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

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

What 3 hospitals in Virginia 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 $286,640 Hospital list price billed
Average payment $24,247 Medicare + patient + other payers
Medicare paid $19,640 Average per stay
State rank #2 of 9 1 = lowest average payment

Hospitals in Virginia billed an average of $286,640 for other musculoskeletal system and connective tissue operating room procedures with major complications, about 11.8 times the average total payment of $24,247. That payment is 16% 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 $24,247Billed $286,640

About 8¢ was paid for every $1 hospitals in Virginia billed for this stay.

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

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

Hospital Stays Avg charge Avg payment Medicare paid
Cjw Medical CenterRichmond 22 $377,797 $20,689 $19,487
Henrico Doctors' HospitalRichmond 20 $297,002 $21,604 $19,510
Inova Fairfax HospitalFalls Church 11 $85,484 $36,170 $20,184
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Lowest and highest payments in Virginia

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

Cjw Medical CenterRichmond, VA$20,689
Henrico Doctors' HospitalRichmond, VA$21,604
Inova Fairfax HospitalFalls Church, VA$36,170

Highest

Inova Fairfax HospitalFalls Church, VA$36,170
Henrico Doctors' HospitalRichmond, VA$21,604
Cjw Medical CenterRichmond, VA$20,689

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 Virginia?

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 Virginia was billed at $286,640 on average, while the average total payment was $24,247, of which Medicare paid $19,640. 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 Virginia, average charges were 11.8 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.