Trauma to the skin, subcutaneous tissue and breast with major complications
What 21 hospitals in the U.S. charged and were paid for a Medicare hospital stay for trauma to the skin, subcutaneous tissue and breast with major complications (DRG 604), from 2024 Medicare claims.
Average charge
$75,873
Hospital list price billed
Average payment
$16,179
Medicare + patient + other payers
Medicare paid
$14,179
Average per stay
Volume
342
Medicare hospital stays
Hospitals in the U.S. billed an average of $75,873 for trauma to the skin, subcutaneous tissue and breast with major complications, about 4.7 times the average total payment of $16,179.
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 $16,179Billed $75,873
About 21¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Adventhealth OrlandoOrlando, FL | $12,161 |
|---|---|
| Los Angeles Community HospitalLos Angeles, CA | $15,990 |
| Hollywood Community Hospital of HollywoodLos Angeles, CA | $16,127 |
| University HospitalStony Brook, NY | $20,384 |
Highest
| University HospitalStony Brook, NY | $20,384 |
|---|---|
| Hollywood Community Hospital of HollywoodLos Angeles, CA | $16,127 |
| Los Angeles Community HospitalLos Angeles, CA | $15,990 |
| Adventhealth OrlandoOrlando, FL | $12,161 |
Trauma to the skin, subcutaneous tissue and breast with major complications 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 |
|---|---|---|---|---|
| California | 5 | $62,428 | $15,959 | $15,311 – $16,323 |
| Florida | 5 | $92,817 | $12,006 | $10,030 – $14,573 |
| Indiana | 1 | $93,974 | $21,792 | – |
| Kansas | 1 | $88,413 | $13,847 | – |
| Maryland | 1 | $21,050 | $18,399 | – |
| Massachusetts | 1 | $29,798 | $12,328 | – |
| New York | 4 | $91,626 | $22,111 | $12,052 – $41,104 |
| North Carolina | 1 | $47,592 | $13,916 | – |
| Pennsylvania | 1 | $100,161 | $13,714 | – |
| Wisconsin | 1 | $79,829 | $18,817 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Hollywood Community Hospital of HollywoodLos Angeles, CA | 44 | $57,828 | $16,127 |
| Los Angeles Community HospitalLos Angeles, CA | 30 | $48,366 | $15,990 |
| Adventhealth OrlandoOrlando, FL | 22 | $74,956 | $12,161 |
| University HospitalStony Brook, NY | 22 | $103,377 | $20,384 |
| Delray Medical CenterDelray Beach, FL | 18 | $147,984 | $10,030 |
| New York-Presbyterian HospitalNew York, NY | 17 | $97,295 | $19,750 |
| Orlando Regional HealthcareOrlando, FL | 16 | $126,896 | $14,573 |
| Foothill Regional Medical CenterTustin, CA | 15 | $75,143 | $15,311 |
| Lakeland Regional Medical CenterLakeland, FL | 13 | $45,244 | $12,028 |
| South Shore HospitalSouth Weymouth, MA | 13 | $29,798 | $12,328 |
| Huntington HospitalHuntington, NY | 13 | $82,118 | $12,052 |
| New Hanover Regional Medical CenterWilmington, NC | 13 | $47,592 | $13,916 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 13 | $79,829 | $18,817 |
| Sutter Roseville Medical CenterRoseville, CA | 12 | $96,516 | $15,741 |
| Naples Community HospitalNaples, FL | 12 | $48,913 | $11,242 |
Questions
How much does trauma to the skin, subcutaneous tissue and breast with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for trauma to the skin, subcutaneous tissue and breast with major complications (DRG 604) at 21 hospitals in the U.S. was billed at $75,873 on average, while the average total payment was $16,179, of which Medicare paid $14,179. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for trauma to the skin, subcutaneous tissue and breast with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($22,111), California ($15,959), Florida ($12,006) and lowest in Florida ($12,006), California ($15,959), New York ($22,111).
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 4.7 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.