CostGrade

Knee Procedures with Principal Diagnosis of Infection without Complications/mcc — what U.S. hospitals charge

MS-DRG 487 · Inpatient stay · 1 U.S. hospitals publish a price

Cheapest quarter

under $102,438

Typical charge

$102,438

Dearest quarter

over $102,438

Actually paid

$18,357

The middle U.S. hospital bills $102,438 for Knee Procedures with Principal Diagnosis of Infection without Complications/mcc. The dearest hospitals charge about 1.0x what the cheapest do for the same coded work. Medicare actually paid about $18,357 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 without Complications/mcc is charged least

Hospitals that performed it at least eleven times, so a single case cannot set the figure.

Hospital Charged Actually paid
Hospital For Special Surgery

New York, NY

$102,438 $18,357

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
Hospital For Special Surgery

New York, NY

$102,438 $18,357

Questions people ask

What do U.S. hospitals charge for Knee Procedures with Principal Diagnosis of Infection without Complications/mcc?

Across 1 U.S. hospitals, the middle charge for Knee Procedures with Principal Diagnosis of Infection without Complications/mcc is $102,438. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $102,438 and the dearest quarter over $102,438.

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 without Complications/mcc, the hospitals in the dearest tenth charge about 1.0x 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. $18,357 is roughly what Medicare actually paid per case, against an average charge of $102,438. 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 487: “KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC”. 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.