Spinal fusion except cervical with major complications in Virginia
What 2 hospitals in Virginia 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
$227,736
Hospital list price billed
Average payment
$71,000
Medicare + patient + other payers
Medicare paid
$52,028
Average per stay
Volume
23
Medicare hospital stays
Hospitals in Virginia billed an average of $227,736 for spinal fusion except cervical with major complications, about 3.2 times the average total payment of $71,000. That payment is 4% 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 $71,000Billed $227,736
About 31¢ was paid for every $1 hospitals in Virginia billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Virginia:
Virginia hospitals: spinal fusion except cervical with major complications
Every Virginia hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Inova Fairfax HospitalFalls Church | 12 | $232,886 | $73,871 | $59,462 |
| Carilion Medical CenterRoanoke | 11 | $222,117 | $67,869 | $43,918 |
Spinal fusion except cervical with major complications in other states
Questions
How much does spinal fusion except cervical with major complications cost in Virginia?
In 2024 Medicare data, a hospital stay for spinal fusion except cervical with major complications (DRG 459) at 2 hospitals in Virginia was billed at $227,736 on average, while the average total payment was $71,000, of which Medicare paid $52,028. 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 Virginia, average charges were 3.2 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.