Medical billing in America, by the numbers
We analyzed what 2,871 US hospitals billed Medicare against what Medicare actually paid — data hardly anyone publishes hospital by hospital. Every figure below is drawn from public CMS datasets and is free to cite. If you write about medical bills, use these.
What the typical US hospital bills, per dollar Medicare actually pays for the same care.
Source: BillStand analysis of CMS Medicare Inpatient Hospitals by Provider & Service, 2024
The average charge-to-payment ratio across all hospitals — pulled higher than the median by extreme outliers.
Source: CMS Medicare Inpatient Hospitals, 2024
The widest gap found: one hospital billed this many times what Medicare pays.
Source: CMS Medicare Inpatient Hospitals, 2024
nonprofit hospitals (54% of all US hospitals) are legally required by IRS §501(r) to offer financial assistance.
Source: CMS Hospital General Information + IRS §501(r)
for-profit hospitals (21%) are NOT bound by §501(r) — a distinction almost no patient is told.
Source: CMS Hospital General Information
of patients said the hospital never told them financial assistance existed at all.
Source: Dollar For, 2024 (patient-advocacy research)
The states where hospital charges run furthest above what's paid
Median charge-to-payment ratio, by the state of the hospital. A higher number means bigger gaps between the sticker price and what the care is actually paid.
| State | Median |
|---|---|
| Nevada | 7.9× |
| Florida | 6.9× |
| New Jersey | 6.5× |
| Colorado | 5.5× |
| Arizona | 5.2× |
| State | Median |
|---|---|
| Maryland | 1.1× |
| Wyoming | 2.0× |
| Massachusetts | 2.0× |
| Hawaii | 2.7× |
| New York | 2.8× |
The single widest markup we found on a procedure
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC is billed, on average nationally, 7.5× what Medicare pays for it (MS-DRG 651). Every one of the 772 procedure groups is broken down on our bill-code directory.
Use this data
Every number on this page is computed from public U.S. Centers for Medicare & Medicaid Services datasets — the full pipeline and every source is on our methodology page, and the underlying figures are downloadable as clean CSVs from our open-data page. The government data is public domain; you are free to republish these numbers, and a link back to billstand.com/statistics is appreciated.