facebook tracking Revision of hip or knee replacement without complications cost in Rhode Island: 2 hospitals compared (DRG 468)

Revision of hip or knee replacement without complications in Rhode Island

What 2 hospitals in Rhode Island charged and were paid for a Medicare hospital stay for revision of hip or knee replacement without complications (DRG 468), from 2024 Medicare claims.

DRG 468 Inpatient 2024 Medicare data
Average charge $55,005 Hospital list price billed
Average payment $22,769 Medicare + patient + other payers
Medicare paid $19,372 Average per stay
Volume 48 Medicare hospital stays

Hospitals in Rhode Island billed an average of $55,005 for revision of hip or knee replacement without complications, about 2.4 times the average total payment of $22,769. That payment is 5% below the U.S. average of $23,925.

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 $22,769Billed $55,005

About 41¢ was paid for every $1 hospitals in Rhode Island billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Rhode Island:

Rhode Island hospitals: revision of hip or knee replacement without complications

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

Hospital Stays Avg charge Avg payment Medicare paid
Miriam HospitalProvidence 28 $47,157 $23,961 $20,520
South County Hospital INCWakefield 20 $65,992 $21,100 $17,764
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Revision of hip or knee replacement without complications in other states

Questions

How much does revision of hip or knee replacement without complications cost in Rhode Island?

In 2024 Medicare data, a hospital stay for revision of hip or knee replacement without complications (DRG 468) at 2 hospitals in Rhode Island was billed at $55,005 on average, while the average total payment was $22,769, of which Medicare paid $19,372. 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 Rhode Island, average charges were 2.4 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.