, VA | $21,604 |
Other musculoskeletal system and connective tissue operating room procedures with major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| California | 4 | $419,598 | $53,531 | $38,084 – $66,687 |
| Colorado | 1 | $168,864 | $22,038 | – |
| Delaware | 1 | $94,708 | $25,422 | – |
| Florida | 9 | $170,032 | $26,352 | $19,392 – $35,432 |
| Georgia | 3 | $200,221 | $25,789 | $22,027 – $29,949 |
| Illinois | 5 | $108,776 | $24,623 | $21,833 – $27,842 |
| Indiana | 2 | $78,724 | $22,189 | $21,388 – $23,227 |
| Iowa | 1 | $59,554 | $19,879 | – |
| Kansas | 4 | $160,439 | $24,887 | $23,430 – $27,090 |
| Kentucky | 2 | $99,956 | $22,019 | $21,525 – $22,472 |
| Maryland | 1 | $80,912 | $71,179 | – |
| Massachusetts | 5 | $94,745 | $33,993 | $27,087 – $39,835 |
| Michigan | 3 | $69,930 | $26,426 | $25,463 – $27,258 |
| Minnesota | 2 | $125,097 | $36,305 | $31,634 – $39,256 |
| Mississippi | 1 | $84,745 | $22,387 | – |
| Nebraska | 1 | $90,002 | $26,726 | – |
| New York | 2 | $267,222 | $44,283 | $42,141 – $45,444 |
| North Carolina | 1 | $90,357 | $22,036 | – |
| Ohio | 1 | $120,299 | $24,992 | – |
| Oklahoma | 2 | $118,536 | $23,417 | $23,229 – $23,568 |
| Pennsylvania | 1 | $93,798 | $25,203 | – |
| South Carolina | 1 | $105,403 | $21,281 | – |
| Tennessee | 1 | $108,588 | $24,580 | – |
| Texas | 6 | $217,256 | $23,090 | $19,512 – $27,474 |
| Virginia | 3 | $286,640 | $24,247 | $20,689 – $36,170 |
| Washington | 1 | $155,068 | $35,604 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 42 | $249,465 | $35,432 |
| Riverside Methodist HospitalColumbus, OH | 40 | $120,299 | $24,992 |
| Massachusetts General HospitalBoston, MA | 25 | $133,314 | $38,319 |
| Methodist Hospital,TheHouston, TX | 25 | $213,541 | $27,474 |
| NYU Hospitals CenterNew York, NY | 24 | $291,898 | $45,444 |
| Deaconess Hospital INCEvansville, IN | 22 | $81,072 | $21,388 |
| South Shore HospitalSouth Weymouth, MA | 22 | $46,976 | $27,087 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 22 | $90,357 | $22,036 |
| Cjw Medical CenterRichmond, VA | 22 | $377,797 | $20,689 |
| Baptist Medical CenterJacksonville, FL | 20 | $100,652 | $24,432 |
| Saint Francis Hospital, INCTulsa, OK | 20 | $73,806 | $23,568 |
| Henrico Doctors' HospitalRichmond, VA | 20 | $297,002 | $21,604 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 19 | $130,838 | $39,256 |
| North Florida Regional Medical CenterGainesville, FL | 18 | $215,170 | $25,447 |
| Wellstar Kennestone HospitalMarietta, GA | 18 | $250,330 | $29,949 |
Questions
How much does other musculoskeletal system and connective tissue operating room procedures with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515) at 64 hospitals in the U.S. was billed at $163,859 on average, while the average total payment was $28,741, of which Medicare paid $25,138. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other musculoskeletal system and connective tissue operating room procedures with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($53,531), Massachusetts ($33,993), Michigan ($26,426) and lowest in Texas ($23,090), Virginia ($24,247), Illinois ($24,623).
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 the U.S., 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.