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

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

What 2 hospitals in Minnesota 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 $87,358 Hospital list price billed
Average payment $36,796 Medicare + patient + other payers
Medicare paid $31,637 Average per stay
Volume 29 Medicare hospital stays

Hospitals in Minnesota billed an average of $87,358 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 2.4 times the average total payment of $36,796. That payment is 12% 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 $36,796Billed $87,358

About 42¢ was paid for every $1 hospitals in Minnesota billed for this stay.

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

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

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

Hospital Stays Avg charge Avg payment Medicare paid
St Cloud HospitalSt Cloud 15 $65,410 $31,712 $30,077
Mayo Clinic - Saint Marys HospitalRochester 14 $110,874 $42,244 $33,310
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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 Minnesota?

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 Minnesota was billed at $87,358 on average, while the average total payment was $36,796, of which Medicare paid $31,637. 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 Minnesota, average charges were 2.4 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.