Inpatient stays / DRG 516
MS-DRG 516 · 338 hospitals · 11,361 stays
DRG 516: Other Musculoskeletal System and Connective Tissue O.R. Procedures with CC
Medicare patients had 11,361 stays in DRG 516 in 2024. Hospitals charged an average of $101,552 per stay and were paid $18,613 — a ratio of 5.5 to 1 — of which Medicare's own share averaged $15,566. Average charges ran from $22,141 at the least expensive hospital to $406,436 at the most; half of hospitals charged between $67,023 and $119,617.
- 1Average charge $101,552
- 2Average paid $18,613
- 3Reporting hospitals 338
- 4Medicare stays 11,361
By state
Average charges for DRG 516 were highest in Nevada ($159,500) and lowest in Maryland ($30,363). Payments vary far less than charges, because Medicare sets them: they range across states from $14,595 to $27,022.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Nevada | 63 | $159,500 | $19,276 | 8.3× |
| California | 1,059 | $158,591 | $24,400 | 6.5× |
| Colorado | 201 | $154,839 | $18,425 | 8.4× |
| Alaska | 36 | $138,307 | $22,521 | 6.1× |
| Florida | 1,245 | $132,270 | $16,422 | 8.1× |
| New Jersey | 166 | $123,478 | $20,615 | 6× |
| Texas | 930 | $121,937 | $17,470 | 7× |
| New York | 472 | $119,519 | $24,082 | 5× |
| Virginia | 393 | $114,444 | $16,441 | 7× |
| Arizona | 174 | $113,454 | $19,721 | 5.8× |
| District of Columbia | 25 | $108,345 | $25,152 | 4.3× |
| Georgia | 289 | $104,304 | $18,275 | 5.7× |
| Alabama | 147 | $103,245 | $15,561 | 6.6× |
| South Carolina | 165 | $101,656 | $17,514 | 5.8× |
| Washington | 191 | $101,301 | $20,263 | 5× |
| Pennsylvania | 446 | $96,865 | $18,684 | 5.2× |
| Louisiana | 109 | $96,548 | $16,935 | 5.7× |
| New Mexico | 24 | $94,539 | $15,957 | 5.9× |
| Oklahoma | 199 | $89,098 | $15,891 | 5.6× |
| New Hampshire | 69 | $88,710 | $19,414 | 4.6× |
| Kansas | 237 | $87,370 | $15,753 | 5.5× |
| Tennessee | 213 | $83,365 | $16,369 | 5.1× |
| Connecticut | 57 | $82,880 | $21,606 | 3.8× |
| Illinois | 618 | $82,878 | $18,563 | 4.5× |
| Idaho | 77 | $82,240 | $16,313 | 5× |
| Missouri | 263 | $82,183 | $16,552 | 5× |
| West Virginia | 59 | $80,091 | $16,741 | 4.8× |
| Indiana | 257 | $79,959 | $16,085 | 5× |
| Ohio | 505 | $79,301 | $16,878 | 4.7× |
| Delaware | 36 | $77,677 | $19,287 | 4× |
| South Dakota | 53 | $77,630 | $16,923 | 4.6× |
| Kentucky | 137 | $77,378 | $14,971 | 5.2× |
| Maine | 20 | $73,024 | $18,277 | 4× |
| North Carolina | 339 | $71,126 | $17,065 | 4.2× |
| Nebraska | 159 | $69,771 | $16,944 | 4.1× |
| Oregon | 86 | $69,147 | $21,557 | 3.2× |
| Wisconsin | 181 | $68,207 | $16,864 | 4× |
| Mississippi | 96 | $68,128 | $14,778 | 4.6× |
| Iowa | 86 | $66,599 | $15,835 | 4.2× |
| Utah | 70 | $65,659 | $17,438 | 3.8× |
| Massachusetts | 344 | $62,913 | $22,003 | 2.9× |
| Michigan | 384 | $62,876 | $17,745 | 3.5× |
| Hawaii | 18 | $61,891 | $24,042 | 2.6× |
| Arkansas | 118 | $55,921 | $14,595 | 3.8× |
| Minnesota | 263 | $55,887 | $18,702 | 3× |
| Montana | 31 | $51,505 | $15,690 | 3.3× |
| North Dakota | 46 | $47,936 | $15,836 | 3× |
| Rhode Island | 21 | $43,488 | $21,595 | 2× |
| Maryland | 169 | $30,363 | $27,022 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| HCA Healthone Swedish Englewood, CO · 11 stays | $406,436 | $26,149 |
| Good Samaritan Hospital San Jose, CA · 12 stays | $372,974 | $22,000 |
| Stanford Health Care Stanford, CA · 36 stays | $321,008 | $34,641 |
| Westchester Medical Center Valhalla, NY · 17 stays | $311,260 | $26,571 |
| Doctors Medical Center Modesto, CA · 14 stays | $308,705 | $21,596 |
| University of California Davis Medical Center Sacramento, CA · 26 stays | $287,441 | $33,530 |
| Cedars-Sinai Medical Center Los Angeles, CA · 28 stays | $278,851 | $25,766 |
| Desert Regional Medical Center Palm Springs, CA · 11 stays | $272,109 | $22,890 |
| OU Health University of Oklahoma Medical Center Oklahoma City, OK · 16 stays | $270,544 | $25,473 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL · 12 stays | $266,328 | $17,140 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Suburban Hospital Bethesda, MD · 12 stays | $22,141 | $19,753 |
| U P M C Western Maryland Cumberland, MD · 15 stays | $23,587 | $20,957 |
| Johns Hopkins Hospital, the Baltimore, MD · 12 stays | $25,912 | $22,728 |
| Tidalhealth Peninsula Regional, Inc Salisbury, MD · 11 stays | $27,614 | $24,680 |
| South Shore Hospital South Weymouth, MA · 36 stays | $33,046 | $16,490 |
| Baystate Medical Center Springfield, MA · 12 stays | $36,289 | $22,156 |
| New England Baptist Hospital Boston, MA · 18 stays | $38,822 | $16,982 |
| Winchester Medical Center Winchester, VA · 15 stays | $39,671 | $16,369 |
| St Cloud Hospital Saint Cloud, MN · 28 stays | $39,741 | $19,526 |
| St Bernards Medical Center Jonesboro, AR · 15 stays | $40,281 | $13,734 |
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.