Knee Procedures with Principal Diagnosis of Infection with Complications — what U.S. hospitals charge
MS-DRG 486 · Inpatient stay · 10 U.S. hospitals publish a price
Cheapest quarter
under $71,572
Typical charge
$81,774
Dearest quarter
over $110,652
Actually paid
$22,128
The middle U.S. hospital bills $81,774 for Knee Procedures with Principal Diagnosis of Infection with Complications. The dearest hospitals charge about 2.4x what the cheapest do for the same coded work. Medicare actually paid about $22,128 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Where Knee Procedures with Principal Diagnosis of Infection with Complications is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Bethesda North
Cincinnati, OH |
$53,287 | $16,457 |
|
Unitypoint Health - Des Moines Iowa Methodist Medi
Des Moines, IA |
$68,748 | $14,836 |
|
Northshore University Healthsystem - Evanston Hospital
Evanston, IL |
$70,103 | $17,771 |
|
Mayo Clinic
Jacksonville, FL |
$75,979 | $23,120 |
|
Allina United Hospital
Saint Paul, MN |
$78,630 | $14,956 |
|
Mayo Clinic Hospital Rochester
Rochester, MN |
$84,918 | $26,472 |
|
Avera Mckennan Hospital & University Health Center
Sioux Falls, SD |
$97,094 | $16,914 |
|
Morristown Medical Center
Morristown, NJ |
$115,172 | $19,576 |
|
Hospital For Special Surgery
New York, NY |
$154,840 | $31,456 |
|
Ucsf Medical Center
San Francisco, CA |
$185,479 | $39,724 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Ucsf Medical Center
San Francisco, CA |
$185,479 | $39,724 |
|
Hospital For Special Surgery
New York, NY |
$154,840 | $31,456 |
|
Morristown Medical Center
Morristown, NJ |
$115,172 | $19,576 |
|
Avera Mckennan Hospital & University Health Center
Sioux Falls, SD |
$97,094 | $16,914 |
|
Mayo Clinic Hospital Rochester
Rochester, MN |
$84,918 | $26,472 |
|
Allina United Hospital
Saint Paul, MN |
$78,630 | $14,956 |
|
Mayo Clinic
Jacksonville, FL |
$75,979 | $23,120 |
|
Northshore University Healthsystem - Evanston Hospital
Evanston, IL |
$70,103 | $17,771 |
|
Unitypoint Health - Des Moines Iowa Methodist Medi
Des Moines, IA |
$68,748 | $14,836 |
|
Bethesda North
Cincinnati, OH |
$53,287 | $16,457 |
Questions people ask
What do U.S. hospitals charge for Knee Procedures with Principal Diagnosis of Infection with Complications?
Across 10 U.S. hospitals, the middle charge for Knee Procedures with Principal Diagnosis of Infection with Complications is $81,774. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $71,572 and the dearest quarter over $110,652.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Knee Procedures with Principal Diagnosis of Infection with Complications, the hospitals in the dearest tenth charge about 2.4x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $22,128 is roughly what Medicare actually paid per case, against an average charge of $101,672. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as MS-DRG 486: “KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC”. A DRG covers a whole inpatient stay rather than a single item, so the charge includes the room, the procedure and the care around it. Codes that mention complications carry a different, usually higher price.