Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without — what U.S. hospitals charge
MS-DRG 494 · Inpatient stay · 112 U.S. hospitals publish a price
Cheapest quarter
under $60,892
Typical charge
$88,643
Dearest quarter
over $125,164
Actually paid
$18,028
The middle U.S. hospital bills $88,643 for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without. The dearest hospitals charge about 3.5x what the cheapest do for the same coded work. Medicare actually paid about $18,028 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 without cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Maryland | 3 | $25,746 | $18,551 – $28,011 |
| Massachusetts | 5 | $48,727 | $31,813 – $97,632 |
| Tennessee | 3 | $58,180 | $46,774 – $86,476 |
| Ohio | 4 | $70,269 | $45,441 – $174,328 |
| Pennsylvania | 6 | $72,032 | $52,086 – $148,071 |
| North Carolina | 5 | $85,911 | $68,226 – $116,404 |
| South Carolina | 5 | $91,211 | $62,032 – $211,846 |
| Florida | 13 | $101,881 | $57,763 – $306,027 |
| Indiana | 3 | $103,602 | $49,620 – $137,522 |
| New York | 9 | $106,027 | $39,310 – $144,676 |
| Texas | 6 | $110,288 | $60,870 – $276,015 |
| California | 11 | $123,785 | $82,584 – $298,632 |
| Arizona | 8 | $146,681 | $58,487 – $181,151 |
Where Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Suburban Hospital
Bethesda, MD |
$18,551 | $16,439 |
|
University Of Md Baltimore Washington Medical Center
Glen Burnie, MD |
$25,746 | $23,901 |
|
Chi St. Vincent Hospital Hot Springs
Hot Springs, AR |
$26,279 | $13,316 |
|
Luminis Health Anne Arundel Medical Center, Inc
Annapolis, MD |
$28,011 | $26,249 |
|
South Shore Hospital
South Weymouth, MA |
$31,813 | $16,330 |
|
Baystate Medical Center
Springfield, MA |
$36,341 | $19,467 |
|
Bronson Methodist Hospital
Kalamazoo, MI |
$38,325 | $19,616 |
|
Erie County Medical Center
Buffalo, NY |
$39,310 | $22,870 |
|
University Of Utah Hospital And Clinics
Salt Lake City, UT |
$41,605 | $19,663 |
|
Riverside Regional Medical Center
Newport News, VA |
$45,006 | $16,430 |
|
Bethesda North
Cincinnati, OH |
$45,441 | $13,542 |
|
University Health System, Inc
Knoxville, TN |
$46,774 | $16,552 |
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 |
|---|---|---|
|
Cjw Medical Center
Richmond, VA |
$314,546 | $12,786 |
|
Hca Florida Fort Walton-Destin Hospital
Fort Walton Beach, FL |
$306,027 | $15,506 |
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$298,632 | $27,479 |
|
Medical City Denton
Denton, TX |
$276,015 | $15,685 |
|
Grand Strand Regional Medical Center
Myrtle Beach, SC |
$211,846 | $15,202 |
|
John Muir Medical Center - Walnut Creek Campus
Walnut Creek, CA |
$211,085 | $20,575 |
|
Scripps Mercy Hospital
San Diego, CA |
$183,942 | $21,507 |
|
Honor Health John C. Lincoln Medical Center
Phoenix, AZ |
$181,151 | $14,859 |
|
Marion Communtiy Hospital
Ocala, FL |
$174,480 | $15,321 |
|
Mercy St Vincent Medical Center
Toledo, OH |
$174,328 | $17,179 |
|
Orlando Health
Orlando, FL |
$166,081 | $16,009 |
|
Medical City Plano
Plano, TX |
$163,541 | $14,043 |
Questions people ask
What do U.S. hospitals charge for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without?
Across 112 U.S. hospitals, the middle charge for Lower Extremity and Humerus Procedures Except Hip, Foot and Femur without is $88,643. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $60,892 and the dearest quarter over $125,164.
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 without, the hospitals in the dearest tenth charge about 3.5x 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. $18,028 is roughly what Medicare actually paid per case, against an average charge of $101,370. 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 494: “LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR 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.