Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota
What 70 hospitals in the U.S. charged and were paid for a Medicare hospital stay for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota (DRG 469), from 2024 Medicare claims.
Average charge
$180,053
Hospital list price billed
Average payment
$32,812
Medicare + patient + other payers
Medicare paid
$28,095
Average per stay
Volume
1,160
Medicare hospital stays
Hospitals in the U.S. billed an average of $180,053 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 5.5 times the average total payment of $32,812.
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 $32,812Billed $180,053
About 18¢ 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:
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
| Methodist Stone Oak HospitalSan Antonio, TX | $21,917 |
|---|---|
| New England Baptist HospitalBoston, MA | $26,271 |
| William Beaumont HospitalRoyal Oak, MI | $26,726 |
| New Hanover Regional Medical CenterWilmington, NC | $27,678 |
| Orlando Regional HealthcareOrlando, FL | $29,829 |
| NYU Hospitals CenterNew York, NY | $38,267 |
| Hospital for Special SurgeryNew York, NY | $40,227 |
| UCSF Medical CenterSan Francisco, CA | $56,776 |
| Stanford HospitalPalo Alto, CA | $58,310 |
Highest
| Stanford HospitalPalo Alto, CA | $58,310 |
|---|---|
| UCSF Medical CenterSan Francisco, CA | $56,776 |
| Hospital for Special SurgeryNew York, NY | $40,227 |
| NYU Hospitals CenterNew York, NY | $38,267 |
| Orlando Regional HealthcareOrlando, FL | $29,829 |
| New Hanover Regional Medical CenterWilmington, NC | $27,678 |
| William Beaumont HospitalRoyal Oak, MI | $26,726 |
| New England Baptist HospitalBoston, MA | $26,271 |
| Methodist Stone Oak HospitalSan Antonio, TX | $21,917 |
Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota 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 | $304,144 | $29,087 | – |
| California | 9 | $263,965 | $43,802 | $25,690 – $58,310 |
| Colorado | 3 | $314,581 | $46,630 | $23,870 – $87,976 |
| Florida | 4 | $183,162 | $28,243 | $20,969 – $38,065 |
| Illinois | 6 | $103,467 | $30,498 | $22,410 – $49,512 |
| Indiana | 1 | $83,387 | $23,585 | – |
| Iowa | 1 | $111,053 | $22,750 | – |
| Kansas | 2 | $195,269 | $26,988 | $25,340 – $28,382 |
| Massachusetts | 4 | $84,435 | $30,278 | $26,271 – $39,529 |
| Michigan | 2 | $104,073 | $28,669 | $26,726 – $32,201 |
| Minnesota | 2 | $87,358 | $36,796 | $31,712 – $42,244 |
| Missouri | 1 | $89,672 | $19,709 | – |
| Nevada | 1 | $272,253 | $28,513 | – |
| New Jersey | 3 | $145,859 | $29,614 | $24,647 – $36,639 |
| New York | 6 | $205,225 | $38,725 | $28,264 – $44,085 |
| North Carolina | 4 | $124,302 | $29,736 | $21,737 – $41,728 |
| Ohio | 1 | $115,429 | $32,231 | – |
| Oklahoma | 1 | $82,136 | $22,950 | – |
| Pennsylvania | 3 | $170,362 | $36,630 | $30,904 – $40,498 |
| South Dakota | 2 | $116,535 | $24,237 | $22,867 – $25,492 |
| Tennessee | 1 | $74,599 | $21,293 | – |
| Texas | 5 | $300,943 | $22,528 | $21,917 – $24,055 |
| Utah | 1 | $85,249 | $32,439 | – |
| Virginia | 2 | $313,986 | $26,397 | $22,094 – $31,874 |
| Washington | 2 | $144,956 | $31,820 | $29,583 – $34,260 |
| West Virginia | 1 | $93,423 | $23,985 | – |
| Wisconsin | 1 | $97,599 | $32,501 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 67 | $276,697 | $38,267 |
| New England Baptist HospitalBoston, MA | 66 | $57,372 | $26,271 |
| Hospital for Special SurgeryNew York, NY | 63 | $160,665 | $40,227 |
| Stanford HospitalPalo Alto, CA | 32 | $444,924 | $58,310 |
| Orlando Regional HealthcareOrlando, FL | 29 | $216,952 | $29,829 |
| UCSF Medical CenterSan Francisco, CA | 28 | $231,593 | $56,776 |
| Methodist Stone Oak HospitalSan Antonio, TX | 25 | $219,181 | $21,917 |
| New Hanover Regional Medical CenterWilmington, NC | 21 | $86,738 | $27,678 |
| William Beaumont HospitalRoyal Oak, MI | 20 | $117,574 | $26,726 |
| Northwestern Memorial HospitalChicago, IL | 19 | $128,457 | $30,965 |
| Methodist HospitalSan Antonio, TX | 19 | $230,345 | $22,703 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 18 | $436,910 | $41,977 |
| Evanston HospitalEvanston, IL | 18 | $100,767 | $27,118 |
| Advocate Lutheran General HospitalPark Ridge, IL | 18 | $77,969 | $29,127 |
| Lee Memorial HospitalFort Myers, FL | 17 | $141,136 | $24,296 |
Questions
How much does major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in the U.S.?
In 2024 Medicare data, a hospital stay for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota (DRG 469) at 70 hospitals in the U.S. was billed at $180,053 on average, while the average total payment was $32,812, of which Medicare paid $28,095. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota?
Among states with at least three hospitals reporting, the average total payment was highest in Colorado ($46,630), California ($43,802), New York ($38,725) and lowest in Texas ($22,528), Florida ($28,243), New Jersey ($29,614).
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 5.5 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.