facebook tracking Pathological fractures and musculoskeletal and connective tissue malignancy with major complications cost in Tennessee: 4 hospitals compared (DRG 542)

Pathological fractures and musculoskeletal and connective tissue malignancy with major complications in Tennessee

What 4 hospitals in Tennessee 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.

DRG 542 Inpatient 2024 Medicare data
Average charge $66,262 Hospital list price billed
Average payment $18,067 Medicare + patient + other payers
Medicare paid $12,592 Average per stay
State rank #15 of 22 1 = lowest average payment

Hospitals in Tennessee billed an average of $66,262 for pathological fractures and musculoskeletal and connective tissue malignancy with major complications, about 3.7 times the average total payment of $18,067. That payment is 4% below the U.S. average 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 $18,067Billed $66,262

About 27¢ was paid for every $1 hospitals in Tennessee billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Tennessee:

Tennessee hospitals: pathological fractures and musculoskeletal and connective tissue malignancy with major complications

Every Tennessee hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Vanderbilt University HospitalNashville 19 $88,334 $23,002 $14,803
St Thomas HospitalNashville 14 $57,367 $14,817 $12,005
Johnson City Medical CenterJohnson City 12 $52,873 $16,097 $11,067
Methodist Healthcare-MemphisMemphis 11 $54,067 $15,827 $11,185
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Lowest and highest payments in Tennessee

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

St Thomas HospitalNashville, TN$14,817
Methodist Healthcare-MemphisMemphis, TN$15,827
Johnson City Medical CenterJohnson City, TN$16,097
Vanderbilt University HospitalNashville, TN$23,002

Highest

Vanderbilt University HospitalNashville, TN$23,002
Johnson City Medical CenterJohnson City, TN$16,097
Methodist Healthcare-MemphisMemphis, TN$15,827
St Thomas HospitalNashville, TN$14,817

Pathological fractures and musculoskeletal and connective tissue malignancy with major complications in other states

Questions

How much does pathological fractures and musculoskeletal and connective tissue malignancy with major complications cost in Tennessee?

In 2024 Medicare data, a hospital stay for pathological fractures and musculoskeletal and connective tissue malignancy with major complications (DRG 542) at 4 hospitals in Tennessee was billed at $66,262 on average, while the average total payment was $18,067, of which Medicare paid $12,592. 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 Tennessee, average charges were 3.7 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.