facebook tracking Spinal fusion except cervical without major complications cost in Montana: 4 hospitals compared (DRG 460)

Spinal fusion except cervical without major complications in Montana

What 4 hospitals in Montana charged and were paid for a Medicare hospital stay for spinal fusion except cervical without major complications (DRG 460), from 2024 Medicare claims.

DRG 460 Inpatient 2024 Medicare data
Average charge $95,343 Hospital list price billed
Average payment $31,215 Medicare + patient + other payers
Medicare paid $24,488 Average per stay
State rank #19 of 43 1 = lowest average payment

Hospitals in Montana billed an average of $95,343 for spinal fusion except cervical without major complications, about 3.1 times the average total payment of $31,215. That payment is 8% below the U.S. average of $34,025.

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 $31,215Billed $95,343

About 33¢ was paid for every $1 hospitals in Montana billed for this stay.

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

Montana hospitals: spinal fusion except cervical without major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Billings Clinic HospitalBillings 54 $82,288 $31,554 $25,030
Benefis Hospitals INCGreat Falls 24 $124,768 $30,371 $22,992
St Patrick Hospital and Health Sciences CenterMissoula 20 $64,419 $29,934 $23,892
St Vincent HealthcareBillings 17 $131,655 $32,838 $25,579
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Lowest and highest payments in Montana

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

St Patrick Hospital and Health Sciences CenterMissoula, MT$29,934
Benefis Hospitals INCGreat Falls, MT$30,371
Billings Clinic HospitalBillings, MT$31,554
St Vincent HealthcareBillings, MT$32,838

Highest

St Vincent HealthcareBillings, MT$32,838
Billings Clinic HospitalBillings, MT$31,554
Benefis Hospitals INCGreat Falls, MT$30,371
St Patrick Hospital and Health Sciences CenterMissoula, MT$29,934

Spinal fusion except cervical without major complications in other states

Questions

How much does spinal fusion except cervical without major complications cost in Montana?

In 2024 Medicare data, a hospital stay for spinal fusion except cervical without major complications (DRG 460) at 4 hospitals in Montana was billed at $95,343 on average, while the average total payment was $31,215, of which Medicare paid $24,488. 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 Montana, average charges were 3.1 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.