Home / Procedures / Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without with Complications/with major complications
Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without with Complications/with major complications
Medicare DRG 494. What hospitals charge and what Medicare pays, 2024.
Avg hospital charge
$99,978
Avg total payment
$18,028
Avg Medicare pays
$14,306
Hospitals reporting
112
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 |
|---|---|---|---|
| Virginia | 2 | $179,776 | $11,181 |
| California | 11 | $144,105 | $17,774 |
| Alaska | 1 | $140,096 | $17,766 |
| Texas | 6 | $134,853 | $12,662 |
| Georgia | 1 | $129,216 | $13,873 |
| New Jersey | 2 | $129,200 | $13,217 |
| Florida | 13 | $124,959 | $12,751 |
| Arizona | 8 | $123,573 | $13,481 |
| South Carolina | 5 | $110,539 | $13,200 |
| Kansas | 2 | $105,728 | $12,119 |
| Washington | 1 | $98,805 | $17,609 |
| Indiana | 3 | $96,914 | $13,304 |
| New York | 9 | $95,779 | $17,443 |
| Kentucky | 1 | $94,314 | $12,144 |
| Louisiana | 1 | $93,422 | $9,876 |
| Alabama | 1 | $92,490 | $9,743 |
| Ohio | 4 | $90,077 | $13,864 |
| North Carolina | 5 | $88,883 | $14,181 |
| Wisconsin | 1 | $88,061 | $14,723 |
| Pennsylvania | 6 | $83,870 | $13,697 |
| Nevada | 1 | $78,712 | $14,779 |
| Iowa | 2 | $69,446 | $11,042 |
| New Hampshire | 1 | $68,656 | $13,831 |
| Delaware | 1 | $64,857 | $12,727 |
| Tennessee | 3 | $63,810 | $12,525 |
| Idaho | 1 | $62,073 | $13,640 |
| Oregon | 1 | $61,731 | $17,659 |
| Nebraska | 1 | $60,899 | $11,028 |
| Massachusetts | 5 | $60,715 | $16,853 |
| Missouri | 2 | $59,439 | $13,561 |
| West Virginia | 1 | $58,300 | $12,414 |
| Illinois | 1 | $57,420 | $14,281 |
| Mississippi | 2 | $55,725 | $12,785 |
| Minnesota | 1 | $55,642 | $15,106 |
| Utah | 1 | $41,605 | $16,449 |
| Michigan | 1 | $38,325 | $9,474 |
| Arkansas | 1 | $26,279 | $11,759 |
| Maryland | 3 | $24,103 | $19,055 |
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.