Lower extremity and humerus procedures except hip, foot and femur without complications
What 112 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 without complications (DRG 494), from 2024 Medicare claims.
Average charge
$101,370
Hospital list price billed
Average payment
$18,176
Medicare + patient + other payers
Medicare paid
$14,303
Average per stay
Volume
1,650
Medicare hospital stays
Hospitals in the U.S. billed an average of $101,370 for lower extremity and humerus procedures except hip, foot and femur without complications, about 5.6 times the average total payment of $18,176.
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 $18,176Billed $101,370
About 18¢ 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
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $14,095 |
|---|---|
| Sarasota Memorial HospitalSarasota, FL | $14,709 |
| Ocala Regional Medical CenterOcala, FL | $15,321 |
| Orlando Regional HealthcareOrlando, FL | $16,009 |
| Evanston HospitalEvanston, IL | $16,287 |
| Univ of Tn Mem HospitalKnoxville, TN | $16,552 |
| Gulf Coast Medical Center Lee HealthFort Myers, FL | $17,203 |
| Christiana Care Health Services, INC.Newark, DE | $18,712 |
| Baystate Medical CenterSpringfield, MA | $19,467 |
| North Shore University HospitalManhasset, NY | $20,402 |
Highest
| Hospital for Special SurgeryNew York, NY | $27,739 |
|---|---|
| Huntsville HospitalHuntsville, AL | $26,313 |
| University HospitalStony Brook, NY | $23,875 |
| Massachusetts General HospitalBoston, MA | $22,116 |
| Clarian Health PartnersIndianapolis, IN | $21,340 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $20,438 |
| North Shore University HospitalManhasset, NY | $20,402 |
| Baystate Medical CenterSpringfield, MA | $19,467 |
| Christiana Care Health Services, INC.Newark, DE | $18,712 |
| Gulf Coast Medical Center Lee HealthFort Myers, FL | $17,203 |
Lower extremity and humerus procedures except hip, foot and femur 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 | $92,490 | $26,313 | – |
| Alaska | 1 | $140,096 | $21,241 | – |
| Arizona | 8 | $121,914 | $15,701 | $13,672 – $20,812 |
| Arkansas | 1 | $26,279 | $13,316 | – |
| California | 11 | $145,379 | $20,468 | $18,007 – $27,479 |
| Delaware | 1 | $64,857 | $18,712 | – |
| Florida | 13 | $127,976 | $16,800 | $12,707 – $23,928 |
| Georgia | 1 | $129,216 | $33,648 | – |
| Idaho | 1 | $62,073 | $15,385 | – |
| Illinois | 1 | $57,420 | $16,287 | – |
| Indiana | 3 | $106,845 | $17,794 | $13,577 – $21,340 |
| Iowa | 2 | $69,380 | $13,592 | $13,511 – $13,685 |
| Kansas | 2 | $113,614 | $13,801 | $12,775 – $14,554 |
| Kentucky | 1 | $94,314 | $13,591 | – |
| Louisiana | 1 | $93,422 | $13,698 | – |
| Maryland | 3 | $24,040 | $22,131 | $16,438 – $26,249 |
| Massachusetts | 5 | $62,093 | $19,647 | $15,724 – $22,847 |
| Michigan | 1 | $38,325 | $19,616 | – |
| Minnesota | 1 | $55,642 | $17,081 | – |
| Mississippi | 2 | $55,725 | $15,355 | $13,580 – $17,130 |
| Missouri | 2 | $60,180 | $16,932 | $13,303 – $20,134 |
| Nebraska | 1 | $60,899 | $14,909 | – |
| Nevada | 1 | $78,712 | $17,078 | – |
| New Hampshire | 1 | $68,656 | $15,187 | – |
| New Jersey | 2 | $129,200 | $17,890 | $16,148 – $19,631 |
| New York | 9 | $98,251 | $23,257 | $20,054 – $27,940 |
| North Carolina | 5 | $89,481 | $17,172 | $14,095 – $22,504 |
| Ohio | 4 | $95,455 | $16,444 | $13,542 – $19,752 |
| Oregon | 1 | $61,731 | $20,117 | – |
| Pennsylvania | 6 | $80,358 | $17,871 | $14,558 – $21,525 |
| South Carolina | 5 | $117,659 | $15,759 | $11,977 – $20,654 |
| Tennessee | 3 | $61,950 | $15,989 | $14,433 – $16,737 |
| Texas | 6 | $135,913 | $15,544 | $12,723 – $17,027 |
| Utah | 1 | $41,605 | $19,663 | – |
| Virginia | 2 | $200,510 | $14,328 | $12,786 – $16,430 |
| Washington | 1 | $98,805 | $22,775 | – |
| West Virginia | 1 | $58,300 | $19,486 | – |
| Wisconsin | 1 | $88,061 | $20,438 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Ocala Regional Medical CenterOcala, FL | 32 | $174,480 | $15,321 |
| Sarasota Memorial HospitalSarasota, FL | 31 | $103,534 | $14,709 |
| Gulf Coast Medical Center Lee HealthFort Myers, FL | 31 | $101,318 | $17,203 |
| Hospital for Special SurgeryNew York, NY | 29 | $133,446 | $27,739 |
| Christiana Care Health Services, INC.Newark, DE | 26 | $64,857 | $18,712 |
| University HospitalStony Brook, NY | 25 | $106,027 | $23,875 |
| Massachusetts General HospitalBoston, MA | 24 | $97,632 | $22,116 |
| Baystate Medical CenterSpringfield, MA | 23 | $36,341 | $19,467 |
| North Shore University HospitalManhasset, NY | 23 | $116,896 | $20,402 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | 23 | $95,587 | $14,095 |
| Univ of Tn Mem HospitalKnoxville, TN | 23 | $46,774 | $16,552 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 23 | $88,061 | $20,438 |
| Clarian Health PartnersIndianapolis, IN | 22 | $137,522 | $21,340 |
| Huntsville HospitalHuntsville, AL | 20 | $92,490 | $26,313 |
| Orlando Regional HealthcareOrlando, FL | 20 | $166,081 | $16,009 |
Questions
How much does lower extremity and humerus procedures except hip, foot and femur without complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur without complications (DRG 494) at 112 hospitals in the U.S. was billed at $101,370 on average, while the average total payment was $18,176, of which Medicare paid $14,303. 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 without complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($23,257), Maryland ($22,131), California ($20,468) and lowest in Texas ($15,544), Arizona ($15,701), South Carolina ($15,759).
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 5.6 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.