facebook tracking Pneumothorax with major complications cost in Pennsylvania: 4 hospitals compared (DRG 199)

Pneumothorax with major complications in Pennsylvania

What 4 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for pneumothorax with major complications (DRG 199), from 2024 Medicare claims.

DRG 199 Inpatient 2024 Medicare data
Average charge $118,935 Hospital list price billed
Average payment $19,849 Medicare + patient + other payers
Medicare paid $14,670 Average per stay
State rank #10 of 13 1 = lowest average payment

Hospitals in Pennsylvania billed an average of $118,935 for pneumothorax with major complications, about 6.0 times the average total payment of $19,849. That payment is 10% 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 $19,849Billed $118,935

About 17¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.

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

Pennsylvania hospitals: pneumothorax with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Reading Hospital and Med CtrWest Reading 14 $89,806 $14,569 $12,863
Lehigh Valley HospitalAllentown 12 $171,285 $26,946 $18,062
Allegheny General HospitalPittsburgh 11 $118,057 $20,371 $14,034
Abington Memorial HospitalAbington 11 $99,777 $18,303 $13,907
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Lowest and highest payments in Pennsylvania

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

Reading Hospital and Med CtrWest Reading, PA$14,569
Abington Memorial HospitalAbington, PA$18,303
Allegheny General HospitalPittsburgh, PA$20,371
Lehigh Valley HospitalAllentown, PA$26,946

Highest

Lehigh Valley HospitalAllentown, PA$26,946
Allegheny General HospitalPittsburgh, PA$20,371
Abington Memorial HospitalAbington, PA$18,303
Reading Hospital and Med CtrWest Reading, PA$14,569

Pneumothorax with major complications in other states

Questions

How much does pneumothorax with major complications cost in Pennsylvania?

In 2024 Medicare data, a hospital stay for pneumothorax with major complications (DRG 199) at 4 hospitals in Pennsylvania was billed at $118,935 on average, while the average total payment was $19,849, of which Medicare paid $14,670. 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 Pennsylvania, average charges were 6.0 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.