Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in California
What 9 hospitals in California 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
$263,965
Hospital list price billed
Average payment
$43,802
Medicare + patient + other payers
Medicare paid
$38,621
Average per stay
State rank
#9 of 10
1 = lowest average payment
Hospitals in California billed an average of $263,965 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 6.0 times the average total payment of $43,802. That payment is 33% above the U.S. average 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 $43,802Billed $263,965
About 17¢ 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: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota
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 |
|---|---|---|---|---|
| Stanford HospitalPalo Alto | 32 | $444,924 | $58,310 | $51,693 |
| UCSF Medical CenterSan Francisco | 28 | $231,593 | $56,776 | $49,937 |
| Cedars-Sinai Medical CenterLos Angeles | 18 | $436,910 | $41,977 | $37,948 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica | 16 | $165,719 | $46,735 | $33,191 |
| Hoag Orthopedic InstituteIrvine | 15 | $107,989 | $25,690 | $24,276 |
| Scripps Green HospitalLa Jolla | 13 | $184,491 | $32,155 | $29,421 |
| Stanford Health Care Tri-ValleyPleasanton | 11 | $187,664 | $32,547 | $30,915 |
| Saint John's Health CenterSanta Monica | 11 | $102,782 | $29,171 | $27,431 |
| Shasta Regional Medical CenterRedding | 11 | $223,940 | $31,639 | $30,116 |
Lowest and highest payments in California
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Hoag Orthopedic InstituteIrvine, CA | $25,690 |
|---|---|
| Saint John's Health CenterSanta Monica, CA | $29,171 |
| Shasta Regional Medical CenterRedding, CA | $31,639 |
| Scripps Green HospitalLa Jolla, CA | $32,155 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $32,547 |
Highest
| Stanford HospitalPalo Alto, CA | $58,310 |
|---|---|
| UCSF Medical CenterSan Francisco, CA | $56,776 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica, CA | $46,735 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $41,977 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $32,547 |
Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in other states
Questions
How much does major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in California?
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 9 hospitals in California was billed at $263,965 on average, while the average total payment was $43,802, of which Medicare paid $38,621. 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 6.0 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.