facebook tracking Other respiratory system operating room procedures with complications cost in New York: 4 hospitals compared (DRG 167)

Other respiratory system operating room procedures with complications in New York

What 4 hospitals in New York charged and were paid for a Medicare hospital stay for other respiratory system operating room procedures with complications (DRG 167), from 2024 Medicare claims.

DRG 167 Inpatient 2024 Medicare data
Average charge $160,637 Hospital list price billed
Average payment $27,076 Medicare + patient + other payers
Medicare paid $20,246 Average per stay
State rank #8 of 8 1 = lowest average payment

Hospitals in New York billed an average of $160,637 for other respiratory system operating room procedures with complications, about 5.9 times the average total payment of $27,076. That payment is 25% above the U.S. average 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 $27,076Billed $160,637

About 17¢ was paid for every $1 hospitals in New York billed for this stay.

New York hospitals: other respiratory system operating room procedures with 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
New York-Presbyterian HospitalNew York 44 $159,110 $28,902 $20,902
NYU Hospitals CenterNew York 44 $194,806 $26,074 $19,936
Mount Sinai HospitalNew York 19 $99,503 $29,137 $20,026
Long Island Jewish Medical CenterNew Hyde Park 15 $142,324 $22,044 $19,512
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Lowest and highest payments in New York

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

Long Island Jewish Medical CenterNew Hyde Park, NY$22,044
NYU Hospitals CenterNew York, NY$26,074
New York-Presbyterian HospitalNew York, NY$28,902
Mount Sinai HospitalNew York, NY$29,137

Highest

Mount Sinai HospitalNew York, NY$29,137
New York-Presbyterian HospitalNew York, NY$28,902
NYU Hospitals CenterNew York, NY$26,074
Long Island Jewish Medical CenterNew Hyde Park, NY$22,044

Other respiratory system operating room procedures with complications in other states

Questions

How much does other respiratory system operating room procedures with complications cost in New York?

In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with complications (DRG 167) at 4 hospitals in New York was billed at $160,637 on average, while the average total payment was $27,076, of which Medicare paid $20,246. 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 5.9 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.