facebook tracking Spinal fusion except cervical without major complications cost in Wisconsin: 8 hospitals compared (DRG 460)

Spinal fusion except cervical without major complications in Wisconsin

What 8 hospitals in Wisconsin 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 $126,682 Hospital list price billed
Average payment $32,992 Medicare + patient + other payers
Medicare paid $25,251 Average per stay
State rank #27 of 43 1 = lowest average payment

Hospitals in Wisconsin billed an average of $126,682 for spinal fusion except cervical without major complications, about 3.8 times the average total payment of $32,992. That payment is 3% 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 $32,992Billed $126,682

About 26¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

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

Wisconsin hospitals: spinal fusion except cervical without major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Waukesha Memorial HospitalWaukesha 29 $155,320 $30,930 $23,472
Aurora St Lukes Medical CenterMilwaukee 29 $178,061 $31,832 $26,469
Aspirus Wausau HospitalWausau 26 $98,815 $28,994 $22,295
St Mary's HospitalMadison 23 $87,941 $28,853 $24,631
University of Wi Hospitals & Clinics AuthorityMadison 21 $115,163 $38,843 $28,034
Froedtert Mem Lutheran HsptlMilwaukee 19 $165,793 $46,577 $30,398
Mayo Clinic Health System-Franciscan Medical CenterLa Crosse 15 $86,131 $33,064 $25,685
Orthopaedic Hsptl of WiGlendale 15 $86,828 $27,023 $21,562
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Lowest and highest payments in Wisconsin

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

Orthopaedic Hsptl of WiGlendale, WI$27,023
St Mary's HospitalMadison, WI$28,853
Aspirus Wausau HospitalWausau, WI$28,994
Waukesha Memorial HospitalWaukesha, WI$30,930
Aurora St Lukes Medical CenterMilwaukee, WI$31,832

Spinal fusion except cervical without major complications in other states

Questions

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

In 2024 Medicare data, a hospital stay for spinal fusion except cervical without major complications (DRG 460) at 8 hospitals in Wisconsin was billed at $126,682 on average, while the average total payment was $32,992, of which Medicare paid $25,251. 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 Wisconsin, average charges were 3.8 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.