Other respiratory system operating room procedures with major complications in Virginia
What 3 hospitals in Virginia 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
$161,214
Hospital list price billed
Average payment
$37,333
Medicare + patient + other payers
Medicare paid
$25,610
Average per stay
State rank
#11 of 22
1 = lowest average payment
Hospitals in Virginia billed an average of $161,214 for other respiratory system operating room procedures with major complications, about 4.3 times the average total payment of $37,333. That payment is 16% below 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 $37,333Billed $161,214
About 23¢ was paid for every $1 hospitals in Virginia billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Virginia:
Virginia hospitals: other respiratory system 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 |
|---|---|---|---|---|
| Inova Fairfax HospitalFalls Church | 26 | $79,602 | $44,922 | $25,547 |
| Cjw Medical CenterRichmond | 12 | $418,948 | $27,978 | $24,152 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 11 | $72,952 | $29,602 | $27,348 |
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 | $27,978 |
|---|---|
| Centra Health - Lynchburg Gen HospitalLynchburg, VA | $29,602 |
| Inova Fairfax HospitalFalls Church, VA | $44,922 |
Highest
| Inova Fairfax HospitalFalls Church, VA | $44,922 |
|---|---|
| Centra Health - Lynchburg Gen HospitalLynchburg, VA | $29,602 |
| Cjw Medical CenterRichmond, VA | $27,978 |
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 Virginia?
In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with major complications (DRG 166) at 3 hospitals in Virginia was billed at $161,214 on average, while the average total payment was $37,333, of which Medicare paid $25,610. 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 4.3 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.