facebook tracking Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in Michigan: 2 hospitals compared (DRG 469)

Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in Michigan

What 2 hospitals in Michigan 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.

DRG 469 Inpatient 2024 Medicare data
Average charge $104,073 Hospital list price billed
Average payment $28,669 Medicare + patient + other payers
Medicare paid $22,414 Average per stay
Volume 31 Medicare hospital stays

Hospitals in Michigan billed an average of $104,073 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 3.6 times the average total payment of $28,669. That payment is 13% 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 $28,669Billed $104,073

About 28¢ was paid for every $1 hospitals in Michigan billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Michigan:

Michigan hospitals: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota

Every Michigan hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
William Beaumont HospitalRoyal Oak 20 $117,574 $26,726 $24,073
Trinity Health Ann Arbor HospitalAnn Arbor 11 $79,525 $32,201 $19,396
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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 Michigan?

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 2 hospitals in Michigan was billed at $104,073 on average, while the average total payment was $28,669, of which Medicare paid $22,414. 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 Michigan, average charges were 3.6 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.