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Viral Illness with major complications
Medicare DRG 865. What hospitals charge and what Medicare pays, 2024.
Avg hospital charge
$122,627
Avg total payment
$22,285
Avg Medicare pays
$17,369
Hospitals reporting
17
The "charge" is the hospital's list price — almost nobody pays it. "Total payment" is what the hospital actually received (Medicare plus patient copays and other payers). These figures cover Medicare fee-for-service inpatient stays only.
| State | Hospitals | Avg charge | Avg Medicare payment |
|---|---|---|---|
| California | 1 | $575,004 | $45,095 |
| Texas | 1 | $173,655 | $11,015 |
| New York | 4 | $167,089 | $20,972 |
| Florida | 1 | $98,015 | $9,580 |
| New Jersey | 1 | $76,414 | $12,796 |
| Massachusetts | 4 | $62,402 | $15,963 |
| Illinois | 1 | $57,790 | $13,897 |
| Connecticut | 1 | $52,113 | $17,672 |
| Tennessee | 1 | $50,637 | $9,293 |
| North Carolina | 1 | $44,671 | $15,782 |
| Delaware | 1 | $38,396 | $12,397 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service. A DRG (Diagnosis Related Group) is how Medicare classifies an inpatient stay for payment; the description is Medicare's, not a diagnosis for any individual.