At the median TEAM hospital, the hospital stay uses 38% to 70% of the target, by surgery
Kent Applied estimate of the inpatient stay's share of the 2026 target price at the median TEAM hospital, by surgery. The rest is left for doctors and the 30 days after discharge.
Show the numbers as a table
| Category | Hospital stay | Left for doctors and the 30 days after discharge |
|---|---|---|
| Coronary bypass | 70% | 30% |
| Major bowel surgery | 63% | 37% |
| Spinal fusion | 59% | 41% |
| Joint replacement | 50% | 50% |
| Hip or femur fracture | 38% | 62% |
About the data
- Sources
- Kent Applied, TEAM position report and methodFig. 1 table and How we count the stay
- CMS, TEAM PY1 preliminary target prices (opens in a new tab)Preliminary target price by region and MS-DRG
- CMS, Medicare Inpatient Hospitals by Provider and Service, 2024 (opens in a new tab)Discharges and average Medicare payment by hospital and MS-DRG
- CMS, TEAM episode construction specifications (opens in a new tab)how episode spending is added up, in standardized dollars
- CMS, payment standardization method (opens in a new tab)what standardization keeps and takes out
- CMS, TEAM model page (opens in a new tab)Model overview: what target prices cover and when an episode ends
- Method
- This is a Kent Applied analysis of public CMS files. Each hospital's 2024 Medicare inpatient stays for the five surgeries are counted the way TEAM counts them, in CMS standardized dollars: wage, teaching and low-income add-ons come out and outlier payments stay in. The stays are moved to 2026 prices and divided by CMS's 2026 preliminary target price for the hospital's region and mix of cases. The target used is CMS's regional price for the hospital's mix of cases, before CMS adjusts it for the hospital's own patients. Each bar is the median across hospitals with at least 11 stays in that surgery, 144 to 461 hospitals. It covers inpatient stays only. Spinal fusion leaves out 2024 stays billed under codes CMS retired that October. The full method, and the numbers for every hospital with at least 11 stays in a surgery, are at kentapplied.com/team-report/.
- Published
- Updated
Free to share and embed with credit to Kent Applied (CC BY 4.0). The source data keeps its own terms.
Related charts
- From the blog
A TEAM hospital in Track 3 can owe CMS up to 20% of its total target price in a year
CMS, TEAM Model Overview slides (updated September 2026); 42 CFR 512.550, TEAM reconciliation (eCFR) - From the blog
Length of stay rose most for patients going to psychiatric hospitals or skilled nursing
American Hospital Association, Increasing Delays in Timely Discharges issue brief (December 2022) - From the blog
Finding a place that would take the patient caused the most discharge delay days
HANYS, The scope of complex case discharge delays in New York state (2023) - From the blog
Payers initially denied nearly 12% of hospital and physician claims in 2024
Kodiak Solutions, press release on 2024 initial denial rates (May 21, 2025)
Sources for the figures above: 42 CFR 512.550, Reconciliation process and determination of the reconciliation payment or repayment amount (opens in a new tab); American Hospital Association, Increasing Delays in Timely Discharges issue brief (December 2022) (opens in a new tab); HANYS, The scope of complex case discharge delays in New York state (2023) (opens in a new tab); Rate of initial denials of medical insurance claims continued to rise in 2024, Kodiak Solutions proprietary data show (opens in a new tab).
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