Pneumothorax with major complications
What 86 hospitals in the U.S. charged and were paid for a Medicare hospital stay for pneumothorax with major complications (DRG 199), from 2024 Medicare claims.
Average charge
$88,934
Hospital list price billed
Average payment
$18,061
Medicare + patient + other payers
Medicare paid
$13,958
Average per stay
Volume
1,183
Medicare hospital stays
Hospitals in the U.S. billed an average of $88,934 for pneumothorax with major complications, about 4.9 times the average total payment of $18,061.
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 $18,061Billed $88,934
About 20¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 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
| Jackson-Madison Cnty Gen HospJackson, TN | $13,654 |
|---|---|
| Methodist HospitalSan Antonio, TX | $13,722 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $14,657 |
| Adventhealth OrlandoOrlando, FL | $17,360 |
| Vanderbilt University HospitalNashville, TN | $24,144 |
Highest
| Vanderbilt University HospitalNashville, TN | $24,144 |
|---|---|
| Adventhealth OrlandoOrlando, FL | $17,360 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $14,657 |
| Methodist HospitalSan Antonio, TX | $13,722 |
| Jackson-Madison Cnty Gen HospJackson, TN | $13,654 |
Pneumothorax 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 |
|---|---|---|---|---|
| Arizona | 2 | $70,684 | $13,155 | $13,003 – $13,320 |
| Arkansas | 2 | $44,098 | $12,662 | $11,988 – $13,387 |
| California | 6 | $161,278 | $20,972 | $16,494 – $34,329 |
| Delaware | 2 | $37,819 | $18,119 | $13,898 – $21,021 |
| Florida | 9 | $103,537 | $14,957 | $11,056 – $24,283 |
| Georgia | 2 | $88,422 | $18,219 | $16,503 – $19,803 |
| Idaho | 1 | $52,648 | $13,718 | – |
| Illinois | 2 | $73,370 | $22,535 | $15,911 – $31,525 |
| Indiana | 3 | $86,033 | $18,101 | $14,929 – $20,048 |
| Iowa | 2 | $74,628 | $16,854 | $14,244 – $19,463 |
| Kansas | 4 | $93,533 | $16,040 | $12,227 – $20,204 |
| Kentucky | 2 | $63,655 | $14,697 | $12,274 – $17,255 |
| Maryland | 3 | $20,682 | $18,813 | $14,455 – $23,325 |
| Massachusetts | 7 | $61,020 | $22,194 | $15,470 – $25,992 |
| Michigan | 1 | $52,783 | $19,654 | – |
| Minnesota | 3 | $51,111 | $16,935 | $13,939 – $22,265 |
| Mississippi | 1 | $40,161 | $12,519 | – |
| Missouri | 1 | $83,183 | $22,324 | – |
| Nevada | 3 | $113,099 | $18,086 | $16,438 – $20,867 |
| New Hampshire | 1 | $76,340 | $14,527 | – |
| New Jersey | 1 | $127,431 | $16,221 | – |
| New York | 5 | $134,488 | $25,914 | $19,065 – $40,376 |
| North Carolina | 1 | $69,588 | $14,657 | – |
| North Dakota | 1 | $31,895 | $14,515 | – |
| Ohio | 1 | $47,285 | $14,515 | – |
| Oklahoma | 2 | $48,540 | $13,966 | $13,690 – $14,358 |
| Pennsylvania | 4 | $118,935 | $19,849 | $14,569 – $26,946 |
| Rhode Island | 1 | $46,717 | $21,392 | – |
| Tennessee | 4 | $92,891 | $17,986 | $13,654 – $24,144 |
| Texas | 5 | $132,409 | $15,534 | $12,227 – $21,366 |
| Virginia | 4 | $90,460 | $19,440 | $15,323 – $25,270 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 24 | $69,588 | $14,657 |
| Jackson-Madison Cnty Gen HospJackson, TN | 22 | $47,769 | $13,654 |
| Vanderbilt University HospitalNashville, TN | 22 | $104,647 | $24,144 |
| Adventhealth OrlandoOrlando, FL | 21 | $91,077 | $17,360 |
| Methodist HospitalSan Antonio, TX | 21 | $123,605 | $13,722 |
| Evanston HospitalEvanston, IL | 19 | $56,773 | $15,911 |
| Norton Healthcare PavilionLouisville, KY | 19 | $52,219 | $12,274 |
| Massachusetts General HospitalBoston, MA | 19 | $96,004 | $24,848 |
| Deaconess Hospital INCEvansville, IN | 18 | $52,097 | $14,929 |
| University of Kentucky HospLexington, KY | 18 | $75,727 | $17,255 |
| Lahey Clinic HospitalBurlington, MA | 18 | $41,119 | $20,082 |
| St Vincent Hospital & Health ServicesIndianapolis, IN | 17 | $100,499 | $20,048 |
| Saint Francis Hospital, INCTulsa, OK | 17 | $59,901 | $13,690 |
| Christiana Care Health Services, INC.Newark, DE | 16 | $41,991 | $21,021 |
| Sarasota Memorial HospitalSarasota, FL | 16 | $65,684 | $14,297 |
Questions
How much does pneumothorax with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for pneumothorax with major complications (DRG 199) at 86 hospitals in the U.S. was billed at $88,934 on average, while the average total payment was $18,061, of which Medicare paid $13,958. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for pneumothorax with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($25,914), Massachusetts ($22,194), California ($20,972) and lowest in Florida ($14,957), Texas ($15,534), Kansas ($16,040).
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 4.9 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.