Spinal fusion except cervical with major complications
What 28 hospitals in the U.S. charged and were paid for a Medicare hospital stay for spinal fusion except cervical with major complications (DRG 459), from 2024 Medicare claims.
Average charge
$344,494
Hospital list price billed
Average payment
$68,211
Medicare + patient + other payers
Medicare paid
$58,261
Average per stay
Volume
388
Medicare hospital stays
Hospitals in the U.S. billed an average of $344,494 for spinal fusion except cervical with major complications, about 5.1 times the average total payment of $68,211.
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 $68,211Billed $344,494
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:
Spinal fusion except cervical 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 |
|---|---|---|---|---|
| Alabama | 1 | $266,757 | $52,321 | – |
| Arizona | 1 | $781,606 | $49,461 | – |
| California | 3 | $618,293 | $94,576 | $77,429 – $108,696 |
| Colorado | 1 | $439,051 | $55,035 | – |
| Delaware | 1 | $194,150 | $63,853 | – |
| Florida | 2 | $447,349 | $48,159 | $47,204 – $48,924 |
| Iowa | 1 | $225,689 | $57,626 | – |
| Kentucky | 1 | $330,896 | $46,404 | – |
| Maryland | 1 | $128,520 | $116,896 | – |
| Massachusetts | 2 | $143,809 | $66,314 | $58,104 – $71,066 |
| Michigan | 1 | $182,874 | $45,718 | – |
| Minnesota | 1 | $185,939 | $104,945 | – |
| Missouri | 1 | $326,600 | $81,282 | – |
| New York | 1 | $537,669 | $73,629 | – |
| Ohio | 2 | $225,960 | $52,358 | $49,919 – $55,018 |
| Rhode Island | 1 | $150,878 | $64,315 | – |
| South Carolina | 1 | $488,948 | $47,590 | – |
| Tennessee | 1 | $214,250 | $46,982 | – |
| Texas | 1 | $766,148 | $47,237 | – |
| Virginia | 2 | $227,736 | $71,000 | $67,869 – $73,871 |
| Washington | 1 | $293,203 | $91,376 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 28 | $537,669 | $73,629 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 21 | $185,939 | $104,945 |
| Brigham and Women's HosptialBoston, MA | 19 | $153,791 | $71,066 |
| Medstar Georgetown University HospitalWashington, DC | 16 | $233,270 | $76,999 |
| Harborview Medical CenterSeattle, WA | 16 | $293,203 | $91,376 |
| Orlando Regional HealthcareOrlando, FL | 15 | $464,190 | $48,924 |
| Grand Strand Reg Med CenterMyrtle Beach, SC | 15 | $488,948 | $47,590 |
| University of Alabama HospitalBirmingham, AL | 14 | $266,757 | $52,321 |
| Christiana Care Health Services, INC.Newark, DE | 14 | $194,150 | $63,853 |
| William Beaumont HospitalRoyal Oak, MI | 14 | $182,874 | $45,718 |
| St Thomas HospitalNashville, TN | 14 | $214,250 | $46,982 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 13 | $748,026 | $77,429 |
| Norton Healthcare PavilionLouisville, KY | 13 | $330,896 | $46,404 |
| Barnes Jewish HospitalSt Louis, MO | 13 | $326,600 | $81,282 |
| UCSF Medical CenterSan Francisco, CA | 12 | $482,792 | $108,696 |
Questions
How much does spinal fusion except cervical with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for spinal fusion except cervical with major complications (DRG 459) at 28 hospitals in the U.S. was billed at $344,494 on average, while the average total payment was $68,211, of which Medicare paid $58,261. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for spinal fusion except cervical with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($94,576) and lowest in California ($94,576).
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 5.1 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.