Other respiratory system operating room procedures with complications
What 56 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other respiratory system operating room procedures with complications (DRG 167), from 2024 Medicare claims.
Average charge
$109,818
Hospital list price billed
Average payment
$21,619
Medicare + patient + other payers
Medicare paid
$15,989
Average per stay
Volume
965
Medicare hospital stays
Hospitals in the U.S. billed an average of $109,818 for other respiratory system operating room procedures with complications, about 5.1 times the average total payment of $21,619.
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 $21,619Billed $109,818
About 20¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| UT Southwestern University HospitalDallas, TX | $16,309 |
|---|---|
| South Shore HospitalSouth Weymouth, MA | $16,486 |
| Morristown Memorial HospitalMorristown, NJ | $18,607 |
| Cleveland Clinic - Main CampusCleveland, OH | $20,834 |
| Duke University Medical CenterDurham, NC | $20,837 |
| Hospital of the Univ of PaPhiladelphia, PA | $20,858 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $23,078 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $23,082 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $23,161 |
| NYU Hospitals CenterNew York, NY | $26,074 |
Highest
| Stanford HospitalPalo Alto, CA | $31,807 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $28,902 |
| NYU Hospitals CenterNew York, NY | $26,074 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $23,161 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $23,082 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $23,078 |
| Hospital of the Univ of PaPhiladelphia, PA | $20,858 |
| Duke University Medical CenterDurham, NC | $20,837 |
| Cleveland Clinic - Main CampusCleveland, OH | $20,834 |
| Morristown Memorial HospitalMorristown, NJ | $18,607 |
Other respiratory system operating room procedures with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $87,836 | $18,131 | – |
| Arizona | 1 | $74,761 | $23,871 | – |
| Arkansas | 1 | $69,727 | $12,510 | – |
| California | 5 | $208,035 | $25,072 | $19,922 – $31,807 |
| Colorado | 1 | $100,309 | $18,839 | – |
| Connecticut | 2 | $63,117 | $21,412 | $20,176 – $22,458 |
| Delaware | 1 | $76,364 | $19,596 | – |
| Florida | 4 | $133,487 | $17,958 | $14,298 – $23,182 |
| Georgia | 1 | $69,125 | $18,367 | – |
| Illinois | 3 | $76,799 | $22,997 | $22,003 – $23,534 |
| Kentucky | 1 | $78,099 | $17,279 | – |
| Maryland | 2 | $29,960 | $28,402 | $28,269 – $28,507 |
| Massachusetts | 4 | $63,741 | $20,491 | $16,486 – $23,292 |
| Michigan | 1 | $55,292 | $22,319 | – |
| Minnesota | 1 | $70,508 | $23,082 | – |
| Mississippi | 1 | $65,423 | $12,121 | – |
| Missouri | 2 | $84,048 | $20,253 | $17,135 – $22,058 |
| New Jersey | 1 | $81,910 | $18,607 | – |
| New York | 4 | $160,637 | $27,076 | $22,044 – $29,137 |
| North Carolina | 1 | $56,259 | $20,837 | – |
| Ohio | 1 | $75,189 | $20,834 | – |
| Pennsylvania | 3 | $164,507 | $20,014 | $10,479 – $28,115 |
| South Carolina | 3 | $74,336 | $18,860 | $16,436 – $21,311 |
| Tennessee | 2 | $102,179 | $17,987 | $15,956 – $20,019 |
| Texas | 2 | $120,346 | $20,828 | $16,309 – $29,543 |
| Utah | 1 | $59,673 | $20,600 | – |
| Virginia | 4 | $102,309 | $20,590 | $13,858 – $26,822 |
| Washington | 1 | $65,395 | $18,886 | – |
| Wisconsin | 1 | $76,545 | $23,078 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| New York-Presbyterian HospitalNew York, NY | 44 | $159,110 | $28,902 |
| NYU Hospitals CenterNew York, NY | 44 | $194,806 | $26,074 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 33 | $252,037 | $23,161 |
| Hospital of the Univ of PaPhiladelphia, PA | 30 | $142,814 | $20,858 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 29 | $76,545 | $23,078 |
| UT Southwestern University HospitalDallas, TX | 27 | $72,304 | $16,309 |
| Cleveland Clinic - Main CampusCleveland, OH | 26 | $75,189 | $20,834 |
| Morristown Memorial HospitalMorristown, NJ | 24 | $81,910 | $18,607 |
| Duke University Medical CenterDurham, NC | 23 | $56,259 | $20,837 |
| Stanford HospitalPalo Alto, CA | 21 | $252,412 | $31,807 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 21 | $70,508 | $23,082 |
| South Shore HospitalSouth Weymouth, MA | 20 | $24,670 | $16,486 |
| Brigham and Women's HosptialBoston, MA | 19 | $111,583 | $23,292 |
| Barnes Jewish HospitalSt Louis, MO | 19 | $68,875 | $22,058 |
| Mount Sinai HospitalNew York, NY | 19 | $99,503 | $29,137 |
Questions
How much does other respiratory system operating room procedures with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with complications (DRG 167) at 56 hospitals in the U.S. was billed at $109,818 on average, while the average total payment was $21,619, of which Medicare paid $15,989. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other respiratory system operating room procedures with complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($27,076), California ($25,072), Illinois ($22,997) and lowest in Florida ($17,958), South Carolina ($18,860), Pennsylvania ($20,014).
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 the U.S., average charges were 5.1 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.