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   Fifty-five hospitals in 21 states, including one in the St. Louis area, have agreed to pay $34 million to the U.S. government to settle allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger payments from Medicare.  

   The Justice Department announced the settlement Tuesday over kyphoplasty procedures used to treat spinal fractures usually caused by osteoporosis.  

   Des Peres Hospital in west St. Louis County has agreed to pay $900,000 to satisfy its part of the settlement. 

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