Shoulder, elbow or forearm procedures, except major joint procedures with complications in Texas
What 1 hospital in Texas charged and were paid for a Medicare hospital stay for shoulder, elbow or forearm procedures, except major joint procedures with complications (DRG 511), from 2024 Medicare claims.
Average charge
$150,693
Hospital list price billed
Average payment
$14,793
Medicare + patient + other payers
Medicare paid
$12,257
Average per stay
Volume
12
Medicare hospital stays
Hospitals in Texas billed an average of $150,693 for shoulder, elbow or forearm procedures, except major joint procedures with complications, about 10.2 times the average total payment of $14,793. That payment is 7% below the U.S. average of $15,909.
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 $14,793Billed $150,693
About 10¢ 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: shoulder, elbow or forearm procedures, except major joint procedures with 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 |
|---|---|---|---|---|
| Covenant Medical CenterLubbock | 12 | $150,693 | $14,793 | $12,257 |
Shoulder, elbow or forearm procedures, except major joint procedures with complications in other states
Questions
How much does shoulder, elbow or forearm procedures, except major joint procedures with complications cost in Texas?
In 2024 Medicare data, a hospital stay for shoulder, elbow or forearm procedures, except major joint procedures with complications (DRG 511) at 1 hospital in Texas was billed at $150,693 on average, while the average total payment was $14,793, of which Medicare paid $12,257. 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 10.2 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.