facebook tracking Revision of hip or knee replacement with major complications cost in Wisconsin: 1 hospitals compared (DRG 466)

Revision of hip or knee replacement with major complications in Wisconsin

What 1 hospital in Wisconsin 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 $144,434 Hospital list price billed
Average payment $35,942 Medicare + patient + other payers
Medicare paid $33,987 Average per stay
Volume 12 Medicare hospital stays

Hospitals in Wisconsin billed an average of $144,434 for revision of hip or knee replacement with major complications, about 4.0 times the average total payment of $35,942. That payment is 53% 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 $35,942Billed $144,434

About 25¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

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

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

Hospital Stays Avg charge Avg payment Medicare paid
St Mary's HospitalMadison 12 $144,434 $35,942 $33,987
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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 Wisconsin?

In 2024 Medicare data, a hospital stay for revision of hip or knee replacement with major complications (DRG 466) at 1 hospital in Wisconsin was billed at $144,434 on average, while the average total payment was $35,942, of which Medicare paid $33,987. 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 Wisconsin, average charges were 4.0 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.