Knee procedures with principal diagnosis of infection with complications in California
What 1 hospital in California charged and were paid for a Medicare hospital stay for knee procedures with principal diagnosis of infection with complications (DRG 486), from 2024 Medicare claims.
Average charge
$185,479
Hospital list price billed
Average payment
$39,724
Medicare + patient + other payers
Medicare paid
$28,412
Average per stay
Volume
13
Medicare hospital stays
Hospitals in California billed an average of $185,479 for knee procedures with principal diagnosis of infection with complications, about 4.7 times the average total payment of $39,724. That payment is 71% above the U.S. average of $23,210.
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 $39,724Billed $185,479
About 21¢ was paid for every $1 hospitals in California billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in California:
California hospitals: knee procedures with principal diagnosis of infection with complications
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 |
|---|---|---|---|---|
| UCSF Medical CenterSan Francisco | 13 | $185,479 | $39,724 | $28,412 |
Knee procedures with principal diagnosis of infection with complications in other states
Questions
How much does knee procedures with principal diagnosis of infection with complications cost in California?
In 2024 Medicare data, a hospital stay for knee procedures with principal diagnosis of infection with complications (DRG 486) at 1 hospital in California was billed at $185,479 on average, while the average total payment was $39,724, of which Medicare paid $28,412. 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 California, average charges were 4.7 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.