Atherosclerosis with Major Complications — what U.S. hospitals charge
MS-DRG 302 · Inpatient stay · 3 U.S. hospitals publish a price
Cheapest quarter
under $41,763
Typical charge
$55,485
Dearest quarter
over $61,586
Actually paid
$10,979
The middle U.S. hospital bills $55,485 for Atherosclerosis with Major Complications. The dearest hospitals charge about 2.0x what the cheapest do for the same coded work. Medicare actually paid about $10,979 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Where Atherosclerosis with Major Complications is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Adventhealth Daytona Beach
Daytona Beach, FL |
$28,041 | $8,234 |
|
Massachusetts General Hospital
Boston, MA |
$55,485 | $14,655 |
|
Adventhealth Orlando
Orlando, FL |
$67,687 | $10,047 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Adventhealth Orlando
Orlando, FL |
$67,687 | $10,047 |
|
Massachusetts General Hospital
Boston, MA |
$55,485 | $14,655 |
|
Adventhealth Daytona Beach
Daytona Beach, FL |
$28,041 | $8,234 |
Questions people ask
What do U.S. hospitals charge for Atherosclerosis with Major Complications?
Across 3 U.S. hospitals, the middle charge for Atherosclerosis with Major Complications is $55,485. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $41,763 and the dearest quarter over $61,586.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Atherosclerosis with Major Complications, the hospitals in the dearest tenth charge about 2.0x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $10,979 is roughly what Medicare actually paid per case, against an average charge of $53,856. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as MS-DRG 302: “ATHEROSCLEROSIS WITH MCC”. A DRG covers a whole inpatient stay rather than a single item, so the charge includes the room, the procedure and the care around it. Codes that mention complications carry a different, usually higher price.