Lower extremity and humerus procedures except hip, foot and femur with major complications
What 85 hospitals in the U.S. charged and were paid for a Medicare hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492), from 2024 Medicare claims.
Average charge
$171,636
Hospital list price billed
Average payment
$34,208
Medicare + patient + other payers
Medicare paid
$28,955
Average per stay
Volume
1,225
Medicare hospital stays
Hospitals in the U.S. billed an average of $171,636 for lower extremity and humerus procedures except hip, foot and femur with major complications, about 5.0 times the average total payment of $34,208.
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 $34,208Billed $171,636
About 20¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Gulf Coast Medical Center Lee HealthFort Myers, FL | $23,387 |
|---|---|
| Via Christi Hospitals Wichita INCWichita, KS | $25,062 |
| Orlando Regional HealthcareOrlando, FL | $25,755 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $27,379 |
| Providence Sacred Heart Medical CenterSpokane, WA | $30,135 |
| St Vincent Hospital & Health ServicesIndianapolis, IN | $31,747 |
| Christiana Care Health Services, INC.Newark, DE | $39,040 |
| University of Kentucky HospLexington, KY | $44,652 |
| University of California Davis Medical CenterSacramento, CA | $57,842 |
Highest
| University of California Davis Medical CenterSacramento, CA | $57,842 |
|---|---|
| University of Kentucky HospLexington, KY | $44,652 |
| Christiana Care Health Services, INC.Newark, DE | $39,040 |
| St Vincent Hospital & Health ServicesIndianapolis, IN | $31,747 |
| Providence Sacred Heart Medical CenterSpokane, WA | $30,135 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $27,379 |
| Orlando Regional HealthcareOrlando, FL | $25,755 |
| Via Christi Hospitals Wichita INCWichita, KS | $25,062 |
| Gulf Coast Medical Center Lee HealthFort Myers, FL | $23,387 |
Lower extremity and humerus procedures except hip, foot and femur with major 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 |
|---|---|---|---|---|
| Alaska | 1 | $247,704 | $34,677 | – |
| Arizona | 2 | $160,047 | $29,328 | $22,293 – $37,536 |
| California | 6 | $381,464 | $48,534 | $34,740 – $66,487 |
| Colorado | 1 | $246,779 | $32,433 | – |
| Delaware | 1 | $122,276 | $39,040 | – |
| Florida | 8 | $204,818 | $27,000 | $22,563 – $35,482 |
| Georgia | 1 | $197,386 | $31,586 | – |
| Illinois | 1 | $148,353 | $44,148 | – |
| Indiana | 4 | $136,059 | $28,861 | $22,540 – $34,282 |
| Iowa | 2 | $168,539 | $31,166 | $22,157 – $39,424 |
| Kansas | 2 | $100,996 | $24,504 | $23,236 – $25,062 |
| Kentucky | 3 | $153,963 | $36,220 | $21,572 – $44,652 |
| Maryland | 2 | $56,339 | $51,053 | $40,646 – $57,414 |
| Massachusetts | 5 | $79,487 | $42,167 | $26,523 – $56,901 |
| Minnesota | 3 | $106,978 | $35,686 | $25,543 – $52,431 |
| Missouri | 4 | $130,198 | $31,051 | $24,139 – $39,691 |
| Montana | 1 | $75,154 | $26,152 | – |
| Nevada | 2 | $215,690 | $34,586 | $29,283 – $39,536 |
| New Hampshire | 1 | $90,687 | $26,088 | – |
| New Jersey | 1 | $165,180 | $33,291 | – |
| New York | 4 | $275,996 | $46,024 | $40,494 – $57,299 |
| North Carolina | 3 | $149,423 | $31,674 | $27,379 – $38,755 |
| Ohio | 3 | $119,165 | $29,289 | $23,359 – $37,349 |
| Oklahoma | 2 | $116,042 | $24,272 | $22,923 – $26,071 |
| Pennsylvania | 1 | $258,360 | $33,719 | – |
| Rhode Island | 1 | $106,013 | $44,276 | – |
| South Carolina | 2 | $219,985 | $27,661 | $25,480 – $29,507 |
| Tennessee | 2 | $153,283 | $35,744 | $30,788 – $39,380 |
| Texas | 7 | $186,862 | $31,432 | $22,491 – $60,545 |
| Utah | 2 | $116,424 | $32,082 | $26,689 – $38,946 |
| Virginia | 3 | $89,530 | $29,851 | $26,794 – $32,892 |
| Washington | 1 | $113,982 | $30,135 | – |
| Wisconsin | 3 | $151,851 | $34,745 | $24,693 – $42,014 |
Hospitals that treat the most Medicare patients for this
Questions
How much does lower extremity and humerus procedures except hip, foot and femur with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with major complications (DRG 492) at 85 hospitals in the U.S. was billed at $171,636 on average, while the average total payment was $34,208, of which Medicare paid $28,955. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for lower extremity and humerus procedures except hip, foot and femur with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($48,534), New York ($46,024), Massachusetts ($42,167) and lowest in Florida ($27,000), Indiana ($28,861), Ohio ($29,289).
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 5.0 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.