Inpatient stays / DRG 468
MS-DRG 468 · 420 hospitals · 14,300 stays
DRG 468: Revision of Hip or Knee Replacement without CC/MCC
Medicare patients had 14,300 stays in DRG 468 in 2024. Hospitals charged an average of $123,873 per stay and were paid $23,778 — a ratio of 5.2 to 1 — of which Medicare's own share averaged $19,706. Average charges ran from $27,769 at the least expensive hospital to $600,082 at the most; half of hospitals charged between $78,918 and $149,488.
- 1Average charge $123,873
- 2Average paid $23,778
- 3Reporting hospitals 420
- 4Medicare stays 14,300
By state
Average charges for DRG 468 were highest in Alaska ($213,405) and lowest in Maryland ($41,055). Payments vary far less than charges, because Medicare sets them: they range across states from $15,044 to $37,093.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Alaska | 63 | $213,405 | $25,657 | 8.3× |
| Kentucky | 210 | $200,871 | $25,356 | 7.9× |
| Nevada | 130 | $196,158 | $24,421 | 8× |
| Texas | 975 | $195,381 | $24,009 | 8.1× |
| California | 979 | $174,201 | $30,077 | 5.8× |
| Colorado | 314 | $172,248 | $23,721 | 7.3× |
| Florida | 1,031 | $158,574 | $21,364 | 7.4× |
| Alabama | 242 | $150,299 | $20,466 | 7.3× |
| Mississippi | 115 | $145,749 | $19,028 | 7.7× |
| Arizona | 427 | $141,515 | $22,198 | 6.4× |
| Virginia | 498 | $139,336 | $22,697 | 6.1× |
| New Mexico | 74 | $132,504 | $23,448 | 5.7× |
| Georgia | 340 | $130,524 | $22,544 | 5.8× |
| South Carolina | 308 | $127,996 | $20,818 | 6.1× |
| New Hampshire | 70 | $122,363 | $23,636 | 5.2× |
| Louisiana | 213 | $119,903 | $19,178 | 6.3× |
| New Jersey | 281 | $119,164 | $24,112 | 4.9× |
| Indiana | 337 | $118,179 | $20,259 | 5.8× |
| Illinois | 444 | $116,934 | $25,145 | 4.7× |
| New York | 730 | $116,033 | $31,318 | 3.7× |
| Tennessee | 400 | $115,221 | $20,784 | 5.5× |
| Washington | 293 | $113,812 | $25,202 | 4.5× |
| North Carolina | 559 | $109,394 | $22,266 | 4.9× |
| Pennsylvania | 674 | $106,620 | $22,350 | 4.8× |
| Utah | 219 | $105,347 | $23,661 | 4.5× |
| Ohio | 534 | $102,022 | $21,333 | 4.8× |
| Idaho | 114 | $100,259 | $21,953 | 4.6× |
| Maine | 64 | $99,683 | $25,683 | 3.9× |
| Kansas | 224 | $99,559 | $20,245 | 4.9× |
| Hawaii | 29 | $95,491 | $31,243 | 3.1× |
| West Virginia | 55 | $94,702 | $21,873 | 4.3× |
| Missouri | 326 | $89,299 | $20,532 | 4.3× |
| Oklahoma | 296 | $87,118 | $19,112 | 4.6× |
| District of Columbia | 77 | $87,004 | $25,811 | 3.4× |
| Michigan | 311 | $86,816 | $24,576 | 3.5× |
| South Dakota | 124 | $85,029 | $19,804 | 4.3× |
| Iowa | 158 | $84,332 | $19,214 | 4.4× |
| Montana | 135 | $83,961 | $21,162 | 4× |
| Oregon | 163 | $83,864 | $29,047 | 2.9× |
| Wyoming | 43 | $82,198 | $32,679 | 2.5× |
| Wisconsin | 190 | $81,714 | $20,964 | 3.9× |
| Nebraska | 168 | $78,924 | $20,209 | 3.9× |
| Delaware | 97 | $72,960 | $25,361 | 2.9× |
| Arkansas | 269 | $72,253 | $19,133 | 3.8× |
| Vermont | 14 | $70,340 | $15,044 | 4.7× |
| Connecticut | 106 | $69,517 | $28,579 | 2.4× |
| Minnesota | 196 | $67,486 | $24,923 | 2.7× |
| North Dakota | 64 | $60,809 | $20,601 | 3× |
| Massachusetts | 262 | $60,384 | $25,530 | 2.4× |
| Rhode Island | 60 | $54,154 | $22,835 | 2.4× |
| Maryland | 295 | $41,055 | $37,093 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Medical City Plano Plano, TX · 58 stays | $600,082 | $39,358 |
| HCA Healthone Presbyterian St Lukes Denver, CO · 12 stays | $418,511 | $22,520 |
| Texas Orthopedic Hospital Houston, TX · 14 stays | $414,509 | $20,583 |
| Henrico Doctors' Hospital Richmond, VA · 26 stays | $413,501 | $19,642 |
| University Medical Center Lubbock, TX · 13 stays | $412,980 | $60,466 |
| Medical City Mckinney Mckinney, TX · 14 stays | $407,055 | $20,595 |
| UCLA West Valley Medical Center West Hills, CA · 13 stays | $367,084 | $25,890 |
| Medical City Dallas Dallas, TX · 20 stays | $365,522 | $20,454 |
| Baptist Health La Grange La Grange, KY · 18 stays | $333,978 | $41,637 |
| Cedars-Sinai Medical Center Los Angeles, CA · 39 stays | $325,340 | $31,786 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Beverly Hospital Corporation Beverly, MA · 14 stays | $27,769 | $21,998 |
| Saint Agnes Hospital Baltimore, MD · 22 stays | $28,589 | $24,839 |
| Baystate Medical Center Springfield, MA · 15 stays | $29,471 | $27,528 |
| Kell West Regional Hospital Wichita Falls, TX · 13 stays | $31,722 | $16,927 |
| Mercy Medical Center Inc Baltimore, MD · 16 stays | $33,253 | $29,150 |
| Johns Hopkins Howard County Medical Center Columbia, MD · 12 stays | $34,299 | $31,710 |
| Medstar Union Memorial Hospital Baltimore, MD · 38 stays | $35,940 | $32,168 |
| Suburban Hospital Bethesda, MD · 37 stays | $39,369 | $35,089 |
| Uams Medical Center Little Rock, AR · 36 stays | $40,060 | $23,324 |
| Crouse Hospital Syracuse, NY · 17 stays | $43,453 | $24,374 |
These are averages over each hospital's Medicare stays in this DRG, which mix simple and complicated cases. A high average charge is the hospital's pricing, not a sign of better or worse care, and not what a patient pays: Medicare patients owe the inpatient deductible, and people with other coverage pay their plan's negotiated rate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Hospitals with fewer than 11 stays are suppressed by CMS. Checked 2026-10-24. Methodology.