facebook tracking Other musculoskeletal system and connective tissue operating room procedures with major complications cost in Georgia: 3 hospitals compared (DRG 515)

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

What 3 hospitals in Georgia 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 $200,221 Hospital list price billed
Average payment $25,789 Medicare + patient + other payers
Medicare paid $23,689 Average per stay
State rank #5 of 9 1 = lowest average payment

Hospitals in Georgia billed an average of $200,221 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 7.8 times the average total payment of $25,789. That payment is 10% below 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 $25,789Billed $200,221

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Wellstar Kennestone HospitalMarietta 18 $250,330 $29,949 $27,000
Northside Hospital CherokeeCanton 12 $143,896 $23,000 $22,050
Northside Hospital ForsythCumming 11 $179,670 $22,027 $20,061
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Lowest and highest payments in Georgia

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

Northside Hospital ForsythCumming, GA$22,027
Northside Hospital CherokeeCanton, GA$23,000
Wellstar Kennestone HospitalMarietta, GA$29,949

Highest

Wellstar Kennestone HospitalMarietta, GA$29,949
Northside Hospital CherokeeCanton, GA$23,000
Northside Hospital ForsythCumming, GA$22,027

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 Georgia?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515) at 3 hospitals in Georgia was billed at $200,221 on average, while the average total payment was $25,789, of which Medicare paid $23,689. 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 Georgia, 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.