Pneumothorax with major complications in California
What 6 hospitals in California charged and were paid for a Medicare hospital stay for pneumothorax with major complications (DRG 199), from 2024 Medicare claims.
Average charge
$161,278
Hospital list price billed
Average payment
$20,972
Medicare + patient + other payers
Medicare paid
$17,025
Average per stay
State rank
#11 of 13
1 = lowest average payment
Hospitals in California billed an average of $161,278 for pneumothorax with major complications, about 7.7 times the average total payment of $20,972. That payment is 16% above the U.S. average 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 $20,972Billed $161,278
About 13¢ 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: pneumothorax 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 |
|---|---|---|---|---|
| Mercy Medical Center ReddingRedding | 14 | $104,237 | $18,351 | $17,203 |
| Scripps Memorial Hospital la JollaLa Jolla | 13 | $230,898 | $16,494 | $15,115 |
| Enloe Medical CenterChico | 12 | $148,049 | $16,971 | $15,614 |
| Sutter Roseville Medical CenterRoseville | 12 | $63,068 | $18,466 | $17,434 |
| Alta Bates Summit Medical CenterOakland | 11 | $118,576 | $34,329 | $17,442 |
| Cedars-Sinai Medical CenterLos Angeles | 11 | $315,867 | $23,340 | $19,732 |
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
| Scripps Memorial Hospital la JollaLa Jolla, CA | $16,494 |
|---|---|
| Enloe Medical CenterChico, CA | $16,971 |
| Mercy Medical Center ReddingRedding, CA | $18,351 |
| Sutter Roseville Medical CenterRoseville, CA | $18,466 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $23,340 |
Highest
| Alta Bates Summit Medical CenterOakland, CA | $34,329 |
|---|---|
| Cedars-Sinai Medical CenterLos Angeles, CA | $23,340 |
| Sutter Roseville Medical CenterRoseville, CA | $18,466 |
| Mercy Medical Center ReddingRedding, CA | $18,351 |
| Enloe Medical CenterChico, CA | $16,971 |
Pneumothorax with major complications in other states
Questions
How much does pneumothorax with major complications cost in California?
In 2024 Medicare data, a hospital stay for pneumothorax with major complications (DRG 199) at 6 hospitals in California was billed at $161,278 on average, while the average total payment was $20,972, of which Medicare paid $17,025. 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 7.7 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.