facebook tracking Revision of hip or knee replacement without complications cost in Wisconsin: 3 hospitals compared (DRG 468)

Revision of hip or knee replacement without complications in Wisconsin

What 3 hospitals in Wisconsin 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 $89,842 Hospital list price billed
Average payment $21,478 Medicare + patient + other payers
Medicare paid $19,049 Average per stay
State rank #17 of 42 1 = lowest average payment

Hospitals in Wisconsin billed an average of $89,842 for revision of hip or knee replacement without complications, about 4.2 times the average total payment of $21,478. That payment is 10% 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 $21,478Billed $89,842

About 24¢ was paid for every $1 hospitals in Wisconsin billed for this stay.

Wisconsin hospitals: revision of hip or knee replacement without 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
Oakleaf Surgical HospitalEau Claire 17 $72,639 $18,829 $17,293
Oconomowoc Mem HsptlOconomowoc 16 $118,877 $19,905 $18,476
University of Wi Hospitals & Clinics AuthorityMadison 15 $78,369 $26,157 $21,651
Advertisement

Lowest and highest payments in Wisconsin

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

Oakleaf Surgical HospitalEau Claire, WI$18,829
Oconomowoc Mem HsptlOconomowoc, WI$19,905
University of Wi Hospitals & Clinics AuthorityMadison, WI$26,157

Highest

University of Wi Hospitals & Clinics AuthorityMadison, WI$26,157
Oconomowoc Mem HsptlOconomowoc, WI$19,905
Oakleaf Surgical HospitalEau Claire, WI$18,829

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 Wisconsin?

In 2024 Medicare data, a hospital stay for revision of hip or knee replacement without complications (DRG 468) at 3 hospitals in Wisconsin was billed at $89,842 on average, while the average total payment was $21,478, of which Medicare paid $19,049. 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 4.2 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.