facebook tracking Other musculoskeletal system and connective tissue operating room procedures with major complications cost in New York: 2 hospitals compared (DRG 515)

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

What 2 hospitals in New York 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 $267,222 Hospital list price billed
Average payment $44,283 Medicare + patient + other payers
Medicare paid $38,196 Average per stay
Volume 37 Medicare hospital stays

Hospitals in New York billed an average of $267,222 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 6.0 times the average total payment of $44,283. That payment is 54% 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 $44,283Billed $267,222

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 major 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
NYU Hospitals CenterNew York 24 $291,898 $45,444 $38,885
New York-Presbyterian HospitalNew York 13 $221,666 $42,141 $36,924
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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 New York?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515) at 2 hospitals in New York was billed at $267,222 on average, while the average total payment was $44,283, of which Medicare paid $38,196. 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 6.0 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.