facebook tracking Other musculoskeletal system and connective tissue operating room procedures with major complications cost in California: 4 hospitals compared (DRG 515)

Other musculoskeletal system and connective tissue operating room procedures with major complications in California

What 4 hospitals in California 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.

DRG 515 Inpatient 2024 Medicare data
Average charge $419,598 Hospital list price billed
Average payment $53,531 Medicare + patient + other payers
Medicare paid $47,115 Average per stay
State rank #9 of 9 1 = lowest average payment

Hospitals in California billed an average of $419,598 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 7.8 times the average total payment of $53,531. That payment is 86% above the U.S. average 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 $53,531Billed $419,598

About 13¢ was paid for every $1 hospitals in California billed for this stay.

California hospitals: other musculoskeletal system and connective tissue operating room procedures with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Cedars-Sinai Medical CenterLos Angeles 16 $403,408 $38,084 $33,702
University of California Davis Medical CenterSacramento 15 $471,614 $66,687 $58,155
Stanford HospitalPalo Alto 14 $469,686 $53,441 $47,768
UCSF Medical CenterSan Francisco 12 $317,728 $57,788 $50,437
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Lowest and highest payments in California

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.

Lowest

Cedars-Sinai Medical CenterLos Angeles, CA$38,084
Stanford HospitalPalo Alto, CA$53,441
UCSF Medical CenterSan Francisco, CA$57,788
University of California Davis Medical CenterSacramento, CA$66,687

Highest

University of California Davis Medical CenterSacramento, CA$66,687
UCSF Medical CenterSan Francisco, CA$57,788
Stanford HospitalPalo Alto, CA$53,441
Cedars-Sinai Medical CenterLos Angeles, CA$38,084

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

Questions

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

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515) at 4 hospitals in California was billed at $419,598 on average, while the average total payment was $53,531, of which Medicare paid $47,115. 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 California, average charges were 7.8 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.