Revision of hip or knee replacement with major complications
What 67 hospitals in the U.S. charged and were paid for a Medicare hospital stay for revision of hip or knee replacement with major complications (DRG 466), from 2024 Medicare claims.
Average charge
$337,370
Hospital list price billed
Average payment
$75,768
Medicare + patient + other payers
Medicare paid
$68,101
Average per stay
Volume
992
Medicare hospital stays
Hospitals in the U.S. billed an average of $337,370 for revision of hip or knee replacement with major complications, about 4.5 times the average total payment of $75,768.
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 $75,768Billed $337,370
About 22¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Naples Community HospitalNaples, FL | $26,005 |
|---|---|
| Adventhealth OrlandoOrlando, FL | $36,352 |
| Toledo Hospital theToledo, OH | $40,670 |
| University of Alabama HospitalBirmingham, AL | $50,823 |
| Medical Center of PlanoPlano, TX | $51,645 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $58,062 |
| Cleveland Clinic - Main CampusCleveland, OH | $69,124 |
| NYU Hospitals CenterNew York, NY | $71,315 |
| Cedars-Sinai Medical CenterLos Angeles, CA | $89,353 |
Highest
| Cedars-Sinai Medical CenterLos Angeles, CA | $89,353 |
|---|---|
| NYU Hospitals CenterNew York, NY | $71,315 |
| Cleveland Clinic - Main CampusCleveland, OH | $69,124 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | $58,062 |
| Medical Center of PlanoPlano, TX | $51,645 |
| University of Alabama HospitalBirmingham, AL | $50,823 |
| Toledo Hospital theToledo, OH | $40,670 |
| Adventhealth OrlandoOrlando, FL | $36,352 |
| Naples Community HospitalNaples, FL | $26,005 |
Revision of hip or knee replacement with major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $234,931 | $50,823 | – |
| Arizona | 2 | $223,352 | $44,109 | $38,515 – $50,450 |
| Arkansas | 1 | $101,739 | $40,242 | – |
| California | 4 | $530,739 | $79,899 | $64,999 – $89,353 |
| Colorado | 1 | $527,877 | $36,653 | – |
| Connecticut | 1 | $196,636 | $62,193 | – |
| Delaware | 1 | $150,838 | $53,954 | – |
| Florida | 8 | $235,054 | $36,176 | $26,005 – $49,990 |
| Georgia | 1 | $252,966 | $36,830 | – |
| Indiana | 3 | $1,753,101 | $628,568 | $35,258 – $1,443,310 |
| Kentucky | 1 | $296,808 | $55,547 | – |
| Massachusetts | 3 | $184,957 | $62,257 | $53,344 – $73,939 |
| Michigan | 1 | $86,159 | $36,417 | – |
| Minnesota | 1 | $160,120 | $58,062 | – |
| Montana | 1 | $143,203 | $43,127 | – |
| Nebraska | 3 | $163,783 | $39,903 | $33,378 – $52,697 |
| Nevada | 2 | $377,608 | $36,540 | $34,868 – $38,211 |
| New Hampshire | 1 | $131,435 | $56,293 | – |
| New Jersey | 3 | $240,596 | $48,386 | $40,218 – $60,240 |
| New York | 5 | $340,801 | $68,110 | $53,333 – $80,727 |
| North Carolina | 1 | $178,858 | $42,653 | – |
| North Dakota | 1 | $129,143 | $40,101 | – |
| Ohio | 2 | $201,826 | $54,897 | $40,670 – $69,124 |
| Oklahoma | 1 | $145,199 | $28,654 | – |
| Oregon | 3 | $185,162 | $60,379 | $52,750 – $64,200 |
| Pennsylvania | 4 | $251,910 | $49,262 | $37,617 – $58,491 |
| South Carolina | 1 | $179,588 | $35,256 | – |
| Tennessee | 2 | $247,265 | $41,220 | $32,584 – $51,582 |
| Texas | 4 | $557,915 | $48,454 | $38,525 – $51,645 |
| Utah | 1 | $108,268 | $45,673 | – |
| West Virginia | 1 | $194,192 | $45,736 | – |
| Wisconsin | 1 | $144,434 | $35,942 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Medical Center of PlanoPlano, TX | 32 | $921,876 | $51,645 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 28 | $160,120 | $58,062 |
| NYU Hospitals CenterNew York, NY | 27 | $538,765 | $71,315 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 26 | $788,413 | $89,353 |
| University of Alabama HospitalBirmingham, AL | 22 | $234,931 | $50,823 |
| Adventhealth OrlandoOrlando, FL | 20 | $377,309 | $36,352 |
| Naples Community HospitalNaples, FL | 20 | $130,385 | $26,005 |
| Toledo Hospital theToledo, OH | 20 | $227,061 | $40,670 |
| Cleveland Clinic - Main CampusCleveland, OH | 20 | $176,591 | $69,124 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica, CA | 19 | $320,893 | $74,865 |
| Orlando Regional HealthcareOrlando, FL | 19 | $310,348 | $34,657 |
| Bryan Medical CenterLincoln, NE | 19 | $169,354 | $36,286 |
| Thomas Jefferson University HospitalPhiladelphia, PA | 19 | $243,422 | $58,491 |
| UCSF Medical CenterSan Francisco, CA | 18 | $372,095 | $82,319 |
| St Vincent Hospital & Health ServicesIndianapolis, IN | 18 | $3,838,130 | $1,443,310 |
Questions
How much does revision of hip or knee replacement with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for revision of hip or knee replacement with major complications (DRG 466) at 67 hospitals in the U.S. was billed at $337,370 on average, while the average total payment was $75,768, of which Medicare paid $68,101. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for revision of hip or knee replacement with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in Indiana ($628,568), California ($79,899), New York ($68,110) and lowest in Florida ($36,176), Nebraska ($39,903), New Jersey ($48,386).
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 the U.S., average charges were 4.5 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.