Hip or knee joint replacement surgery without major complications

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 41efcec26401
Generated: October 17, 2026

Original text from hospital filings

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Payers reporting MS-DRG 470

65 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	UnitedHealthcare case rate · inpatient · +14 other terms	705	$26,732	$27,705	$71.39 – $99,402
2	Aetna case rate · inpatient · +13 other terms	529	$25,701	$28,920	$69.22 – $401,211
3	Cigna case rate · inpatient · +12 other terms	478	$30,969	$32,329	$4,622 – $122,030
4	Humana fee schedule · inpatient · +13 other terms	438	$16,673	$18,869	$1,640 – $58,162
5	Blue Cross Blue Shield fee schedule · inpatient · +12 other terms	400	$27,050	$31,768	$73.00 – $129,742
6	WellCare fee schedule · inpatient · +9 other terms	270	$17,094	$17,933	$1,640 – $39,075
7	Molina fee schedule · inpatient · +11 other terms	256	$18,979	$20,783	$10,593 – $48,147
8	Devoted fee schedule · inpatient · +9 other terms	223	$16,862	$16,874	$1,624 – $37,115
9	Anthem case rate · inpatient · +10 other terms	198	$27,303	$31,104	$5,596 – $148,737
10	Oscar fee schedule · inpatient · +7 other terms	153	$20,986	$21,544	$13,516 – $48,102
11	Cigna Healthspring fee schedule · inpatient · +4 other terms	111	$17,448	$17,571	$1,640 – $36,388
12	Ambetter case rate · inpatient · +7 other terms	109	$26,035	$26,072	$12,892 – $57,044
13	Kaiser case rate · inpatient · +10 other terms	94	$21,717	$26,458	$4,089 – $59,838
14	Highmark facility · case rate · inpatient · +8 other terms	79	$29,505	$29,846	$2,535 – $65,432
15	Tricare case rate · inpatient · +9 other terms	72	$19,833	$19,967	$12,856 – $38,133
16	Optum case rate · inpatient · +9 other terms	63	$16,659	$17,738	$599.00 – $54,073
17	MultiPlan per diem · inpatient · +9 other terms	58	$9,371	$8,605	$950.00 – $24,705
18	Phcs per diem · inpatient · +9 other terms	56	$9,371	$12,024	$1,320 – $89,264
19	Healthcare Highways fee schedule · inpatient · +4 other terms	54	$24,552	$24,205	$18,478 – $25,625
20	Caresource other · inpatient · +8 other terms	52	$19,359	$19,740	$2.06 – $37,394
21	Medica case rate · inpatient · +9 other terms	52	$25,566	$27,639	$7,999 – $48,979
22	Medicare facility · other · inpatient · +8 other terms	46	$15,253	$16,412	$1,935 – $36,167
23	Superior Healthplan fee schedule · inpatient · +2 other terms	43	$18,873	$19,881	$14,481 – $38,207
24	Medical Mutual fee schedule · inpatient · +7 other terms	38	$27,701	$27,453	$13,106 – $59,214
25	Regence facility · case rate · inpatient · +8 other terms	35	$36,035	$37,186	$12,533 – $65,301

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