Knee procedures without principal diagnosis of infection with complications
What 11 hospitals in the U.S. charged and were paid for a Medicare hospital stay for knee procedures without principal diagnosis of infection with complications (DRG 488), from 2024 Medicare claims.
Average charge
$85,896
Hospital list price billed
Average payment
$20,222
Medicare + patient + other payers
Medicare paid
$16,674
Average per stay
Volume
154
Medicare hospital stays
Hospitals in the U.S. billed an average of $85,896 for knee procedures without principal diagnosis of infection with complications, about 4.2 times the average total payment of $20,222.
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 $20,222Billed $85,896
About 24¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Knee procedures without principal diagnosis of infection with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| California | 1 | $253,506 | $26,202 | – |
| Illinois | 1 | $62,628 | $25,014 | – |
| Iowa | 1 | $76,231 | $15,157 | – |
| Maryland | 1 | $17,314 | $15,051 | – |
| Massachusetts | 1 | $38,515 | $16,204 | – |
| Minnesota | 1 | $56,452 | $25,675 | – |
| New York | 1 | $94,001 | $24,037 | – |
| Pennsylvania | 1 | $178,684 | $18,938 | – |
| South Dakota | 1 | $40,820 | $13,953 | – |
| Tennessee | 1 | $83,073 | $18,467 | – |
| Utah | 1 | $31,491 | $16,893 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Hospital for Special SurgeryNew York, NY | 30 | $94,001 | $24,037 |
| Rush University Medical CenterChicago, IL | 14 | $62,628 | $25,014 |
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | 14 | $40,820 | $13,953 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 13 | $253,506 | $26,202 |
| Mercy Medical Center INCBaltimore, MD | 13 | $17,314 | $15,051 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 13 | $56,452 | $25,675 |
| New England Baptist HospitalBoston, MA | 12 | $38,515 | $16,204 |
| Lehigh Valley HospitalAllentown, PA | 12 | $178,684 | $18,938 |
| Iowa Methodist Medical CenterDes Moines, IA | 11 | $76,231 | $15,157 |
| Erlanger Medical CenterChattanooga, TN | 11 | $83,073 | $18,467 |
| St. George Regional HospitalSt George, UT | 11 | $31,491 | $16,893 |
Questions
How much does knee procedures without principal diagnosis of infection with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for knee procedures without principal diagnosis of infection with complications (DRG 488) at 11 hospitals in the U.S. was billed at $85,896 on average, while the average total payment was $20,222, of which Medicare paid $16,674. 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 the U.S., average charges were 4.2 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.