Texas / Texas Orthopedic Hospital
CMS certification 450804 · Houston, TX · 2 entries in CMS's price-transparency list
Texas Orthopedic Hospital: charges and Medicare payments
Texas Orthopedic Hospital reported 542 Medicare inpatient stays across 14 DRGs in 2024. Across them it charged 11.8 times what it was paid — among the higher ratios in Texas, number 15 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 454, Combined Anterior and Posterior Spinal Fusion with CC: 131 stays at an average charge of $469,307, 68% above the national average. It also billed 2,703 outpatient services, charging 17.18 times what Medicare paid.
- 1Medicare inpatient stays 542
- 2Charge ÷ paid, inpatient 11.8×
- 3Rank in TX (highest ratio = 1) 15 of 190
- 4CMS price-transparency actions 2
Inpatient stays
For the 14 DRGs that can be compared with the national average, Texas Orthopedic Hospital charged more than the national average in 14 (100%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 131 | $469,307 | +68% | $43,786 |
| 467 Revision of Hip or Knee Replacement with CC | 89 | $370,048 | +135% | $28,375 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 72 | $274,190 | +117% | $18,016 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 43 | $221,817 | +138% | $12,920 |
| 472 Cervical Spinal Fusion with CC | 39 | $224,830 | +57% | $22,366 |
| 427 Multiple Level Combined Anterior and Posterior Spinal Fusion... | 29 | $623,553 | +83% | $60,621 |
| 402 Single Level Combined Anterior and Posterior Spinal Fusion... | 28 | $413,111 | +120% | $41,897 |
| 460 Spinal Fusion except Cervical without MCC | 24 | $333,325 | +96% | $35,145 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 18 | $109,595 | +5% | $13,371 |
| 464 Wound Debridement and Skin Graft except Hand for... | 17 | $290,163 | +99% | $21,194 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 14 | $414,509 | +235% | $20,583 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 14 | $205,884 | +73% | $16,740 |
| 469 Major Hip and Knee Joint Replacement or Reattachment of... | 13 | $421,999 | +182% | $21,996 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $151,590 | +50% | $15,610 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 1,066 | $169,311 | $12,098 |
| Level 1 Nerve Procedures | 647 | $37,696 | $1,478 |
| Level 4 Musculoskeletal Procedures | 438 | $90,228 | $6,537 |
| Level 3 Musculoskeletal Procedures | 267 | $37,702 | $2,970 |
| Level 2 Musculoskeletal Procedures | 174 | $22,097 | $1,477 |
| Level 6 Musculoskeletal Procedures | 95 | $263,902 | $17,078 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 16 | $34,580 | $2,635 |
Against the Texas average
For Combined Anterior and Posterior Spinal Fusion with CC (DRG 454), Texas Orthopedic Hospital charged $469,307 on average, 5% more than the Texas average of $446,825, and was paid $43,786 against a state average of $54,675. For Revision of Hip or Knee Replacement with CC (DRG 467), Texas Orthopedic Hospital charged $370,048 on average, 41% more than the Texas average of $263,167, and was paid $28,375 against a state average of $30,624. For Major Joint or Limb Reattachment Procedures of Upper Extremities (DRG 483), Texas Orthopedic Hospital charged $274,190 on average, 49% more than the Texas average of $184,475, and was paid $18,016 against a state average of $19,757. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Texas Orthopedic Hospital charged $221,817 on average, 91% more than the Texas average of $116,220, and was paid $12,920 against a state average of $15,157. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $169,311 was 71% above the state average of $98,771. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $37,696 was 109% above the state average of $18,063. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $90,228 was 53% above the state average of $58,833. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $37,702 was 24% above the state average of $30,502.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Texas Orthopedic Hospital in Houston, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-12 (CMS case 2006)
- Met Requirements — 2025-05-06 (CMS case 4337)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
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.