CMS Medicare claims · data year 2024
What hospitals charge — and what Medicare actually pays
A hospital's list price and the amount it is paid are far apart. Across the 2,546 hospitals here, the median hospital charged Medicare 4.15 times what Medicare paid for its inpatient stays. Pick a procedure and a state to compare every hospital's average charge and payment, from CMS's own summaries of 2024 claims.
Compare hospitals for a stay
| Hospital | Stays | Avg charge | Avg paid | Ratio |
|---|
Averages per stay for Medicare fee-for-service patients in 2024. "Paid" is the total payment: Medicare's share plus the patient's deductible and coinsurance and any other insurer's share. Hospitals with fewer than 11 stays for a DRG are not reported by CMS.
Why charges and payments differ
Every hospital keeps a chargemaster — its list price for every item and service. Almost nobody pays it. Medicare pays a fixed amount per stay, set by the diagnosis-related group (DRG) and adjusted for local wages, teaching and the hospital's share of low-income patients; commercial insurers pay negotiated rates; and uninsured patients are often billed nearer list price unless they ask for a discount or financial assistance. So the charge on this site is the hospital's own price, and the payment is what that stay was actually worth to Medicare.
The gap varies a lot. Maryland, which sets hospital rates for all payers, has the smallest; states such as Nevada and Florida have the largest. Each state page ranks its hospitals by the gap.
Most common inpatient stays
Hospitals by state
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.