Viral illness with major complications
What 17 hospitals in the U.S. charged and were paid for a Medicare hospital stay for viral illness with major complications (DRG 865), from 2024 Medicare claims.
Average charge
$129,762
Hospital list price billed
Average payment
$23,844
Medicare + patient + other payers
Medicare paid
$18,617
Average per stay
Volume
272
Medicare hospital stays
Hospitals in the U.S. billed an average of $129,762 for viral illness with major complications, about 5.4 times the average total payment of $23,844.
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 $23,844Billed $129,762
About 18¢ 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
| Yale-New Haven HospitalNew Haven, CT | $20,606 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $21,150 |
| Massachusetts General HospitalBoston, MA | $26,765 |
| NYU Hospitals CenterNew York, NY | $47,307 |
Highest
| NYU Hospitals CenterNew York, NY | $47,307 |
|---|---|
| Massachusetts General HospitalBoston, MA | $26,765 |
| New York-Presbyterian HospitalNew York, NY | $21,150 |
| Yale-New Haven HospitalNew Haven, CT | $20,606 |
Viral illness 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 | 1 | $575,004 | $55,076 | – |
| Connecticut | 1 | $52,113 | $20,606 | – |
| Delaware | 1 | $38,396 | $15,102 | – |
| Florida | 1 | $98,015 | $17,230 | – |
| Illinois | 1 | $57,790 | $16,750 | – |
| Massachusetts | 4 | $65,229 | $21,495 | $13,814 – $26,765 |
| New Jersey | 1 | $76,414 | $13,950 | – |
| New York | 4 | $195,251 | $30,631 | $16,704 – $47,307 |
| North Carolina | 1 | $44,671 | $22,289 | – |
| Tennessee | 1 | $50,637 | $12,103 | – |
| Texas | 1 | $173,655 | $16,364 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 31 | $330,441 | $47,307 |
| New York-Presbyterian HospitalNew York, NY | 27 | $114,657 | $21,150 |
| Yale-New Haven HospitalNew Haven, CT | 23 | $52,113 | $20,606 |
| Massachusetts General HospitalBoston, MA | 21 | $99,634 | $26,765 |
| Beth Israel Deaconess Medical CenterBoston, MA | 18 | $29,742 | $20,507 |
| Adventhealth OrlandoOrlando, FL | 17 | $98,015 | $17,230 |
| Valley HospitalRidgewood, NJ | 17 | $76,414 | $13,950 |
| Christiana Care Health Services, INC.Newark, DE | 14 | $38,396 | $15,102 |
| North Shore University HospitalManhasset, NY | 13 | $107,675 | $22,339 |
| Stanford HospitalPalo Alto, CA | 12 | $575,004 | $55,076 |
| Brigham and Women's HosptialBoston, MA | 12 | $93,943 | $20,796 |
| UNC HospitalsChapel Hill, NC | 12 | $44,671 | $22,289 |
| Northwestern Memorial HospitalChicago, IL | 11 | $57,790 | $16,750 |
| Newton-Wellesley HospitalNewton Lower Falls, MA | 11 | $26,290 | $13,814 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | 11 | $115,584 | $16,704 |
Questions
How much does viral illness with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for viral illness with major complications (DRG 865) at 17 hospitals in the U.S. was billed at $129,762 on average, while the average total payment was $23,844, of which Medicare paid $18,617. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for viral illness with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($30,631), Massachusetts ($21,495) and lowest in Massachusetts ($21,495), New York ($30,631).
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 5.4 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.