Cardiac Congenital and Valvular Disorders with Major Complications — what U.S. hospitals charge
MS-DRG 306 · Inpatient stay · 38 U.S. hospitals publish a price
Cheapest quarter
under $56,528
Typical charge
$86,207
Dearest quarter
over $128,147
Actually paid
$18,925
The middle U.S. hospital bills $86,207 for Cardiac Congenital and Valvular Disorders with Major Complications. The dearest hospitals charge about 5.0x what the cheapest do for the same coded work. Medicare actually paid about $18,925 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.
Cardiac Congenital and Valvular Disorders with Major Complications cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Massachusetts | 5 | $39,160 | $21,367 – $103,034 |
| Florida | 3 | $57,021 | $50,169 – $128,201 |
| Pennsylvania | 4 | $98,135 | $86,754 – $243,439 |
| New York | 7 | $159,002 | $83,951 – $303,064 |
Where Cardiac Congenital and Valvular Disorders 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 |
|---|---|---|
|
Baystate Medical Center
Springfield, MA |
$21,367 | $16,743 |
|
Beth Israel Deaconess Hospital Plymouth
Plymouth, MA |
$28,380 | $12,760 |
|
Regions Hospital
Saint Paul, MN |
$29,888 | $14,267 |
|
Beth Israel Deaconess Medical Center
Boston, MA |
$39,160 | $21,531 |
|
Baylor Scott & White The Heart Hospital Plano
Plano, TX |
$42,179 | $13,560 |
|
Rex Hospital
Raleigh, NC |
$46,453 | $10,618 |
|
Lee Memorial Hospital
Fort Myers, FL |
$50,169 | $12,400 |
|
Northshore University Healthsystem - Evanston Hospital
Evanston, IL |
$50,679 | $14,592 |
|
Piedmont Hospital, Inc
Atlanta, GA |
$52,118 | $18,474 |
|
Ascension Saint Thomas Hospital
Nashville, TN |
$56,364 | $12,872 |
|
Sarasota Memorial Hospital
Sarasota, FL |
$57,021 | $11,626 |
|
Inova Fairfax Hospital
Falls Church, VA |
$58,926 | $20,291 |
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 |
|---|---|---|
|
Montefiore Medical Center
Bronx, NY |
$303,064 | $37,388 |
|
Penn Presbyterian Medical Center
Philadelphia, PA |
$243,439 | $23,576 |
|
Stanford Health Care
Stanford, CA |
$225,753 | $33,689 |
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$218,580 | $20,039 |
|
Robert Wood Johnson University Hospital
New Brunswick, NJ |
$198,316 | $19,265 |
|
New York-Presbyterian Hospital
New York, NY |
$187,043 | $26,295 |
|
Lenox Hill Hospital
New York, NY |
$180,403 | $23,771 |
|
Houston Methodist Hospital
Houston, TX |
$159,244 | $24,732 |
|
North Shore University Hospital
Manhasset, NY |
$159,002 | $19,977 |
|
Adventhealth Orlando
Orlando, FL |
$128,201 | $12,472 |
|
Nyu Langone Hospitals
New York, NY |
$127,985 | $22,918 |
|
University Of Virginia Medical Center
Charlottesville, VA |
$116,450 | $28,615 |
Questions people ask
What do U.S. hospitals charge for Cardiac Congenital and Valvular Disorders with Major Complications?
Across 38 U.S. hospitals, the middle charge for Cardiac Congenital and Valvular Disorders with Major Complications is $86,207. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $56,528 and the dearest quarter over $128,147.
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 Cardiac Congenital and Valvular Disorders with Major Complications, the hospitals in the dearest tenth charge about 5.0x 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. $18,925 is roughly what Medicare actually paid per case, against an average charge of $104,180. 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 306: “CARDIAC CONGENITAL AND VALVULAR DISORDERS 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.