What 4 hospitals in California 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.
Hospitals in California billed an average of $187,168 for bilateral or multiple major joint procedures of lower extremity without major complications, about 5.7 times the average total payment of $32,705. That payment is 13% above the U.S. average 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.
About 17¢ was paid for every $1 hospitals in California billed for this stay.
Every California hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Scripps Green HospitalLa Jolla | 71 | $191,396 | $32,338 | $29,662 |
| Glendale Adventist Medical CtrGlendale | 35 | $192,523 | $30,873 | $29,253 |
| Hoag Orthopedic InstituteIrvine | 14 | $126,507 | $27,756 | $19,414 |
| UCSF Medical CenterSan Francisco | 11 | $220,039 | $47,198 | $43,517 |
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| Hoag Orthopedic InstituteIrvine, CA | $27,756 |
|---|---|
| Glendale Adventist Medical CtrGlendale, CA | $30,873 |
| Scripps Green HospitalLa Jolla, CA | $32,338 |
| UCSF Medical CenterSan Francisco, CA | $47,198 |
| UCSF Medical CenterSan Francisco, CA | $47,198 |
|---|---|
| Scripps Green HospitalLa Jolla, CA | $32,338 |
| Glendale Adventist Medical CtrGlendale, CA | $30,873 |
| Hoag Orthopedic InstituteIrvine, CA | $27,756 |
In 2024 Medicare data, a hospital stay for bilateral or multiple major joint procedures of lower extremity without major complications (DRG 462) at 4 hospitals in California was billed at $187,168 on average, while the average total payment was $32,705, of which Medicare paid $29,621. Your own cost depends on your insurance, deductible and the hospital.
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 California, average charges were 5.7 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.