Pleural effusion with major complications in Texas
What 6 hospitals in Texas charged and were paid for a Medicare hospital stay for pleural effusion with major complications (DRG 186), from 2024 Medicare claims.
Average charge
$105,321
Hospital list price billed
Average payment
$13,831
Medicare + patient + other payers
Medicare paid
$11,118
Average per stay
State rank
#8 of 16
1 = lowest average payment
Hospitals in Texas billed an average of $105,321 for pleural effusion with major complications, about 7.6 times the average total payment of $13,831. That payment is 7% below 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 $13,831Billed $105,321
About 13¢ was paid for every $1 hospitals in Texas billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Texas:
Texas hospitals: pleural effusion with major complications
Every Texas hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Methodist HospitalSan Antonio | 19 | $107,811 | $11,634 | $10,018 |
| Baptist Medical CenterSan Antonio | 17 | $118,825 | $12,015 | $9,999 |
| Baylor University Medical CenterDallas | 11 | $90,303 | $21,758 | $13,669 |
| Trinity Mother Frances SystTyler | 11 | $112,841 | $11,514 | $10,403 |
| Mem Hermann Southwest HospHouston | 11 | $71,137 | $13,113 | $12,402 |
| Methodist Hospital,TheHouston | 11 | $121,835 | $15,538 | $11,625 |
Lowest and highest payments in Texas
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
| Trinity Mother Frances SystTyler, TX | $11,514 |
|---|---|
| Methodist HospitalSan Antonio, TX | $11,634 |
| Baptist Medical CenterSan Antonio, TX | $12,015 |
| Mem Hermann Southwest HospHouston, TX | $13,113 |
| Methodist Hospital,TheHouston, TX | $15,538 |
Highest
| Baylor University Medical CenterDallas, TX | $21,758 |
|---|---|
| Methodist Hospital,TheHouston, TX | $15,538 |
| Mem Hermann Southwest HospHouston, TX | $13,113 |
| Baptist Medical CenterSan Antonio, TX | $12,015 |
| Methodist HospitalSan Antonio, TX | $11,634 |
Pleural effusion with major complications in other states
Questions
How much does pleural effusion with major complications cost in Texas?
In 2024 Medicare data, a hospital stay for pleural effusion with major complications (DRG 186) at 6 hospitals in Texas was billed at $105,321 on average, while the average total payment was $13,831, of which Medicare paid $11,118. 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 Texas, average charges were 7.6 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.