Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in Texas
What 5 hospitals in Texas 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
$300,943
Hospital list price billed
Average payment
$22,528
Medicare + patient + other payers
Medicare paid
$20,169
Average per stay
State rank
#1 of 10
1 = lowest average payment
Hospitals in Texas billed an average of $300,943 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 13.4 times the average total payment of $22,528. That payment is 31% 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 $22,528Billed $300,943
About 7¢ was paid for every $1 hospitals in Texas billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Texas:
Texas hospitals: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota
Every Texas hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Methodist Stone Oak HospitalSan Antonio | 25 | $219,181 | $21,917 | $17,611 |
| Methodist HospitalSan Antonio | 19 | $230,345 | $22,703 | $21,108 |
| Baptist Medical CenterSan Antonio | 13 | $244,812 | $22,456 | $20,907 |
| Medical Center of PlanoPlano | 13 | $496,433 | $24,055 | $22,780 |
| Texas Orthopedic HospitalHouston | 13 | $421,999 | $21,996 | $20,364 |
Lowest and highest payments in Texas
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
| Methodist Stone Oak HospitalSan Antonio, TX | $21,917 |
|---|---|
| Texas Orthopedic HospitalHouston, TX | $21,996 |
| Baptist Medical CenterSan Antonio, TX | $22,456 |
| Methodist HospitalSan Antonio, TX | $22,703 |
| Medical Center of PlanoPlano, TX | $24,055 |
Highest
| Medical Center of PlanoPlano, TX | $24,055 |
|---|---|
| Methodist HospitalSan Antonio, TX | $22,703 |
| Baptist Medical CenterSan Antonio, TX | $22,456 |
| Texas Orthopedic HospitalHouston, TX | $21,996 |
| Methodist Stone Oak HospitalSan Antonio, TX | $21,917 |
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 Texas?
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 5 hospitals in Texas was billed at $300,943 on average, while the average total payment was $22,528, of which Medicare paid $20,169. 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 Texas, average charges were 13.4 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.