facebook tracking Revision of hip or knee replacement with major complications cost in Texas: 4 hospitals compared (DRG 466)

Revision of hip or knee replacement with major complications in Texas

What 4 hospitals in Texas 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.

DRG 466 Inpatient 2024 Medicare data
Average charge $557,915 Hospital list price billed
Average payment $48,454 Medicare + patient + other payers
Medicare paid $38,068 Average per stay
State rank #4 of 10 1 = lowest average payment

Hospitals in Texas billed an average of $557,915 for revision of hip or knee replacement with major complications, about 11.5 times the average total payment of $48,454. That payment is 36% below the U.S. average 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 $48,454Billed $557,915

About 9¢ was paid for every $1 hospitals in Texas billed for this stay.

Texas hospitals: revision of hip or knee replacement with major complications

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
Medical Center of PlanoPlano 32 $921,876 $51,645 $40,964
Baylor University Medical CenterDallas 13 $126,712 $48,685 $29,017
Texas Health Presbyterian Hospital DallasDallas 13 $280,779 $38,525 $34,301
Methodist Hospital,TheHouston 12 $354,721 $50,449 $44,230
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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.

Revision of hip or knee replacement with major complications in other states

Questions

How much does revision of hip or knee replacement with major complications cost in Texas?

In 2024 Medicare data, a hospital stay for revision of hip or knee replacement with major complications (DRG 466) at 4 hospitals in Texas was billed at $557,915 on average, while the average total payment was $48,454, of which Medicare paid $38,068. 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 11.5 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.