Knee procedures without principal diagnosis of infection without complications
What 16 hospitals in the U.S. charged and were paid for a Medicare hospital stay for knee procedures without principal diagnosis of infection without complications (DRG 489), from 2024 Medicare claims.
Average charge
$58,630
Hospital list price billed
Average payment
$12,110
Medicare + patient + other payers
Medicare paid
$9,041
Average per stay
Volume
231
Medicare hospital stays
Hospitals in the U.S. billed an average of $58,630 for knee procedures without principal diagnosis of infection without complications, about 4.8 times the average total payment of $12,110.
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 $12,110Billed $58,630
About 21¢ 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 without 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 |
|---|---|---|---|---|
| Alabama | 1 | $22,284 | $9,012 | – |
| Arkansas | 1 | $21,769 | $8,012 | – |
| California | 2 | $133,131 | $20,702 | $15,315 – $25,139 |
| Colorado | 1 | $49,090 | $10,668 | – |
| Illinois | 2 | $42,194 | $12,555 | $9,032 – $15,240 |
| Indiana | 1 | $38,357 | $9,356 | – |
| New York | 1 | $75,294 | $16,278 | – |
| Ohio | 2 | $51,469 | $8,888 | $8,339 – $9,363 |
| Oklahoma | 1 | $36,276 | $8,010 | – |
| South Carolina | 1 | $81,314 | $8,182 | – |
| South Dakota | 1 | $40,231 | $8,556 | – |
| Utah | 2 | $31,626 | $11,718 | $9,967 – $13,469 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Hospital for Special SurgeryNew York, NY | 25 | $75,294 | $16,278 |
| Rush University Medical CenterChicago, IL | 21 | $36,463 | $15,240 |
| UCSF Medical CenterSan Francisco, CA | 17 | $100,097 | $25,139 |
| East Cooper Reg Med CenterMt Pleasant, SC | 17 | $81,314 | $8,182 |
| Sarah Bush Lincoln Health CenterMattoon, IL | 16 | $49,716 | $9,032 |
| Mount Carmel New Albany Surgical HospitalNew Albany, OH | 15 | $62,453 | $9,363 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 14 | $173,243 | $15,315 |
| Crystal Clinic Orthopaedic CenterAkron, OH | 13 | $38,796 | $8,339 |
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | 13 | $40,231 | $8,556 |
| Arkansas Surgical HospitalNorth Little Rock, AR | 12 | $21,769 | $8,012 |
| University Health Care/Univ Hospitals and ClinicsSalt Lake City, UT | 12 | $34,012 | $13,469 |
| St. George Regional HospitalSt George, UT | 12 | $29,241 | $9,967 |
| Jack Hughston Memorial HospitalPhenix City, AL | 11 | $22,284 | $9,012 |
| St Mary's Hospital and Medical CenterGrand Junction, CO | 11 | $49,090 | $10,668 |
| Orthoindy HospitalIndianapolis, IN | 11 | $38,357 | $9,356 |
Questions
How much does knee procedures without principal diagnosis of infection without complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for knee procedures without principal diagnosis of infection without complications (DRG 489) at 16 hospitals in the U.S. was billed at $58,630 on average, while the average total payment was $12,110, of which Medicare paid $9,041. 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 4.8 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.