facebook tracking Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in New York: 6 hospitals compared (DRG 469)

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

What 6 hospitals in New York 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 $205,225 Hospital list price billed
Average payment $38,725 Medicare + patient + other payers
Medicare paid $33,824 Average per stay
State rank #8 of 10 1 = lowest average payment

Hospitals in New York billed an average of $205,225 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 5.3 times the average total payment of $38,725. That payment is 18% 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 $38,725Billed $205,225

About 19¢ was paid for every $1 hospitals in New York billed for this stay.

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

No major complications $17,318 DRG 470 · U.S. average DRG 469 $38,725 DRG 469 · this page

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

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

Hospital Stays Avg charge Avg payment Medicare paid
NYU Hospitals CenterNew York 67 $276,697 $38,267 $34,970
Hospital for Special SurgeryNew York 63 $160,665 $40,227 $33,934
New York-Presbyterian HospitalNew York 15 $186,207 $40,931 $36,812
Long Island Jewish Medical CenterNew Hyde Park 12 $176,748 $28,264 $26,116
Mount Sinai HospitalNew York 11 $100,889 $44,085 $39,863
St Francis Hospital, RoslynRoslyn 11 $186,443 $35,960 $24,516
Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota: all states All New York hospitals New York hospital finances
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Lowest and highest payments in New York

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

Long Island Jewish Medical CenterNew Hyde Park, NY$28,264
St Francis Hospital, RoslynRoslyn, NY$35,960
NYU Hospitals CenterNew York, NY$38,267
Hospital for Special SurgeryNew York, NY$40,227
New York-Presbyterian HospitalNew York, NY$40,931

Highest

Mount Sinai HospitalNew York, NY$44,085
New York-Presbyterian HospitalNew York, NY$40,931
Hospital for Special SurgeryNew York, NY$40,227
NYU Hospitals CenterNew York, NY$38,267
St Francis Hospital, RoslynRoslyn, NY$35,960

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

California · $43,802 Colorado · $46,630 Minnesota · $36,796 Ohio · $32,231 Pennsylvania · $36,630 Utah · $32,439 Washington · $31,820 Wisconsin · $32,501

Questions

How much does major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in New York?

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 New York was billed at $205,225 on average, while the average total payment was $38,725, of which Medicare paid $33,824. 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 New York, average charges were 5.3 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.