facebook tracking Pleural effusion with major complications cost in California: 13 hospitals compared (DRG 186)

Pleural effusion with major complications in California

What 13 hospitals in California charged and were paid for a Medicare hospital stay for pleural effusion with major complications (DRG 186), from 2024 Medicare claims.

DRG 186 Inpatient 2024 Medicare data
Average charge $123,153 Hospital list price billed
Average payment $19,352 Medicare + patient + other payers
Medicare paid $16,253 Average per stay
State rank #15 of 16 1 = lowest average payment

Hospitals in California billed an average of $123,153 for pleural effusion with major complications, about 6.4 times the average total payment of $19,352. That payment is 31% above the U.S. average of $14,801.

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 $19,352Billed $123,153

About 16¢ was paid for every $1 hospitals in California billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in California:

California hospitals: pleural effusion with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Stanford HospitalPalo Alto 16 $285,409 $37,043 $32,752
Eisenhower Memorial HospitalRancho Mirage 16 $86,937 $15,549 $13,577
Providence Saint Joseph Medical CtrBurbank 15 $101,760 $15,153 $13,882
Glendale Adventist Medical CtrGlendale 15 $102,811 $16,544 $15,460
Cedars-Sinai Medical CenterLos Angeles 15 $256,179 $21,288 $16,635
Saint Agnes Medical CenterFresno 13 $36,184 $16,344 $15,116
Sutter General HospitalSacramento 13 $86,323 $19,906 $15,665
Sutter Roseville Medical CenterRoseville 13 $80,093 $23,940 $11,570
Bakersfield Memorial HospitalBakersfield 12 $81,681 $14,930 $13,835
Kaweah Delta Medical CenterVisalia 12 $55,375 $18,028 $16,374
John Muir Medical Center - Walnut Creek CampusWalnut Creek 11 $178,980 $16,496 $16,035
Saint John's Health CenterSanta Monica 11 $87,698 $17,051 $12,855
Orange Coast Memorial Medical CenterFountain Valley 11 $111,339 $14,973 $13,637
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Lowest and highest payments in California

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

Bakersfield Memorial HospitalBakersfield, CA$14,930
Orange Coast Memorial Medical CenterFountain Valley, CA$14,973
Providence Saint Joseph Medical CtrBurbank, CA$15,153
Eisenhower Memorial HospitalRancho Mirage, CA$15,549
Saint Agnes Medical CenterFresno, CA$16,344

Highest

Stanford HospitalPalo Alto, CA$37,043
Sutter Roseville Medical CenterRoseville, CA$23,940
Cedars-Sinai Medical CenterLos Angeles, CA$21,288
Sutter General HospitalSacramento, CA$19,906
Kaweah Delta Medical CenterVisalia, CA$18,028

Pleural effusion with major complications in other states

Questions

How much does pleural effusion with major complications cost in California?

In 2024 Medicare data, a hospital stay for pleural effusion with major complications (DRG 186) at 13 hospitals in California was billed at $123,153 on average, while the average total payment was $19,352, of which Medicare paid $16,253. 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 California, average charges were 6.4 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.