Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in Illinois
What 6 hospitals in Illinois 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
$103,467
Hospital list price billed
Average payment
$30,498
Medicare + patient + other payers
Medicare paid
$24,563
Average per stay
State rank
#6 of 10
1 = lowest average payment
Hospitals in Illinois billed an average of $103,467 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 3.4 times the average total payment of $30,498. That payment is 7% below 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 $30,498Billed $103,467
About 29¢ was paid for every $1 hospitals in Illinois billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Illinois:
Illinois hospitals: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota
Every Illinois hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Northwestern Memorial HospitalChicago | 19 | $128,457 | $30,965 | $23,469 |
| Evanston HospitalEvanston | 18 | $100,767 | $27,118 | $24,938 |
| Advocate Lutheran General HospitalPark Ridge | 18 | $77,969 | $29,127 | $23,502 |
| Rush University Medical CenterChicago | 13 | $111,224 | $49,512 | $31,864 |
| Sarah Bush Lincoln Health CenterMattoon | 12 | $104,271 | $23,699 | $22,478 |
| Elmhurst Memorial HospitalElmhurst | 11 | $96,403 | $22,410 | $21,226 |
Lowest and highest payments in Illinois
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
| Elmhurst Memorial HospitalElmhurst, IL | $22,410 |
|---|---|
| Sarah Bush Lincoln Health CenterMattoon, IL | $23,699 |
| Evanston HospitalEvanston, IL | $27,118 |
| Advocate Lutheran General HospitalPark Ridge, IL | $29,127 |
| Northwestern Memorial HospitalChicago, IL | $30,965 |
Highest
| Rush University Medical CenterChicago, IL | $49,512 |
|---|---|
| Northwestern Memorial HospitalChicago, IL | $30,965 |
| Advocate Lutheran General HospitalPark Ridge, IL | $29,127 |
| Evanston HospitalEvanston, IL | $27,118 |
| Sarah Bush Lincoln Health CenterMattoon, IL | $23,699 |
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 Illinois?
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 6 hospitals in Illinois was billed at $103,467 on average, while the average total payment was $30,498, of which Medicare paid $24,563. 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 Illinois, average charges were 3.4 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.