Other respiratory system operating room procedures with major complications in Massachusetts
What 7 hospitals in Massachusetts 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
$110,922
Hospital list price billed
Average payment
$44,196
Medicare + patient + other payers
Medicare paid
$38,123
Average per stay
State rank
#19 of 22
1 = lowest average payment
Hospitals in Massachusetts billed an average of $110,922 for other respiratory system operating room procedures with major complications, about 2.5 times the average total payment of $44,196. That payment is about the same as the U.S. average 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 $44,196Billed $110,922
About 40¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: other respiratory system operating room procedures with major complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Beth Israel Deaconess Medical CenterBoston | 32 | $91,669 | $53,909 | $44,874 |
| Brigham and Women's HosptialBoston | 21 | $160,746 | $43,146 | $38,576 |
| Massachusetts General HospitalBoston | 18 | $180,358 | $44,017 | $32,653 |
| Baystate Medical CenterSpringfield | 15 | $62,937 | $39,668 | $34,767 |
| Berkshire Medical Center INCPittsfield | 12 | $65,652 | $43,255 | $41,361 |
| Southcoast Hospital Group, INCFall River | 12 | $79,135 | $29,470 | $28,246 |
| Umass Memorial Medical Center INCWorcester | 11 | $107,690 | $41,508 | $38,390 |
Lowest and highest payments in Massachusetts
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
| Southcoast Hospital Group, INCFall River, MA | $29,470 |
|---|---|
| Baystate Medical CenterSpringfield, MA | $39,668 |
| Umass Memorial Medical Center INCWorcester, MA | $41,508 |
| Brigham and Women's HosptialBoston, MA | $43,146 |
| Berkshire Medical Center INCPittsfield, MA | $43,255 |
Highest
| Beth Israel Deaconess Medical CenterBoston, MA | $53,909 |
|---|---|
| Massachusetts General HospitalBoston, MA | $44,017 |
| Berkshire Medical Center INCPittsfield, MA | $43,255 |
| Brigham and Women's HosptialBoston, MA | $43,146 |
| Umass Memorial Medical Center INCWorcester, MA | $41,508 |
Other respiratory system operating room procedures with major complications in other states
Questions
How much does other respiratory system operating room procedures with major complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with major complications (DRG 166) at 7 hospitals in Massachusetts was billed at $110,922 on average, while the average total payment was $44,196, of which Medicare paid $38,123. 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 Massachusetts, average charges were 2.5 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.