The hospital only gets paid for the tests and Operating room time, supplies etc.

The hospitals do not get paid for the organs.

Each region (urban centers or states based on population and geographical size) has a non profit OPO (organ procurement organization) that takes over all billing (once brain death has been determined) and has a nurse (separate from the hospital) that evaluates organ function with testing (blood, endoscopy first lungs, echocardiography for heart)

The OPO places the functional organs with transplant centers based on the list generated by UNOS. (United network for organ sharing)

The lists generated are specified by blood type, other blood tests, and then patients are ordered by degree of illness, sickest patients get offered the organs first. (This is done usually in larger regions like southern US, for instance, some organs have to be transplanted quickly less than 6hrs)

The OPO takes all costs And divides them by the number of organs of each type accepted by a transplant center for transplant. The accepting transplant center pays the price for the organ indirectly. It is called an organ acquisition fee. The transplant recipient’s insurer (either private or Medicare/Medicaid) pays the transplant center’s fee for the transplanted organ.