Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Complications — what U.S. hospitals charge
MS-DRG 511 · Inpatient stay · 9 U.S. hospitals publish a price
Cheapest quarter
under $96,374
Typical charge
$108,099
Dearest quarter
over $127,362
Actually paid
$16,074
The middle U.S. hospital bills $108,099 for Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Complications. The dearest hospitals charge about 2.7x what the cheapest do for the same coded work. Medicare actually paid about $16,074 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.
Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with 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 |
|---|---|---|---|
| Florida | 4 | $114,185 | $97,024 – $211,977 |
Where Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures 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 |
|---|---|---|
|
Riverside Regional Medical Center
Newport News, VA |
$47,264 | $14,686 |
|
Mayo Clinic Hospital Rochester
Rochester, MN |
$64,450 | $23,184 |
|
Charleston Area Medical Center
Charleston, WV |
$96,374 | $15,549 |
|
Gulf Coast Medical Center Lee Health
Fort Myers, FL |
$97,024 | $14,853 |
|
Sarasota Memorial Hospital
Sarasota, FL |
$108,099 | $14,656 |
|
Adventhealth Orlando
Orlando, FL |
$120,271 | $15,336 |
|
Lehigh Valley Hospital
Allentown, PA |
$127,362 | $17,267 |
|
Covenant Medical Center
Lubbock, TX |
$150,693 | $14,793 |
|
Hca Florida Lawnwood Hospital
Fort Pierce, FL |
$211,977 | $14,342 |
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 |
|---|---|---|
|
Hca Florida Lawnwood Hospital
Fort Pierce, FL |
$211,977 | $14,342 |
|
Covenant Medical Center
Lubbock, TX |
$150,693 | $14,793 |
|
Lehigh Valley Hospital
Allentown, PA |
$127,362 | $17,267 |
|
Adventhealth Orlando
Orlando, FL |
$120,271 | $15,336 |
|
Sarasota Memorial Hospital
Sarasota, FL |
$108,099 | $14,656 |
|
Gulf Coast Medical Center Lee Health
Fort Myers, FL |
$97,024 | $14,853 |
|
Charleston Area Medical Center
Charleston, WV |
$96,374 | $15,549 |
|
Mayo Clinic Hospital Rochester
Rochester, MN |
$64,450 | $23,184 |
|
Riverside Regional Medical Center
Newport News, VA |
$47,264 | $14,686 |
Questions people ask
What do U.S. hospitals charge for Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Complications?
Across 9 U.S. hospitals, the middle charge for Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Complications is $108,099. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $96,374 and the dearest quarter over $127,362.
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 Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Complications, the hospitals in the dearest tenth charge about 2.7x 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. $16,074 is roughly what Medicare actually paid per case, against an average charge of $113,404. 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 511: “SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES 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.