Other respiratory system operating room procedures with major complications
What 164 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other respiratory system operating room procedures with major complications (DRG 166), from 2024 Medicare claims.
Average charge
$207,106
Hospital list price billed
Average payment
$44,318
Medicare + patient + other payers
Medicare paid
$36,256
Average per stay
Volume
2,937
Medicare hospital stays
Hospitals in the U.S. billed an average of $207,106 for other respiratory system operating room procedures with major complications, about 4.7 times the average total payment of $44,318.
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 $44,318Billed $207,106
About 21¢ 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
| Norton Healthcare PavilionLouisville, KY | $25,144 |
|---|---|
| Mississippi Baptist Medical CenterJackson, MS | $26,173 |
| Texas Health Harris Methodist Fort WorthFort Worth, TX | $26,328 |
| Memorial Healthcare System, INCChattanooga, TN | $26,389 |
| Methodist HospitalSan Antonio, TX | $26,576 |
| Palos Community HospitalPalos Heights, IL | $28,179 |
| Baptist Memorial HospitalMemphis, TN | $32,255 |
| Inspira Medical Center Mullica HillElmer, NJ | $34,860 |
| New Hanover Regional Medical CenterWilmington, NC | $34,949 |
| ECU Health Medical CenterGreenville, NC | $37,029 |
Highest
| Stanford HospitalPalo Alto, CA | $120,228 |
|---|---|
| UCSF Medical CenterSan Francisco, CA | $88,773 |
| Mount Sinai HospitalNew York, NY | $83,755 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $66,950 |
| Hospital of the Univ of PaPhiladelphia, PA | $64,290 |
| University of California San Diego Medical CenterSan Diego, CA | $64,154 |
| New York-Presbyterian HospitalNew York, NY | $62,522 |
| NYU Hospitals CenterNew York, NY | $61,355 |
| Barnes Jewish HospitalSt Louis, MO | $59,781 |
| Cleveland Clinic - Main CampusCleveland, OH | $57,937 |
Other respiratory system operating room procedures with major 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 | $105,737 | $27,176 | – |
| Arizona | 4 | $157,092 | $42,805 | $28,068 – $48,438 |
| Arkansas | 4 | $89,614 | $29,631 | $23,465 – $40,138 |
| California | 13 | $492,104 | $73,905 | $40,614 – $120,228 |
| Colorado | 1 | $218,380 | $47,912 | – |
| Connecticut | 2 | $112,707 | $45,364 | $39,988 – $53,223 |
| Delaware | 1 | $130,808 | $40,257 | – |
| Florida | 14 | $184,720 | $34,823 | $25,642 – $54,890 |
| Georgia | 3 | $159,344 | $38,170 | $32,410 – $42,007 |
| Hawaii | 1 | $122,379 | $38,832 | – |
| Illinois | 7 | $150,045 | $45,693 | $28,179 – $75,305 |
| Indiana | 5 | $127,817 | $31,744 | $27,331 – $41,195 |
| Iowa | 1 | $119,047 | $29,094 | – |
| Kansas | 3 | $190,502 | $32,817 | $28,824 – $35,164 |
| Kentucky | 5 | $116,744 | $32,466 | $24,471 – $45,349 |
| Louisiana | 1 | $73,707 | $26,833 | – |
| Maryland | 1 | $62,517 | $49,096 | – |
| Massachusetts | 7 | $110,922 | $44,196 | $29,470 – $53,909 |
| Michigan | 6 | $100,544 | $38,584 | $30,152 – $50,378 |
| Minnesota | 1 | $142,064 | $56,424 | – |
| Mississippi | 2 | $99,417 | $25,431 | $23,949 – $26,173 |
| Missouri | 4 | $141,450 | $43,709 | $31,113 – $59,781 |
| Nebraska | 2 | $83,032 | $32,164 | $25,294 – $36,886 |
| Nevada | 1 | $314,832 | $39,188 | – |
| New Jersey | 5 | $221,202 | $43,806 | $34,860 – $57,272 |
| New York | 13 | $295,233 | $55,436 | $32,681 – $83,755 |
| North Carolina | 6 | $128,239 | $37,265 | $30,945 – $44,482 |
| Ohio | 6 | $175,540 | $43,330 | $29,636 – $57,937 |
| Oklahoma | 3 | $209,559 | $36,251 | $28,766 – $43,409 |
| Pennsylvania | 10 | $246,721 | $42,071 | $31,438 – $64,290 |
| South Carolina | 3 | $108,953 | $32,978 | $25,060 – $35,806 |
| Tennessee | 5 | $126,732 | $33,438 | $26,389 – $45,709 |
| Texas | 11 | $203,586 | $37,110 | $24,052 – $51,824 |
| Utah | 2 | $88,631 | $33,867 | $30,188 – $37,113 |
| Virginia | 3 | $161,214 | $37,333 | $27,978 – $44,922 |
| Washington | 1 | $123,333 | $61,848 | – |
| West Virginia | 2 | $141,032 | $35,136 | $33,333 – $36,939 |
| Wisconsin | 2 | $221,998 | $58,448 | $42,218 – $66,950 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Stanford HospitalPalo Alto, CA | 66 | $988,298 | $120,228 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 54 | $478,788 | $50,597 |
| UT Southwestern University HospitalDallas, TX | 53 | $165,400 | $47,668 |
| New York-Presbyterian HospitalNew York, NY | 50 | $325,406 | $62,522 |
| Adventhealth OrlandoOrlando, FL | 43 | $276,809 | $37,469 |
| Cleveland Clinic - Main CampusCleveland, OH | 42 | $227,224 | $57,937 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 42 | $260,861 | $66,950 |
| Christiana Care Health Services, INC.Newark, DE | 41 | $130,808 | $40,257 |
| Methodist Hospital,TheHouston, TX | 41 | $365,364 | $51,824 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | 40 | $310,842 | $48,635 |
| Mississippi Baptist Medical CenterJackson, MS | 34 | $112,056 | $26,173 |
| Beth Israel Deaconess Medical CenterBoston, MA | 32 | $91,669 | $53,909 |
| University of Kentucky HospLexington, KY | 31 | $145,400 | $45,349 |
| Shands Hospital at the University of FloridaGainesville, FL | 29 | $203,613 | $48,250 |
| Palos Community HospitalPalos Heights, IL | 28 | $124,431 | $28,179 |
Questions
How much does other respiratory system operating room procedures with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with major complications (DRG 166) at 164 hospitals in the U.S. was billed at $207,106 on average, while the average total payment was $44,318, of which Medicare paid $36,256. 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 major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($73,905), New York ($55,436), Illinois ($45,693) and lowest in Arkansas ($29,631), Indiana ($31,744), Kentucky ($32,466).
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 4.7 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.