Bilateral or multiple major joint procedures of lower extremity without major complications in Texas
What 2 hospitals in Texas 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
$90,272
Hospital list price billed
Average payment
$19,725
Medicare + patient + other payers
Medicare paid
$16,896
Average per stay
Volume
45
Medicare hospital stays
Hospitals in Texas billed an average of $90,272 for bilateral or multiple major joint procedures of lower extremity without major complications, about 4.6 times the average total payment of $19,725. That payment is 32% 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 $19,725Billed $90,272
About 22¢ was paid for every $1 hospitals in Texas billed for this stay.
Texas hospitals: bilateral or multiple major joint procedures of lower extremity without major complications
Every Texas hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Texas Health Harris Methodist Hospital SouthlakeSouthlake | 30 | $103,672 | $18,949 | $17,372 |
| North Central Surgical Center LLPDallas | 15 | $63,472 | $21,277 | $15,946 |
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 Texas?
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 Texas was billed at $90,272 on average, while the average total payment was $19,725, of which Medicare paid $16,896. 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 Texas, average charges were 4.6 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.