facebook tracking Spinal fusion except cervical with major complications cost in California: 3 hospitals compared (DRG 459)

Spinal fusion except cervical with major complications in California

What 3 hospitals in California charged and were paid for a Medicare hospital stay for spinal fusion except cervical with major complications (DRG 459), from 2024 Medicare claims.

DRG 459 Inpatient 2024 Medicare data
Average charge $618,293 Hospital list price billed
Average payment $94,576 Medicare + patient + other payers
Medicare paid $87,348 Average per stay
State rank #1 of 1 1 = lowest average payment

Hospitals in California billed an average of $618,293 for spinal fusion except cervical with major complications, about 6.5 times the average total payment of $94,576. That payment is 39% above the U.S. average 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 $94,576Billed $618,293

About 15¢ 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: spinal fusion except cervical 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
Cedars-Sinai Medical CenterLos Angeles 13 $748,026 $77,429 $72,764
UCSF Medical CenterSan Francisco 12 $482,792 $108,696 $100,000
University of California Davis Medical CenterSacramento 12 $613,249 $99,032 $90,495
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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

Cedars-Sinai Medical CenterLos Angeles, CA$77,429
University of California Davis Medical CenterSacramento, CA$99,032
UCSF Medical CenterSan Francisco, CA$108,696

Highest

UCSF Medical CenterSan Francisco, CA$108,696
University of California Davis Medical CenterSacramento, CA$99,032
Cedars-Sinai Medical CenterLos Angeles, CA$77,429

Spinal fusion except cervical with major complications in other states

Questions

How much does spinal fusion except cervical with major complications cost in California?

In 2024 Medicare data, a hospital stay for spinal fusion except cervical with major complications (DRG 459) at 3 hospitals in California was billed at $618,293 on average, while the average total payment was $94,576, of which Medicare paid $87,348. 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 6.5 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.