Ohio / Institute for Orthopaedic Surgery
CMS certification 360263 · Lima, OH
Institute for Orthopaedic Surgery: charges and Medicare payments
Institute for Orthopaedic Surgery reported 252 Medicare inpatient stays across 4 DRGs in 2024. Across them it charged 5.87 times what it was paid — among the higher ratios in Ohio, number 4 of 104 hospitals with at least 100 stays (state median 4.01×, national 4.15×). Its most frequent stay was DRG 470, Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC: 151 stays at an average charge of $74,891, 20% below the national average. It also billed 1,249 outpatient services, charging 6.94 times what Medicare paid.
- 1Medicare inpatient stays 252
- 2Charge ÷ paid, inpatient 5.87×
- 3Rank in OH (highest ratio = 1) 4 of 104
- 4CMS price-transparency actions 0
Inpatient stays
For the 4 DRGs that can be compared with the national average, Institute for Orthopaedic Surgery charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 151 | $74,891 | -20% | $11,850 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 67 | $88,085 | -30% | $15,668 |
| 460 Spinal Fusion except Cervical without MCC | 21 | $113,964 | -33% | $22,399 |
| 472 Cervical Spinal Fusion with CC | 13 | $92,245 | -36% | $18,202 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 361 | $68,735 | $10,936 |
| Level 1 Nerve Procedures | 257 | $8,789 | $1,633 |
| Level 3 Musculoskeletal Procedures | 209 | $13,859 | $2,728 |
| Level 4 Musculoskeletal Procedures | 199 | $34,096 | $5,992 |
| Level 2 Musculoskeletal Procedures | 139 | $5,088 | $1,344 |
| Level 6 Musculoskeletal Procedures | 51 | $79,004 | $15,301 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 17 | $6,595 | $1,380 |
| Level 2 Neurostimulator and Related Procedures | 16 | $18,774 | $5,820 |
Against the Ohio average
For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Institute for Orthopaedic Surgery charged $74,891 on average, 4% more than the Ohio average of $71,769, and was paid $11,850 against a state average of $14,325. For Major Joint or Limb Reattachment Procedures of Upper Extremities (DRG 483), Institute for Orthopaedic Surgery charged $88,085 on average, 7% less than the Ohio average of $94,620, and was paid $15,668 against a state average of $19,271. For Spinal Fusion except Cervical without MCC (DRG 460), Institute for Orthopaedic Surgery charged $113,964 on average, 10% less than the Ohio average of $126,933, and was paid $22,399 against a state average of $30,370. For Cervical Spinal Fusion with CC (DRG 472), Institute for Orthopaedic Surgery charged $92,245 on average, 17% less than the Ohio average of $110,692, and was paid $18,202 against a state average of $24,852. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $68,735 was 18% above the state average of $58,420. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $8,789 was 17% below the state average of $10,568. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $13,859 was 32% below the state average of $20,370. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $34,096 was 16% below the state average of $40,587.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.