The 35 most expensive reasons you might have to visit a hospital in the US and how much it cost
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- Hospital stays are expensive — adding up to more than $384.5 billion a year in the US, according to recent data.
- The average hospital stay costs over $10,000, but the amount varies widely depending on the medical condition.
- The top 35 most expensive conditions account for more than 70% of all hospital costs in the US.
Any hospital visit can be scary — and frighteningly expensive.
The average hospital stay in the US costs just over $10,700, based on an analysis of recent data from the Healthcare Cost and Utilization Project (HCUP).
Using the 2014 National Inpatient Survey from the Agency for Healthcare Research and Quality, HCUP found the hospital visits and costs associated with different medical conditions classified by the Clinical Classifications Software principal diagnosis category. In total, there were 35.4 million hospital stays with an aggregate cost of $384.5 billion.
Routine childbirth accounted for the most stays — over 3.8 million — but is a relatively low-cost hospital trip compared to other conditions at $3,600. Of all hospital stays billed to Medicaid, 23.1% fell in this category.
The 35 most expensive conditions accounted for 70% of all hospital costs in the US. Septicemia — also called sepsis, a life-threatening reaction to an infection — created the greatest total cost at $27 billion. But, because of the large number of patients treated for the condition, it did not have the highest average cost per treatment. Heart and lung conditions also show up frequently when looking at the most expensive illnesses.
Who paid the hospital bill tells a different story, and is an important piece of the national debate on health care. Medicare covered 46% of that cost, with Medicaid pitching in 17%. Private insurance paid for 28% of the cost, while 5% went to patients who were uninsured.
In addition to what patients are going to the hospital for, where they are can also affect costs. A trip to the hospital in the US can vary a great deal based on where you live.
We went through the 50 conditions with the highest total hospital cost and found the average cost per hospital stay based on how many visits were made for each condition. These are the 35 conditions with the highest average cost:
35. Pancreatic disorders
Acute pancreatitis, chronic pancreatitis, hereditary pancreatitis, and pancreatic cancer are several of the more common disorders that lead to digestive problems in the pancreas.
Average cost per stay: $9,727
Percent of all US hospital stays: 0.9%
34. Pneumonia
Pneumonia is a lung condition — an infectious inflammation of the air sacs.
Average cost per stay: $9,793
Percent of all US hospital stays: 2.5%
33. Diabetes mellitus with complications
Conditions that occur from poor treatment of diabetes are wide-ranging, from vascular diseases, blindness, and chronic kidney disease.
Average cost per stay: $9,850
Percent of all US hospital stays: 1.5%
32. Diverticulosis and diverticulitis
Diverticulosis is the presence of bulging pouches in the digestive track and diverticulitis occurs when the pouches become inflamed or infected.
Average cost per stay: $10,169
Percent of all US hospital stays: 0.8%
31. Cardiac dysrhythmias
Cardiac dysrhythmia is the medical term for an irregular heartbeat.
Average cost per stay: $10,191
Percent of all US hospital stays: 1.9%
30. Intestinal obstruction without hernia
Intestinal obstruction is a food or liquid blockage that may be caused by Crohn's Disease, colon cancer, or other diseases.
Average cost per stay: $10,944
Percent of all US hospital stays: 1.0%
29. Congestive heart failure
Congestive heat failure is the inability to pump an adequate amount of blood through the body and can be caused by many diseases.
Average cost per stay: $11,500
Percent of all US hospital stays: 2.5%
28 . Other nervous system disorders
Trauma, infections, and tumors are some of the many conditions that afflict the brain, spine, nerves, eyes, ears, or other parts of the nervous system.
Average cost per stay: $11,538
Percent of all US hospital stays: 0.7%
27. Other gastrointestinal disorders
Food allergies, lactose intolerance, and celiac disease are some of the many disorders that harm functionality of the stomach and intestines.
Average cost per stay: $11,564
Percent of all US hospital stays: 0.6%
26. Pulmonary heart disease
A high blood pressure that affects lung arteries and the right side of your heart results in pulmonary hypertension.
Average cost per stay: $11,564
Percent of all US hospital stays: 0.5%
25. Biliary tract disease
Biliary diseases are a group of conditions that affect the biliary system — including gallstones and pancreatitis.
Average cost per stay: $11,764
Percent of all US hospital stays: 1.1%
24. Hypertension with complications and secondary hypertension
Unlike pulmonary hypertension (heart disease), secondary hypertension is high blood pressure caused by another medical condition.
Average cost per stay: $12,164
Percent of all US hospital stays: 0.7%
23. Other nutritional, endocrine, and metabolic disorders
Osteoporosis, cystic fibrosis, and obesity are major diseases related to glands and metabolism.
Average cost per stay: $12,173
Percent of all US hospital stays: 0.6%
22. Complications of surgical procedures or medical care
Any side effect of surgery or a basic medical procedure is included here.
Average cost per stay: $13,565
Percent of all US hospital stays: 1.3%
21. Rehabilitation care, fitting of prostheses, and adjustment of devices
Rehabilitation includes "services that help you keep, get back, or improve skills and functioning for daily living that have been lost or impaired because you were sick, hurt, or disabled."
Average cost per stay: $13,877
Percent of all US hospital stays: 1.1%
20. Other fractures
This category includes broken bones that are not in their own category such as skull breaks.
Average cost per stay: $14,149
Percent of all US hospital stays: 0.6%
19. Abdominal hernia
A hernia is the protrusion of an organ through tissue and often occurs by the pelvic floor or abdominal wall.
Average cost per stay: $14,447
Percent of all US hospital stays: 0.5%
18. Acute cerebrovascular disease
Cerebrovascular disease impacts the blood flow in the brain and often results in strokes.
Average cost per stay: $15,378
Percent of all US hospital stays: 1.7%
17. Osteoarthritis
Osteoarthritis — or degenerative joint disease — is the wearing down of tissue between joints.
Average cost per stay: $15,897
Percent of all US hospital stays: 3.0%
16. Maintenance chemotherapy, radiotherapy
Chemo and radiation therapy are both types of cancer treatment.
Average cost per stay: $15,988
Percent of all US hospital stays: 0.4%
15. Fracture of neck of femur (hip)
Breaks in the neck of the femur are common among athletes and elderly individuals with osteoporosis.
Average cost per stay: $16,133
Percent of all US hospital stays: 0.9%
14. Peripheral and visceral atherosclerosis
Atherosclerosis restricts blood flow to the heart by clogging of the inner walls of the arteries.
Average cost per stay: $16,771
Percent of all US hospital stays: 0.4%
13. Fracture of lower limb
Broken hips, knees, tibias, ankles, and other lower body bones are included here.
Average cost per stay: $16,796
Percent of all US hospital stays: 0.6%
12. Secondary malignancies
New cancers that arrive as a result of treatment of a first cancer are described as secondary malignancies.
Average cost per stay: $17,163
Percent of all US hospital stays: 0.5%
11. Cancer of bronchus, lung
Lung cancer — or bronchial carcinoma — is mainly caused by smoking.
Average cost per stay: $17,530
Percent of all US hospital stays: 0.4%
10. Respiratory failure, insufficiency, arrest (adult)
Respiratory failure and insufficiency happens when the lungs cannot produce enough oxygen or expel enough carbon dioxide. Respiratory arrest is the cessation of breathing.
Average cost per stay: $17,868
Percent of all US hospital stays: 1.2%
9. Septicemia
Septicemia — or sepsis — is blood poisoning caused by a bacterial infection.
Average cost per stay: $18,031
Percent of all US hospital stays: 4.3%
8. Spondylosis, intervertebral disc disorders, other back problems
Spondylosis refers to any degeneration of the spine. Invertebral disc disorders is the breakdown of the discs inbetween the bones of the spine.
Average cost per stay: $18,978
Percent of all US hospital stays: 1.5%
7. Intracranial injury
A traumatic brain injury is a serious blow to the head causing brain dysfunction.
Average cost per stay: $19,539
Percent of all US hospital stays: 0.6%
6. Complication of device, implant or graft
Devices, implants, and grafts are placed in the body during surgery to correct a clinical condition.
Average cost per stay: $20,175
Percent of all US hospital stays: 1.8%
5. Acute myocardial infarction (heart attack)
Acute myocardial infarction is the medical name for a heart attack.
Average cost per stay: $20,246
Percent of all US hospital stays: 1.7%
4. Coronary atherosclerosis
Coronary atherosclerosis is a heart disease caused by plaque buildup in arteries, preventing proper blood flow.
Average cost per stay: $20,936
Percent of all US hospital stays: 1.1%
3. Aortic, peripheral, and visceral artery aneurysms
Aneurysms have different names depending on where the weakened artery is located.
Average cost per stay: $34,656
Percent of all US hospital stays: 0.2%
2. Heart valve disorders
Heart valve disorders is a catch-all term for any illness stemming from the improper use of any of the four heart valves that controls blood flow.
Average cost per stay: $42,647
Percent of all US hospital stays: 0.4%
1. Cardiac and circulatory congenital anomalies
Congenital heart disease and heart murmurs are among this group of heart and lung problems.
Average cost per stay: $63,460
Percent of all US hospital stays: 0.1%
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