Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications — what U.S. hospitals charge
MS-DRG 492 · Inpatient stay · 85 U.S. hospitals publish a price
Cheapest quarter
under $106,013
Typical charge
$150,017
Dearest quarter
over $192,225
Actually paid
$34,099
The middle U.S. hospital bills $150,017 for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications. The dearest hospitals charge about 3.8x what the cheapest do for the same coded work. Medicare actually paid about $34,099 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.
Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Massachusetts | 5 | $61,067 | $43,678 – $134,141 |
| Virginia | 3 | $83,769 | $67,323 – $121,086 |
| Minnesota | 3 | $103,865 | $70,180 – $150,518 |
| Indiana | 4 | $130,144 | $93,956 – $169,922 |
| Missouri | 4 | $130,217 | $85,968 – $180,071 |
| North Carolina | 3 | $145,172 | $125,725 – $172,470 |
| Ohio | 3 | $150,002 | $69,003 – $163,571 |
| Wisconsin | 3 | $153,288 | $101,389 – $186,457 |
| Kentucky | 3 | $158,834 | $137,098 – $160,254 |
| Texas | 7 | $166,440 | $145,319 – $276,467 |
| Florida | 8 | $196,832 | $108,510 – $362,943 |
| New York | 4 | $294,798 | $96,425 – $426,187 |
| California | 6 | $383,542 | $155,195 – $538,939 |
Where Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
South Shore Hospital
South Weymouth, MA |
$43,678 | $26,523 |
|
Johns Hopkins Bayview Medical Center
Baltimore, MD |
$46,660 | $40,646 |
|
Beth Israel Deaconess Medical Center
Boston, MA |
$58,065 | $42,336 |
|
Baystate Medical Center
Springfield, MA |
$61,067 | $35,280 |
|
University Of Maryland Medical Center
Baltimore, MD |
$62,254 | $57,414 |
|
Riverside Regional Medical Center
Newport News, VA |
$67,323 | $29,106 |
|
Bethesda North
Cincinnati, OH |
$69,003 | $23,359 |
|
Essentia Health St Mary's Medical Center
Duluth, MN |
$70,180 | $25,543 |
|
St. Patrick Hospital
Missoula, MT |
$75,154 | $26,152 |
|
Inova Fairfax Hospital
Falls Church, VA |
$83,769 | $32,892 |
|
Mercy Hospital St Louis
Saint Louis, MO |
$85,968 | $25,705 |
|
Elliot Hospital
Manchester, NH |
$90,687 | $26,088 |
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 |
|---|---|---|
|
Stanford Health Care
Stanford, CA |
$538,939 | $66,487 |
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$516,187 | $44,149 |
|
Westchester Medical Center
Valhalla, NY |
$426,187 | $42,509 |
|
University Of California Davis Medical Center
Sacramento, CA |
$420,765 | $57,842 |
|
Marion Communtiy Hospital
Ocala, FL |
$362,943 | $27,396 |
|
Scripps Memorial Hospital La Jolla
La Jolla, CA |
$346,318 | $37,721 |
|
Nyu Langone Hospitals
New York, NY |
$335,133 | $57,299 |
|
Trident Medical Center
Charleston, SC |
$314,241 | $25,480 |
|
Providence Santa Rosa Memorial Hospital
Santa Rosa, CA |
$307,644 | $45,644 |
|
Sunrise Hospital And Medical Center
Las Vegas, NV |
$293,061 | $29,283 |
|
Medical City Plano
Plano, TX |
$276,467 | $22,491 |
|
Methodist Hospital
San Antonio, TX |
$265,563 | $26,002 |
Questions people ask
What do U.S. hospitals charge for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications?
Across 85 U.S. hospitals, the middle charge for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications is $150,017. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $106,013 and the dearest quarter over $192,225.
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 Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Major Complications, the hospitals in the dearest tenth charge about 3.8x 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. $34,099 is roughly what Medicare actually paid per case, against an average charge of $171,636. 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 492: “LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH 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.