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Stomach, esophageal and duodenal procedures with major complications in South Dakota

What 2 hospitals in South Dakota 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 $210,771 Hospital list price billed
Average payment $41,683 Medicare + patient + other payers
Medicare paid $38,787 Average per stay
Volume 28 Medicare hospital stays

Hospitals in South Dakota billed an average of $210,771 for stomach, esophageal and duodenal procedures with major complications, about 5.1 times the average total payment of $41,683. That payment is 27% below 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 $41,683Billed $210,771

About 20¢ was paid for every $1 hospitals in South Dakota billed for this stay.

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

South Dakota hospitals: stomach, esophageal and duodenal procedures with major complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Avera McKennan Hospital & University Health CenterSioux Falls 17 $199,967 $40,972 $37,896
Sanford Usd Medical CenterSioux Falls 11 $227,469 $42,781 $40,164
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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 South Dakota?

In 2024 Medicare data, a hospital stay for stomach, esophageal and duodenal procedures with major complications (DRG 326) at 2 hospitals in South Dakota was billed at $210,771 on average, while the average total payment was $41,683, of which Medicare paid $38,787. 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 South Dakota, average charges were 5.1 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.