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Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with major complications or Tota
Medicare DRG 469. What hospitals charge and what Medicare pays, 2024.
Avg hospital charge
$174,936
Avg total payment
$31,835
Avg Medicare pays
$27,163
Hospitals reporting
70
The "charge" is the hospital's list price — almost nobody pays it. "Total payment" is what the hospital actually received (Medicare plus patient copays and other payers). These figures cover Medicare fee-for-service inpatient stays only.
| State | Hospitals | Avg charge | Avg Medicare payment |
|---|---|---|---|
| Texas | 5 | $322,554 | $20,554 |
| Colorado | 3 | $307,660 | $42,980 |
| Alaska | 1 | $304,144 | $27,455 |
| Virginia | 2 | $294,546 | $20,975 |
| Nevada | 1 | $272,253 | $23,257 |
| California | 9 | $231,779 | $34,992 |
| Kansas | 2 | $205,664 | $22,979 |
| New York | 6 | $181,275 | $32,702 |
| Florida | 4 | $179,078 | $19,421 |
| Pennsylvania | 3 | $167,871 | $29,215 |
| New Jersey | 3 | $145,451 | $24,738 |
| Washington | 2 | $144,116 | $28,776 |
| North Carolina | 4 | $130,787 | $25,747 |
| South Dakota | 2 | $115,508 | $22,300 |
| Ohio | 1 | $115,429 | $28,409 |
| Iowa | 1 | $111,053 | $21,255 |
| Massachusetts | 4 | $108,898 | $29,415 |
| Illinois | 6 | $103,182 | $24,579 |
| Michigan | 2 | $98,550 | $21,735 |
| Wisconsin | 1 | $97,599 | $27,918 |
| West Virginia | 1 | $93,423 | $22,340 |
| Missouri | 1 | $89,672 | $18,378 |
| Minnesota | 2 | $88,142 | $31,693 |
| Utah | 1 | $85,249 | $28,170 |
| Indiana | 1 | $83,387 | $22,127 |
| Oklahoma | 1 | $82,136 | $17,944 |
| Tennessee | 1 | $74,599 | $16,753 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service. A DRG (Diagnosis Related Group) is how Medicare classifies an inpatient stay for payment; the description is Medicare's, not a diagnosis for any individual.