Bilateral or multiple major joint procedures of lower extremity without major complications in New York
What 4 hospitals in New York 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
$153,119
Hospital list price billed
Average payment
$40,178
Medicare + patient + other payers
Medicare paid
$24,639
Average per stay
State rank
#3 of 3
1 = lowest average payment
Hospitals in New York billed an average of $153,119 for bilateral or multiple major joint procedures of lower extremity without major complications, about 3.8 times the average total payment of $40,178. That payment is 38% 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.
Paid $40,178Billed $153,119
About 26¢ was paid for every $1 hospitals in New York billed for this stay.
New York hospitals: bilateral or multiple major joint procedures of lower extremity without major complications
Every New York hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Hospital for Special SurgeryNew York | 46 | $189,583 | $45,773 | $27,061 |
| Montefiore New Rochelle HospitalNew Rochelle | 31 | $130,787 | $39,180 | $25,286 |
| St Francis Hospital, RoslynRoslyn | 17 | $122,310 | $32,650 | $20,002 |
| Peconic Bay Medical CenterRiverhead | 11 | $111,184 | $31,226 | $19,851 |
Lowest and highest payments in New York
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.
Lowest
| Peconic Bay Medical CenterRiverhead, NY | $31,226 |
|---|---|
| St Francis Hospital, RoslynRoslyn, NY | $32,650 |
| 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 |
| St Francis Hospital, RoslynRoslyn, NY | $32,650 |
| Peconic Bay Medical CenterRiverhead, NY | $31,226 |
Bilateral or multiple major joint procedures of lower extremity without major complications in other states
Questions
How much does bilateral or multiple major joint procedures of lower extremity without major complications cost in New York?
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 New York was billed at $153,119 on average, while the average total payment was $40,178, of which Medicare paid $24,639. Your own cost depends on your insurance, deductible and the hospital.
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 New York, average charges were 3.8 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.