facebook tracking Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive cost: hospital prices by state (DRG 458)

Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive

What 7 hospitals in the U.S. charged and were paid for a Medicare hospital stay for spinal fusion except cervical with spinal curvature, malignancy, infection or extensive (DRG 458), from 2024 Medicare claims.

DRG 458 Inpatient 2024 Medicare data
Average charge $186,701 Hospital list price billed
Average payment $41,355 Medicare + patient + other payers
Medicare paid $33,026 Average per stay
Volume 119 Medicare hospital stays

Hospitals in the U.S. billed an average of $186,701 for spinal fusion except cervical with spinal curvature, malignancy, infection or extensive, about 4.5 times the average total payment of $41,355.

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 $41,355Billed $186,701

About 22¢ was paid for every $1 hospitals in the U.S. billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:

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Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive 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 $451,208 $29,527 –
Florida 1 $100,705 $32,140 –
Indiana 1 $77,524 $30,077 –
New York 1 $217,615 $59,820 –
Ohio 1 $118,107 $28,016 –
Oklahoma 1 $160,445 $32,015 –

Hospitals that treat the most Medicare patients for this

HospitalStaysAvg chargeAvg payment
Hospital for Special SurgeryNew York, NY31$217,615$59,820
Oklahoma Spine HospitalOklahoma City, OK23$160,445$32,015
Medstar Georgetown University HospitalWashington, DC17$187,312$52,518
Orthoindy HospitalIndianapolis, IN13$77,524$30,077
Naples Community HospitalNaples, FL12$100,705$32,140
Crystal Clinic Orthopaedic CenterAkron, OH12$118,107$28,016
Grandview Medical CenterBirmingham, AL11$451,208$29,527

Questions

How much does spinal fusion except cervical with spinal curvature, malignancy, infection or extensive cost in the U.S.?

In 2024 Medicare data, a hospital stay for spinal fusion except cervical with spinal curvature, malignancy, infection or extensive (DRG 458) at 7 hospitals in the U.S. was billed at $186,701 on average, while the average total payment was $41,355, of which Medicare paid $33,026. 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 the U.S., average charges were 4.5 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.