Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in Pennsylvania
What 3 hospitals in Pennsylvania 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
$170,362
Hospital list price billed
Average payment
$36,630
Medicare + patient + other payers
Medicare paid
$29,593
Average per stay
State rank
#7 of 10
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $170,362 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 4.7 times the average total payment of $36,630. 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 $36,630Billed $170,362
About 22¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Penn Presbyterian Medical CenterPhiladelphia | 15 | $216,193 | $37,601 | $35,063 |
| Thomas Jefferson University HospitalPhiladelphia | 14 | $146,451 | $40,498 | $28,202 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 12 | $140,970 | $30,904 | $24,380 |
Lowest and highest payments in Pennsylvania
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
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia, PA | $30,904 |
|---|---|
| Penn Presbyterian Medical CenterPhiladelphia, PA | $37,601 |
| Thomas Jefferson University HospitalPhiladelphia, PA | $40,498 |
Highest
| Thomas Jefferson University HospitalPhiladelphia, PA | $40,498 |
|---|---|
| Penn Presbyterian Medical CenterPhiladelphia, PA | $37,601 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia, PA | $30,904 |
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 Pennsylvania?
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 3 hospitals in Pennsylvania was billed at $170,362 on average, while the average total payment was $36,630, of which Medicare paid $29,593. 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 Pennsylvania, average charges were 4.7 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.