facebook tracking Spinal fusion except cervical with major complications cost in Ohio: 2 hospitals compared (DRG 459)

Spinal fusion except cervical with major complications in Ohio

What 2 hospitals in Ohio 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 $225,960 Hospital list price billed
Average payment $52,358 Medicare + patient + other payers
Medicare paid $44,691 Average per stay
Volume 23 Medicare hospital stays

Hospitals in Ohio billed an average of $225,960 for spinal fusion except cervical with major complications, about 4.3 times the average total payment of $52,358. That payment is 23% below 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 $52,358Billed $225,960

About 23¢ was paid for every $1 hospitals in Ohio billed for this stay.

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

Ohio hospitals: spinal fusion except cervical with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Miami Valley HospitalDayton 12 $242,328 $49,919 $39,554
Cleveland Clinic - Main CampusCleveland 11 $208,104 $55,018 $50,296
Advertisement

Spinal fusion except cervical with major complications in other states

Questions

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

In 2024 Medicare data, a hospital stay for spinal fusion except cervical with major complications (DRG 459) at 2 hospitals in Ohio was billed at $225,960 on average, while the average total payment was $52,358, of which Medicare paid $44,691. 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 Ohio, average charges were 4.3 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.