Knee procedures without principal diagnosis of infection without complications in California
What 2 hospitals in California 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
$133,131
Hospital list price billed
Average payment
$20,702
Medicare + patient + other payers
Medicare paid
$14,739
Average per stay
Volume
31
Medicare hospital stays
Hospitals in California billed an average of $133,131 for knee procedures without principal diagnosis of infection without complications, about 6.4 times the average total payment of $20,702. That payment is 71% above the U.S. average 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 $20,702Billed $133,131
About 16¢ was paid for every $1 hospitals in California billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in California:
California hospitals: knee procedures without principal diagnosis of infection without 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 | 17 | $100,097 | $25,139 | $16,096 |
| Cedars-Sinai Medical CenterLos Angeles | 14 | $173,243 | $15,315 | $13,093 |
Knee procedures without principal diagnosis of infection without complications in other states
Questions
How much does knee procedures without principal diagnosis of infection without complications cost in California?
In 2024 Medicare data, a hospital stay for knee procedures without principal diagnosis of infection without complications (DRG 489) at 2 hospitals in California was billed at $133,131 on average, while the average total payment was $20,702, of which Medicare paid $14,739. 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 6.4 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.