CostGrade

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

MS-DRG 488 · Inpatient stay · 11 U.S. hospitals publish a price

Cheapest quarter

under $39,667

Typical charge

$62,628

Dearest quarter

over $88,537

Actually paid

$19,599

The middle U.S. hospital bills $62,628 for Knee Procedures without Principal Diagnosis of Infection with Complications/mcc. The dearest hospitals charge about 5.7x what the cheapest do for the same coded work. Medicare actually paid about $19,599 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 without Principal Diagnosis of Infection with 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
Mercy Medical Center Inc

Baltimore, MD

$17,314 $15,051
St. George Regional Hospital

St George, UT

$31,491 $16,893
New England Baptist Hospital

Boston, MA

$38,515 $16,204
Sioux Falls Specialty Hospital

Sioux Falls, SD

$40,820 $13,953
Mayo Clinic Hospital Rochester

Rochester, MN

$56,452 $25,675
Rush University Medical Center

Chicago, IL

$62,628 $25,014
Unitypoint Health - Des Moines Iowa Methodist Medi

Des Moines, IA

$76,231 $15,157
Erlanger Medical Center

Chattanooga, TN

$83,073 $18,467
Hospital For Special Surgery

New York, NY

$94,001 $24,037
Lehigh Valley Hospital

Allentown, PA

$178,684 $18,938
Cedars-Sinai Medical Center

Los Angeles, CA

$253,506 $26,202

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
Cedars-Sinai Medical Center

Los Angeles, CA

$253,506 $26,202
Lehigh Valley Hospital

Allentown, PA

$178,684 $18,938
Hospital For Special Surgery

New York, NY

$94,001 $24,037
Erlanger Medical Center

Chattanooga, TN

$83,073 $18,467
Unitypoint Health - Des Moines Iowa Methodist Medi

Des Moines, IA

$76,231 $15,157
Rush University Medical Center

Chicago, IL

$62,628 $25,014
Mayo Clinic Hospital Rochester

Rochester, MN

$56,452 $25,675
Sioux Falls Specialty Hospital

Sioux Falls, SD

$40,820 $13,953
New England Baptist Hospital

Boston, MA

$38,515 $16,204
St. George Regional Hospital

St George, UT

$31,491 $16,893
Mercy Medical Center Inc

Baltimore, MD

$17,314 $15,051

Questions people ask

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

Across 11 U.S. hospitals, the middle charge for Knee Procedures without Principal Diagnosis of Infection with Complications/mcc is $62,628. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $39,667 and the dearest quarter over $88,537.

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 without Principal Diagnosis of Infection with Complications/mcc, the hospitals in the dearest tenth charge about 5.7x 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. $19,599 is roughly what Medicare actually paid per case, against an average charge of $85,896. 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 488: “KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH 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.