Pathological fractures and musculoskeletal and connective tissue malignancy with major complications
What 184 hospitals in the U.S. charged and were paid for a Medicare hospital stay for pathological fractures and musculoskeletal and connective tissue malignancy with major complications (DRG 542), from 2024 Medicare claims.
Average charge
$89,227
Hospital list price billed
Average payment
$18,732
Medicare + patient + other payers
Medicare paid
$15,129
Average per stay
Volume
3,536
Medicare hospital stays
Hospitals in the U.S. billed an average of $89,227 for pathological fractures and musculoskeletal and connective tissue malignancy with major complications, about 4.8 times the average total payment of $18,732.
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 $18,732Billed $89,227
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
| Naples Community HospitalNaples, FL | $11,364 |
|---|---|
| Palos Community HospitalPalos Heights, IL | $11,674 |
| Deaconess Hospital INCEvansville, IN | $11,997 |
| John C Lincoln Deer Valley HospitalPhoenix, AZ | $12,260 |
| Ohiohealth Mansfield HospitalMansfield, OH | $12,298 |
| St Mary's HospitalMadison, WI | $12,619 |
| Northwestern Medicine McHenryMcHenry, IL | $12,908 |
| St Lukes Regional Medical CenterBoise, ID | $13,090 |
| Saint Francis Hospital, INCTulsa, OK | $13,236 |
| Central Dupage HospitalWinfield, IL | $13,438 |
Highest
| University of California San Diego Medical CenterSan Diego, CA | $38,747 |
|---|---|
| Mayo Clinic - Saint Marys HospitalRochester, MN | $37,533 |
| Stanford HospitalPalo Alto, CA | $33,277 |
| Advocate Christ Hospital & Medical CenterOak Lawn, IL | $32,600 |
| Beth Israel Deaconess Medical CenterBoston, MA | $30,954 |
| Barnes Jewish HospitalSt Louis, MO | $28,257 |
| New York-Presbyterian HospitalNew York, NY | $28,109 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica, CA | $26,730 |
| Mayo Clinic HospitalPhoenix, AZ | $24,835 |
| NYU Hospitals CenterNew York, NY | $24,344 |
Pathological fractures and musculoskeletal and connective tissue malignancy 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 |
|---|---|---|---|---|
| Alaska | 1 | $183,781 | $21,021 | – |
| Arizona | 8 | $87,395 | $15,449 | $12,260 – $24,835 |
| Arkansas | 1 | $27,120 | $14,093 | – |
| California | 13 | $194,838 | $27,789 | $15,997 – $56,610 |
| Colorado | 4 | $143,523 | $14,732 | $12,808 – $18,905 |
| Connecticut | 1 | $93,331 | $24,183 | – |
| Delaware | 1 | $77,654 | $17,150 | – |
| Florida | 15 | $92,274 | $15,349 | $11,350 – $28,708 |
| Georgia | 2 | $71,176 | $14,912 | $12,020 – $17,803 |
| Idaho | 1 | $50,605 | $13,090 | – |
| Illinois | 13 | $64,863 | $16,447 | $11,674 – $32,600 |
| Indiana | 2 | $44,797 | $12,743 | $11,997 – $13,845 |
| Iowa | 1 | $114,216 | $19,869 | – |
| Kansas | 2 | $84,955 | $16,030 | $14,163 – $17,524 |
| Kentucky | 2 | $76,584 | $15,489 | $12,365 – $16,989 |
| Maryland | 1 | $66,696 | $58,919 | – |
| Massachusetts | 15 | $52,552 | $19,319 | $13,468 – $30,954 |
| Michigan | 5 | $70,012 | $17,164 | $12,396 – $27,143 |
| Minnesota | 6 | $58,139 | $20,971 | $12,659 – $37,533 |
| Mississippi | 1 | $52,656 | $17,158 | – |
| Missouri | 5 | $61,277 | $16,994 | $11,481 – $28,257 |
| Nebraska | 1 | $33,394 | $12,630 | – |
| Nevada | 2 | $131,605 | $16,388 | $15,832 – $17,045 |
| New Hampshire | 2 | $58,136 | $18,008 | $12,687 – $22,077 |
| New Jersey | 7 | $118,602 | $17,860 | $12,713 – $25,554 |
| New Mexico | 3 | $50,517 | $17,881 | $14,316 – $20,442 |
| New York | 13 | $162,714 | $24,409 | $15,539 – $33,211 |
| North Carolina | 4 | $60,818 | $20,998 | $13,417 – $28,674 |
| North Dakota | 1 | $70,885 | $16,991 | – |
| Ohio | 6 | $55,744 | $14,669 | $12,298 – $16,043 |
| Oklahoma | 1 | $54,816 | $13,236 | – |
| Oregon | 3 | $54,459 | $19,543 | $18,485 – $23,218 |
| Pennsylvania | 10 | $142,548 | $20,042 | $12,122 – $55,740 |
| Rhode Island | 1 | $47,285 | $19,241 | – |
| South Carolina | 3 | $54,893 | $15,359 | $12,551 – $17,085 |
| South Dakota | 1 | $67,391 | $14,799 | – |
| Tennessee | 4 | $66,262 | $18,067 | $14,817 – $23,002 |
| Texas | 5 | $120,294 | $17,311 | $12,111 – $29,788 |
| Utah | 1 | $51,441 | $20,110 | – |
| Virginia | 5 | $50,856 | $16,069 | $12,089 – $19,970 |
| Washington | 5 | $58,834 | $17,083 | $14,616 – $23,696 |
| Wisconsin | 5 | $64,966 | $17,646 | $12,619 – $22,993 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Grant Medical CenterColumbus, OH | 64 | $52,523 | $15,676 |
| Riverside Methodist HospitalColumbus, OH | 63 | $51,450 | $14,567 |
| New York-Presbyterian HospitalNew York, NY | 59 | $220,427 | $28,109 |
| NYU Hospitals CenterNew York, NY | 50 | $184,788 | $24,344 |
| Lehigh Valley HospitalAllentown, PA | 46 | $112,394 | $15,791 |
| Evanston HospitalEvanston, IL | 45 | $55,646 | $16,120 |
| Massachusetts General HospitalBoston, MA | 44 | $92,568 | $23,199 |
| Rhode Island HospitalProvidence, RI | 43 | $47,285 | $19,241 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 42 | $91,643 | $22,993 |
| Inova Fairfax HospitalFalls Church, VA | 39 | $49,437 | $19,970 |
| Adventhealth OrlandoOrlando, FL | 37 | $144,140 | $19,088 |
| Newton-Wellesley HospitalNewton Lower Falls, MA | 37 | $39,179 | $14,917 |
| Beth Israel Deaconess Medical CenterBoston, MA | 35 | $68,466 | $30,954 |
| Brigham and Women's HosptialBoston, MA | 34 | $119,400 | $23,168 |
| Saint Francis Hospital, INCTulsa, OK | 34 | $54,816 | $13,236 |
Questions
How much does pathological fractures and musculoskeletal and connective tissue malignancy with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for pathological fractures and musculoskeletal and connective tissue malignancy with major complications (DRG 542) at 184 hospitals in the U.S. was billed at $89,227 on average, while the average total payment was $18,732, of which Medicare paid $15,129. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for pathological fractures and musculoskeletal and connective tissue malignancy with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($27,789), New York ($24,409), North Carolina ($20,998) and lowest in Ohio ($14,669), Colorado ($14,732), Florida ($15,349).
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 4.8 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.