Inpatient stays / DRG 469
MS-DRG 469 · 70 hospitals · 5,530 stays
DRG 469: Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Tota
Medicare patients had 5,530 stays in DRG 469 in 2024. Hospitals charged an average of $149,677 per stay and were paid $29,663 — a ratio of 5 to 1 — of which Medicare's own share averaged $25,757. Average charges ran from $47,104 at the least expensive hospital to $496,433 at the most; half of hospitals charged between $100,858 and $217,509.
- 1Average charge $149,677
- 2Average paid $29,663
- 3Reporting hospitals 70
- 4Medicare stays 5,530
By state
Average charges for DRG 469 were highest in Nevada ($256,751) and lowest in Maryland ($50,543). Payments vary far less than charges, because Medicare sets them: they range across states from $21,785 to $45,422.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Nevada | 69 | $256,751 | $30,695 | 8.4× |
| Colorado | 117 | $233,390 | $33,084 | 7.1× |
| California | 496 | $230,370 | $40,817 | 5.6× |
| Alaska | 26 | $222,611 | $36,086 | 6.2× |
| Texas | 332 | $221,465 | $25,716 | 8.6× |
| Florida | 376 | $200,746 | $25,534 | 7.9× |
| Arizona | 128 | $195,372 | $38,256 | 5.1× |
| Vermont | 11 | $177,464 | $45,422 | 3.9× |
| New Jersey | 124 | $169,015 | $30,365 | 5.6× |
| New York | 396 | $168,334 | $36,185 | 4.7× |
| South Carolina | 85 | $160,097 | $25,365 | 6.3× |
| Alabama | 76 | $157,897 | $26,938 | 5.9× |
| Virginia | 151 | $154,455 | $26,759 | 5.8× |
| District of Columbia | 20 | $148,694 | $35,599 | 4.2× |
| Idaho | 22 | $140,326 | $32,086 | 4.4× |
| Pennsylvania | 223 | $140,137 | $28,530 | 4.9× |
| Georgia | 114 | $139,273 | $27,503 | 5.1× |
| Indiana | 131 | $135,416 | $26,464 | 5.1× |
| Washington | 122 | $132,926 | $29,832 | 4.5× |
| Mississippi | 51 | $130,691 | $22,750 | 5.7× |
| Kansas | 102 | $130,000 | $25,961 | 5× |
| North Carolina | 162 | $123,415 | $28,556 | 4.3× |
| Kentucky | 68 | $123,346 | $24,138 | 5.1× |
| New Mexico | 17 | $123,066 | $26,132 | 4.7× |
| Tennessee | 148 | $121,125 | $24,311 | 5× |
| Illinois | 274 | $119,427 | $27,383 | 4.4× |
| Oklahoma | 78 | $118,957 | $23,384 | 5.1× |
| Louisiana | 46 | $117,872 | $21,785 | 5.4× |
| Missouri | 119 | $112,031 | $22,851 | 4.9× |
| New Hampshire | 30 | $111,400 | $28,398 | 3.9× |
| Ohio | 217 | $110,256 | $24,546 | 4.5× |
| Wyoming | 12 | $109,701 | $43,067 | 2.5× |
| Hawaii | 19 | $109,696 | $35,980 | 3× |
| Nebraska | 46 | $108,904 | $24,357 | 4.5× |
| Maine | 21 | $107,156 | $28,795 | 3.7× |
| South Dakota | 44 | $105,398 | $24,482 | 4.3× |
| Connecticut | 54 | $104,519 | $33,147 | 3.2× |
| Wisconsin | 69 | $103,028 | $27,002 | 3.8× |
| Utah | 47 | $102,693 | $28,918 | 3.6× |
| West Virginia | 39 | $99,785 | $24,231 | 4.1× |
| Michigan | 160 | $98,796 | $27,869 | 3.5× |
| Oregon | 61 | $97,058 | $32,698 | 3× |
| Iowa | 74 | $93,366 | $24,848 | 3.8× |
| Montana | 26 | $89,615 | $25,097 | 3.6× |
| Minnesota | 100 | $88,500 | $29,686 | 3× |
| Arkansas | 48 | $86,741 | $22,635 | 3.8× |
| North Dakota | 21 | $84,294 | $26,696 | 3.2× |
| Massachusetts | 258 | $71,386 | $30,388 | 2.3× |
| Maryland | 85 | $50,543 | $45,098 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Medical City Plano Plano, TX · 13 stays | $496,433 | $24,055 |
| University of Colorado Hospital Authority Aurora, CO · 12 stays | $470,692 | $87,976 |
| Cjw Medical Center Richmond, VA · 14 stays | $456,548 | $22,094 |
| Stanford Health Care Stanford, CA · 32 stays | $444,924 | $58,310 |
| Cedars-Sinai Medical Center Los Angeles, CA · 18 stays | $436,910 | $41,977 |
| Texas Orthopedic Hospital Houston, TX · 13 stays | $421,999 | $21,996 |
| HCA Healthone Sky Ridge Lone Tree, CO · 14 stays | $338,677 | $29,073 |
| Wesley Medical Center Wichita, KS · 11 stays | $330,400 | $25,340 |
| Alaska Regional Hospital Anchorage, AK · 11 stays | $304,144 | $29,087 |
| NYU Langone Hospitals New York, NY · 67 stays | $276,697 | $38,267 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Lahey Hospital & Medical Center, Burlington Burlington, MA · 13 stays | $47,104 | $31,737 |
| New England Baptist Hospital Boston, MA · 66 stays | $57,372 | $26,271 |
| St Cloud Hospital Saint Cloud, MN · 15 stays | $65,410 | $31,712 |
| Parkwest Medical Center Knoxville, TN · 11 stays | $74,599 | $21,293 |
| Advocate Lutheran General Hospital Park Ridge, IL · 18 stays | $77,969 | $29,127 |
| Trinity Health Ann Arbor Hospital Ann Arbor, MI · 11 stays | $79,525 | $32,201 |
| Ascension Via Christi Hospitals Wichita, Inc. Wichita, KS · 13 stays | $80,928 | $28,382 |
| Saint Francis Hospital, Inc Tulsa, OK · 11 stays | $82,136 | $22,950 |
| Deaconess Hospital Inc Evansville, IN · 14 stays | $83,387 | $23,585 |
| University of Utah Hospital and Clinics Salt Lake City, UT · 14 stays | $85,249 | $32,439 |
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.