Inborn and Other Disorders of Metabolism — what U.S. hospitals charge
MS-DRG 642 · Inpatient stay · 3 U.S. hospitals publish a price
Cheapest quarter
under $158,308
Typical charge
$160,304
Dearest quarter
over $182,677
Actually paid
$25,553
The middle U.S. hospital bills $160,304 for Inborn and Other Disorders of Metabolism. The dearest hospitals charge about 1.3x what the cheapest do for the same coded work. Medicare actually paid about $25,553 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 Inborn and Other Disorders of Metabolism is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Massachusetts General Hospital
Boston, MA |
$156,311 | $24,005 |
|
St Lukes Hospital Of Kansas City
Kansas City, MO |
$160,304 | $12,160 |
|
M Health Fairview University Of Mn Medical Center
Minneapolis, MN |
$205,050 | $40,495 |
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 |
|---|---|---|
|
M Health Fairview University Of Mn Medical Center
Minneapolis, MN |
$205,050 | $40,495 |
|
St Lukes Hospital Of Kansas City
Kansas City, MO |
$160,304 | $12,160 |
|
Massachusetts General Hospital
Boston, MA |
$156,311 | $24,005 |
Questions people ask
What do U.S. hospitals charge for Inborn and Other Disorders of Metabolism?
Across 3 U.S. hospitals, the middle charge for Inborn and Other Disorders of Metabolism is $160,304. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $158,308 and the dearest quarter over $182,677.
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 Inborn and Other Disorders of Metabolism, the hospitals in the dearest tenth charge about 1.3x 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. $25,553 is roughly what Medicare actually paid per case, against an average charge of $174,805. 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 642: “INBORN AND OTHER DISORDERS OF METABOLISM”. 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.