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Bilateral or multiple major joint procedures of lower extremity without major complications in Tennessee

What 2 hospitals in Tennessee 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.

DRG 462 Inpatient 2024 Medicare data
Average charge $96,567 Hospital list price billed
Average payment $22,103 Medicare + patient + other payers
Medicare paid $19,501 Average per stay
Volume 44 Medicare hospital stays

Hospitals in Tennessee billed an average of $96,567 for bilateral or multiple major joint procedures of lower extremity without major complications, about 4.4 times the average total payment of $22,103. That payment is 24% below 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 $22,103Billed $96,567

About 23¢ was paid for every $1 hospitals in Tennessee billed for this stay.

Tennessee hospitals: bilateral or multiple major joint procedures of lower extremity without major complications

Every Tennessee hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
St Thomas HospitalNashville 26 $122,360 $21,026 $18,937
Erlanger Medical CenterChattanooga 18 $59,311 $23,657 $20,316
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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 Tennessee?

In 2024 Medicare data, a hospital stay for bilateral or multiple major joint procedures of lower extremity without major complications (DRG 462) at 2 hospitals in Tennessee was billed at $96,567 on average, while the average total payment was $22,103, of which Medicare paid $19,501. 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 Tennessee, average charges were 4.4 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.