facebook tracking Other musculoskeletal system and connective tissue operating room procedures with major complications cost in Texas: 6 hospitals compared (DRG 515)

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

What 6 hospitals in Texas 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 $217,256 Hospital list price billed
Average payment $23,090 Medicare + patient + other payers
Medicare paid $20,850 Average per stay
State rank #1 of 9 1 = lowest average payment

Hospitals in Texas billed an average of $217,256 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 9.4 times the average total payment of $23,090. That payment is 20% 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 $23,090Billed $217,256

About 11¢ was paid for every $1 hospitals in Texas billed for this stay.

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Methodist Hospital,TheHouston 25 $213,541 $27,474 $23,363
Methodist HospitalSan Antonio 14 $203,678 $23,063 $21,167
Texas Health Harris Methodist Fort WorthFort Worth 11 $99,750 $22,415 $20,632
Medical Center of PlanoPlano 11 $321,104 $19,668 $18,370
Longview Regional Medical CenterLongview 11 $261,083 $20,840 $19,807
Methodist Stone Oak HospitalSan Antonio 11 $212,813 $19,512 $18,473
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Lowest and highest payments in Texas

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

Methodist Stone Oak HospitalSan Antonio, TX$19,512
Medical Center of PlanoPlano, TX$19,668
Longview Regional Medical CenterLongview, TX$20,840
Texas Health Harris Methodist Fort WorthFort Worth, TX$22,415
Methodist HospitalSan Antonio, TX$23,063

Highest

Methodist Hospital,TheHouston, TX$27,474
Methodist HospitalSan Antonio, TX$23,063
Texas Health Harris Methodist Fort WorthFort Worth, TX$22,415
Longview Regional Medical CenterLongview, TX$20,840
Medical Center of PlanoPlano, TX$19,668

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 Texas?

In 2024 Medicare data, a hospital stay for other musculoskeletal system and connective tissue operating room procedures with major complications (DRG 515) at 6 hospitals in Texas was billed at $217,256 on average, while the average total payment was $23,090, of which Medicare paid $20,850. 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 Texas, average charges were 9.4 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.