Inpatient stays / DRG 216
MS-DRG 216 · 124 hospitals · 5,483 stays
DRG 216: Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit
Medicare patients had 5,483 stays in DRG 216 in 2024. Hospitals charged an average of $492,416 per stay and were paid $98,495 — a ratio of 5 to 1 — of which Medicare's own share averaged $84,106. Average charges ran from $142,973 at the least expensive hospital to $1,715,805 at the most; half of hospitals charged between $333,356 and $569,954.
- 1Average charge $492,416
- 2Average paid $98,495
- 3Reporting hospitals 124
- 4Medicare stays 5,483
By state
Average charges for DRG 216 were highest in Nevada ($1,043,823) and lowest in Maryland ($164,262). Payments vary far less than charges, because Medicare sets them: they range across states from $66,146 to $143,075.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Nevada | 59 | $1,043,823 | $91,346 | 11.4× |
| California | 496 | $765,628 | $133,605 | 5.7× |
| Texas | 408 | $633,553 | $88,542 | 7.2× |
| Colorado | 50 | $628,459 | $83,539 | 7.5× |
| Florida | 380 | $615,585 | $79,045 | 7.8× |
| Pennsylvania | 229 | $586,714 | $95,718 | 6.1× |
| South Carolina | 77 | $545,513 | $85,136 | 6.4× |
| New Jersey | 169 | $542,371 | $106,852 | 5.1× |
| New York | 477 | $517,205 | $122,600 | 4.2× |
| Arizona | 156 | $512,325 | $87,738 | 5.8× |
| Kansas | 51 | $492,279 | $79,584 | 6.2× |
| Georgia | 103 | $486,216 | $89,520 | 5.4× |
| Virginia | 142 | $463,564 | $92,023 | 5× |
| Alabama | 73 | $456,661 | $79,669 | 5.7× |
| Tennessee | 146 | $446,006 | $78,737 | 5.7× |
| Washington | 100 | $442,487 | $102,893 | 4.3× |
| South Dakota | 15 | $438,276 | $81,641 | 5.4× |
| Illinois | 188 | $426,469 | $102,556 | 4.2× |
| Indiana | 104 | $419,499 | $79,325 | 5.3× |
| District of Columbia | 54 | $418,909 | $117,231 | 3.6× |
| Utah | 25 | $415,731 | $91,826 | 4.5× |
| Louisiana | 70 | $415,222 | $71,889 | 5.8× |
| Kentucky | 72 | $412,198 | $75,594 | 5.5× |
| Oklahoma | 63 | $410,831 | $78,220 | 5.3× |
| Idaho | 20 | $400,734 | $87,308 | 4.6× |
| New Mexico | 44 | $392,723 | $79,017 | 5× |
| Wyoming | 22 | $386,820 | $90,657 | 4.3× |
| New Hampshire | 36 | $384,683 | $101,769 | 3.8× |
| Ohio | 319 | $377,666 | $95,403 | 4× |
| Missouri | 108 | $374,209 | $90,354 | 4.1× |
| Mississippi | 48 | $367,090 | $66,304 | 5.5× |
| Iowa | 38 | $366,142 | $82,773 | 4.4× |
| North Carolina | 147 | $359,177 | $86,113 | 4.2× |
| Vermont | 14 | $355,748 | $79,632 | 4.5× |
| West Virginia | 29 | $342,454 | $84,843 | 4× |
| Minnesota | 131 | $340,038 | $108,261 | 3.1× |
| Rhode Island | 12 | $338,711 | $109,622 | 3.1× |
| Wisconsin | 95 | $337,409 | $100,352 | 3.4× |
| Connecticut | 42 | $335,231 | $108,958 | 3.1× |
| Oregon | 55 | $328,699 | $106,089 | 3.1× |
| Massachusetts | 154 | $327,221 | $115,567 | 2.8× |
| Michigan | 154 | $326,928 | $98,497 | 3.3× |
| Maine | 26 | $324,232 | $93,535 | 3.5× |
| Hawaii | 21 | $316,481 | $132,372 | 2.4× |
| Arkansas | 85 | $308,065 | $66,146 | 4.7× |
| Nebraska | 43 | $299,070 | $82,328 | 3.6× |
| Montana | 23 | $274,744 | $84,815 | 3.2× |
| North Dakota | 15 | $268,403 | $80,098 | 3.4× |
| Maryland | 77 | $164,262 | $143,075 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Stanford Health Care Stanford, CA · 24 stays | $1,715,805 | $241,297 |
| Mountainview Hospital Las Vegas, NV · 15 stays | $1,641,909 | $102,488 |
| Cedars-Sinai Medical Center Los Angeles, CA · 12 stays | $1,609,453 | $175,022 |
| Cjw Medical Center Richmond, VA · 11 stays | $1,163,451 | $92,381 |
| HCA Houston Healthcare Medical Center Houston, TX · 17 stays | $1,047,827 | $81,566 |
| St David's Medical Center Austin, TX · 15 stays | $1,042,068 | $77,193 |
| UPMC Presbyterian Shadyside Pittsburgh, PA · 13 stays | $1,028,155 | $92,839 |
| Delray Medical Center Delray Beach, FL · 16 stays | $1,012,941 | $60,321 |
| Hospital of Univ of Pennsylvania Philadelphia, PA · 28 stays | $1,010,581 | $141,317 |
| Wesley Medical Center Wichita, KS · 11 stays | $999,387 | $72,351 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Beth Israel Deaconess Medical Center Boston, MA · 46 stays | $142,973 | $107,846 |
| Medstar Union Memorial Hospital Baltimore, MD · 19 stays | $147,677 | $132,311 |
| University of MD St Joseph Medical Center Towson, MD · 15 stays | $158,801 | $140,995 |
| Johns Hopkins Hospital, the Baltimore, MD · 13 stays | $179,214 | $156,888 |
| Arkansas Heart Hospital, LLC Little Rock, AR · 13 stays | $192,525 | $56,530 |
| St Joseph's Hospital Health Center Syracuse, NY · 11 stays | $200,119 | $80,076 |
| Memorial Hermann Memorial City Medical Center Houston, TX · 17 stays | $222,525 | $69,316 |
| University of Maryland Medical Center Baltimore, MD · 13 stays | $232,158 | $187,979 |
| Presbyterian Hospital Albuquerque, NM · 13 stays | $237,408 | $76,590 |
| Parkwest Medical Center Knoxville, TN · 20 stays | $240,808 | $57,488 |
These are averages over each hospital's Medicare stays in this DRG, which mix simple and complicated cases. A high average charge is the hospital's pricing, not a sign of better or worse care, and not what a patient pays: Medicare patients owe the inpatient deductible, and people with other coverage pay their plan's negotiated rate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Hospitals with fewer than 11 stays are suppressed by CMS. Checked 2026-10-24. Methodology.