Other skin, subcutaneous tissue and breast procedures with major complications
What 16 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other skin, subcutaneous tissue and breast procedures with major complications (DRG 579), from 2024 Medicare claims.
Average charge
$213,487
Hospital list price billed
Average payment
$37,306
Medicare + patient + other payers
Medicare paid
$29,908
Average per stay
Volume
210
Medicare hospital stays
Hospitals in the U.S. billed an average of $213,487 for other skin, subcutaneous tissue and breast procedures with major complications, about 5.7 times the average total payment of $37,306.
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 $37,306Billed $213,487
About 17¢ 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:
Other skin, subcutaneous tissue and breast 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 |
|---|---|---|---|---|
| California | 1 | $478,017 | $52,677 | – |
| Florida | 2 | $276,031 | $34,807 | $29,091 – $37,540 |
| Illinois | 1 | $183,240 | $38,104 | – |
| Kansas | 1 | $162,746 | $28,048 | – |
| Massachusetts | 2 | $114,621 | $35,840 | $35,557 – $36,149 |
| Mississippi | 1 | $84,153 | $19,824 | – |
| New York | 5 | $244,266 | $44,563 | $36,799 – $56,437 |
| Tennessee | 1 | $140,826 | $32,124 | – |
| Texas | 2 | $110,483 | $30,909 | $29,848 – $32,052 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 23 | $249,363 | $37,540 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 18 | $478,017 | $52,677 |
| Baylor University Medical CenterDallas, TX | 14 | $61,165 | $29,848 |
| University of Kansas HospitalKansas City, KS | 13 | $162,746 | $28,048 |
| Mississippi Baptist Medical CenterJackson, MS | 13 | $84,153 | $19,824 |
| New York-Presbyterian HospitalNew York, NY | 13 | $246,713 | $42,986 |
| Vanderbilt University HospitalNashville, TN | 13 | $140,826 | $32,124 |
| Texas Health Presbyterian Hospital DallasDallas, TX | 13 | $163,595 | $32,052 |
| Massachusetts General HospitalBoston, MA | 12 | $120,226 | $35,557 |
| NYU Hospitals CenterNew York, NY | 12 | $216,863 | $38,992 |
| Orlando Regional HealthcareOrlando, FL | 11 | $331,789 | $29,091 |
| Northwestern Memorial HospitalChicago, IL | 11 | $183,240 | $38,104 |
| Brigham and Women's HosptialBoston, MA | 11 | $108,507 | $36,149 |
| Mount Sinai HospitalNew York, NY | 11 | $241,245 | $56,437 |
| North Shore University HospitalManhasset, NY | 11 | $322,286 | $48,393 |
Questions
How much does other skin, subcutaneous tissue and breast procedures with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other skin, subcutaneous tissue and breast procedures with major complications (DRG 579) at 16 hospitals in the U.S. was billed at $213,487 on average, while the average total payment was $37,306, of which Medicare paid $29,908. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other skin, subcutaneous tissue and breast procedures with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($44,563) and lowest in New York ($44,563).
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 5.7 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.