Inpatient stays / DRG 459
MS-DRG 459 · 28 hospitals · 2,694 stays
DRG 459: Spinal Fusion except Cervical with MCC
Medicare patients had 2,694 stays in DRG 459 in 2024. Hospitals charged an average of $289,773 per stay and were paid $59,155 — a ratio of 4.9 to 1 — of which Medicare's own share averaged $51,511. Average charges ran from $126,567 at the least expensive hospital to $781,606 at the most; half of hospitals charged between $197,638 and $478,142.
- 1Average charge $289,773
- 2Average paid $59,155
- 3Reporting hospitals 28
- 4Medicare stays 2,694
By state
Average charges for DRG 459 were highest in California ($489,314) and lowest in Maryland ($102,222). Payments vary far less than charges, because Medicare sets them: they range across states from $41,411 to $91,145.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| California | 226 | $489,314 | $79,586 | 6.1× |
| Nevada | 28 | $422,639 | $58,230 | 7.3× |
| District of Columbia | 34 | $385,279 | $79,229 | 4.9× |
| Florida | 234 | $381,091 | $47,729 | 8× |
| Arizona | 64 | $370,450 | $59,520 | 6.2× |
| New Jersey | 45 | $370,387 | $59,126 | 6.3× |
| Texas | 193 | $357,597 | $51,568 | 6.9× |
| Colorado | 70 | $357,565 | $54,946 | 6.5× |
| New York | 142 | $345,388 | $71,195 | 4.9× |
| South Carolina | 50 | $341,221 | $51,684 | 6.6× |
| Pennsylvania | 102 | $295,630 | $56,331 | 5.2× |
| Missouri | 58 | $288,157 | $59,815 | 4.8× |
| South Dakota | 13 | $285,314 | $55,440 | 5.1× |
| Indiana | 49 | $282,783 | $53,264 | 5.3× |
| Georgia | 73 | $281,561 | $55,759 | 5× |
| Kentucky | 38 | $275,097 | $50,644 | 5.4× |
| Washington | 48 | $269,707 | $70,591 | 3.8× |
| Oklahoma | 30 | $260,953 | $47,676 | 5.5× |
| West Virginia | 11 | $243,945 | $51,963 | 4.7× |
| Tennessee | 61 | $239,592 | $53,634 | 4.5× |
| North Carolina | 59 | $238,761 | $52,698 | 4.5× |
| Virginia | 91 | $237,102 | $57,186 | 4.1× |
| Louisiana | 34 | $234,671 | $51,232 | 4.6× |
| Connecticut | 33 | $231,547 | $62,241 | 3.7× |
| Kansas | 47 | $228,441 | $48,664 | 4.7× |
| Oregon | 32 | $227,092 | $65,189 | 3.5× |
| Illinois | 108 | $224,310 | $60,168 | 3.7× |
| Ohio | 128 | $222,012 | $50,824 | 4.4× |
| Nebraska | 20 | $213,778 | $51,115 | 4.2× |
| Alabama | 48 | $213,704 | $45,199 | 4.7× |
| New Mexico | 14 | $198,582 | $50,916 | 3.9× |
| Delaware | 14 | $194,150 | $63,853 | 3× |
| Minnesota | 52 | $173,390 | $74,271 | 2.3× |
| Wisconsin | 42 | $172,046 | $56,507 | 3× |
| Iowa | 32 | $171,224 | $52,584 | 3.3× |
| Michigan | 76 | $167,114 | $53,122 | 3.1× |
| Arkansas | 28 | $156,613 | $41,411 | 3.8× |
| Utah | 28 | $153,092 | $52,206 | 2.9× |
| Rhode Island | 16 | $150,859 | $60,435 | 2.5× |
| Montana | 11 | $142,172 | $54,722 | 2.6× |
| Mississippi | 12 | $140,791 | $42,490 | 3.3× |
| Massachusetts | 93 | $138,671 | $63,805 | 2.2× |
| Maryland | 60 | $102,222 | $91,145 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| St Joseph's Hospital Tucson, AZ · 11 stays | $781,606 | $49,461 |
| Medical City Plano Plano, TX · 12 stays | $766,148 | $47,237 |
| Cedars-Sinai Medical Center Los Angeles, CA · 13 stays | $748,026 | $77,429 |
| University of California Davis Medical Center Sacramento, CA · 12 stays | $613,249 | $99,032 |
| NYU Langone Hospitals New York, NY · 28 stays | $537,669 | $73,629 |
| Grand Strand Regional Medical Center Myrtle Beach, SC · 15 stays | $488,948 | $47,590 |
| UCSF Medical Center San Francisco, CA · 12 stays | $482,792 | $108,696 |
| Orlando Health Orlando Regional Medical Center Orlando, FL · 15 stays | $464,190 | $48,924 |
| University of Colorado Hospital Authority Aurora, CO · 11 stays | $439,051 | $55,035 |
| Adventhealth Orlando Orlando, FL · 12 stays | $426,299 | $47,204 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| New England Baptist Hospital Boston, MA · 11 stays | $126,567 | $58,104 |
| University of Maryland Medical Center Baltimore, MD · 12 stays | $128,520 | $116,896 |
| Rhode Island Hospital Providence, RI · 12 stays | $150,878 | $64,315 |
| Brigham and Women's Hospital Boston, MA · 19 stays | $153,791 | $71,066 |
| Corewell Health William Beaumont University Hospit Royal Oak, MI · 14 stays | $182,874 | $45,718 |
| Mayo Clinic Hospital Rochester Rochester, MN · 21 stays | $185,939 | $104,945 |
| Christianacare Newark, DE · 14 stays | $194,150 | $63,853 |
| Cleveland Clinic Cleveland, OH · 11 stays | $208,104 | $55,018 |
| Ascension Saint Thomas Hospital Nashville, TN · 14 stays | $214,250 | $46,982 |
| Carilion Roanoke Memorial Hospital Roanoke, VA · 11 stays | $222,117 | $67,869 |
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.