DRG 512 Surgical

Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures without CC/MCC

Hospital inpatient stay cost data from CMS

Avg Medicare Payment
$10,760
National average
Avg Total Costs
$12,837
CMS Inpatient data
Avg Length of Stay
2.3 days
CMS MS-DRG
Est. Commercial Insurance
$16,140 — $26,900
1.5x — 2.5x Medicare
Annual Discharges
22
Medicare beneficiaries

CMS Inpatient National Data

From CMS Medicare Provider Utilization & Payment Data (FY 2023)

22
Total Discharges
$12,837
Avg Total Costs
$10,989
Avg Medicare Payment

Cost by Severity Level

NY SPARCS hospital discharge data (2022) — costs reflect New York State hospitals

Severity Discharges Avg LOS Avg Charges Avg Costs Median Costs
Extreme 37 21.3 days $198,555 $77,777 $56,027
Major 203 6.5 days $80,088 $29,226 $21,407
Minor 611 2.2 days $44,185 $15,688 $12,224
Moderate 745 3 days $49,740 $16,799 $13,976

Frequently Asked Questions

How much does a hospital stay for shoulder, elbow or forearm procedures, except major joint procedures without cc/... cost?

The average Medicare payment for DRG 512 is $10,760. Average hospital costs are $12,837. Commercial insurance typically pays 150-250% of Medicare rates ($16,140 — $26,900).

How long is the hospital stay for DRG 512?

The average length of stay is 2.3 days. This varies by severity — NY data shows stays from 2.2 to 21.3 days depending on severity.

How much does this hospital stay cost without insurance?

Without insurance, you may be billed the hospital's chargemaster rate, which can be 3-5x the actual cost. Request an itemized bill and ask about financial assistance programs. Many hospitals offer 40-60% discounts for self-pay patients.

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