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Stomach, esophageal and duodenal procedures with major complications in Idaho

What 2 hospitals in Idaho charged and were paid for a Medicare hospital stay for stomach, esophageal and duodenal procedures with major complications (DRG 326), from 2024 Medicare claims.

DRG 326 Inpatient 2024 Medicare data
Average charge $238,266 Hospital list price billed
Average payment $73,193 Medicare + patient + other payers
Medicare paid $49,878 Average per stay
Volume 23 Medicare hospital stays

Hospitals in Idaho billed an average of $238,266 for stomach, esophageal and duodenal procedures with major complications, about 3.3 times the average total payment of $73,193. That payment is 27% above the U.S. average of $57,450.

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 $73,193Billed $238,266

About 31¢ was paid for every $1 hospitals in Idaho billed for this stay.

Idaho hospitals: stomach, esophageal and duodenal procedures with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Kootenai Medical CenterCoeur D'alene 12 $146,188 $48,937 $42,430
St Alphonsus Regional Medical CenterBoise 11 $338,714 $99,653 $58,004
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Stomach, esophageal and duodenal procedures with major complications in other states

Questions

How much does stomach, esophageal and duodenal procedures with major complications cost in Idaho?

In 2024 Medicare data, a hospital stay for stomach, esophageal and duodenal procedures with major complications (DRG 326) at 2 hospitals in Idaho was billed at $238,266 on average, while the average total payment was $73,193, of which Medicare paid $49,878. 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 Idaho, average charges were 3.3 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.