Bilateral or multiple major joint procedures of lower extremity without major complications
What 25 hospitals in the U.S. charged and were paid for a Medicare hospital stay for bilateral or multiple major joint procedures of lower extremity without major complications (DRG 462), from 2024 Medicare claims.
Average charge
$123,097
Hospital list price billed
Average payment
$29,055
Medicare + patient + other payers
Medicare paid
$22,968
Average per stay
Volume
590
Medicare hospital stays
Hospitals in the U.S. billed an average of $123,097 for bilateral or multiple major joint procedures of lower extremity without major complications, about 4.2 times the average total payment of $29,055.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $29,055Billed $123,097
About 24¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Texas Health Harris Methodist Hospital SouthlakeSouthlake, TX | $18,949 |
|---|---|
| St Thomas HospitalNashville, TN | $21,026 |
| Naples Community HospitalNaples, FL | $21,799 |
| Jefferson Health- NortheastPhiladelphia, PA | $24,746 |
| Henry County Memorial HospitalNew Castle, IN | $25,893 |
| Glendale Adventist Medical CtrGlendale, CA | $30,873 |
| Morristown Memorial HospitalMorristown, NJ | $31,711 |
| Scripps Green HospitalLa Jolla, CA | $32,338 |
| Montefiore New Rochelle HospitalNew Rochelle, NY | $39,180 |
| Hospital for Special SurgeryNew York, NY | $45,773 |
Highest
| Hospital for Special SurgeryNew York, NY | $45,773 |
|---|---|
| Montefiore New Rochelle HospitalNew Rochelle, NY | $39,180 |
| Scripps Green HospitalLa Jolla, CA | $32,338 |
| Morristown Memorial HospitalMorristown, NJ | $31,711 |
| Glendale Adventist Medical CtrGlendale, CA | $30,873 |
| Henry County Memorial HospitalNew Castle, IN | $25,893 |
| Jefferson Health- NortheastPhiladelphia, PA | $24,746 |
| Naples Community HospitalNaples, FL | $21,799 |
| St Thomas HospitalNashville, TN | $21,026 |
| Texas Health Harris Methodist Hospital SouthlakeSouthlake, TX | $18,949 |
Bilateral or multiple major joint procedures of lower extremity without major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $43,360 | $21,512 | – |
| California | 4 | $187,168 | $32,705 | $27,756 – $47,198 |
| Florida | 1 | $120,908 | $21,799 | – |
| Hawaii | 1 | $90,083 | $35,644 | – |
| Indiana | 1 | $99,271 | $25,893 | – |
| Kansas | 1 | $55,805 | $29,671 | – |
| New Jersey | 1 | $110,338 | $31,711 | – |
| New York | 4 | $153,119 | $40,178 | $31,226 – $45,773 |
| North Carolina | 1 | $147,033 | $24,818 | – |
| North Dakota | 1 | $64,038 | $23,626 | – |
| Oregon | 1 | $97,652 | $23,823 | – |
| Pennsylvania | 4 | $80,496 | $23,679 | $19,666 – $25,263 |
| Tennessee | 2 | $96,567 | $22,103 | $21,026 – $23,657 |
| Texas | 2 | $90,272 | $19,725 | $18,949 – $21,277 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Scripps Green HospitalLa Jolla, CA | 71 | $191,396 | $32,338 |
| Jefferson Health- NortheastPhiladelphia, PA | 62 | $65,635 | $24,746 |
| Hospital for Special SurgeryNew York, NY | 46 | $189,583 | $45,773 |
| Glendale Adventist Medical CtrGlendale, CA | 35 | $192,523 | $30,873 |
| Henry County Memorial HospitalNew Castle, IN | 33 | $99,271 | $25,893 |
| Montefiore New Rochelle HospitalNew Rochelle, NY | 31 | $130,787 | $39,180 |
| Texas Health Harris Methodist Hospital SouthlakeSouthlake, TX | 30 | $103,672 | $18,949 |
| St Thomas HospitalNashville, TN | 26 | $122,360 | $21,026 |
| Naples Community HospitalNaples, FL | 21 | $120,908 | $21,799 |
| Morristown Memorial HospitalMorristown, NJ | 20 | $110,338 | $31,711 |
| Pratt Regional Medical CenterPratt, KS | 19 | $55,805 | $29,671 |
| Erlanger Medical CenterChattanooga, TN | 18 | $59,311 | $23,657 |
| Straub Clinic and HospitalHonolulu, HI | 17 | $90,083 | $35,644 |
| St Francis Hospital, RoslynRoslyn, NY | 17 | $122,310 | $32,650 |
| Sacred Heart Medical Center - RiverbendSpringfield, OR | 16 | $97,652 | $23,823 |
Questions
How much does bilateral or multiple major joint procedures of lower extremity without major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for bilateral or multiple major joint procedures of lower extremity without major complications (DRG 462) at 25 hospitals in the U.S. was billed at $123,097 on average, while the average total payment was $29,055, of which Medicare paid $22,968. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for bilateral or multiple major joint procedures of lower extremity without major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($40,178), California ($32,705), Pennsylvania ($23,679) and lowest in Pennsylvania ($23,679), California ($32,705), New York ($40,178).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in the U.S., average charges were 4.2 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.