Journal article
Variation of Medicare Payments for Total Knee Arthroplasty
The Journal of arthroplasty, Vol.28(9), pp.1513-1520
10/2013
DOI: 10.1016/j.arth.2013.06.001
PMCID: PMC3795823
PMID: 23845765
Abstract
We analyzed the 2009 Medicare inpatient claims data and other databases to estimate Medicare payments for primary or revision total knee arthroplasty (TKA). The average Medicare hospital payment per procedure was $13,464 for primary TKA (n=227,587) and $17,331 for revision TKA (n=18,677). For both primary and revision TKAs Medicare payments varied substantially across patients, hospitals and healthcare markets. Less than one percent of primary TKA cases but seven percent of revision TKA cases triggered Medicare “outlier” payments, which were $10,000 or higher per case beyond regular diagnosis-related-group payments. Urban and major teaching hospitals were more likely to treat these unusually expensive cases. Hospitals in the Northeast and West regions tended to receive higher Medicare payments than hospitals in the Midwest.
Details
- Title: Subtitle
- Variation of Medicare Payments for Total Knee Arthroplasty
- Creators
- Yue Li - Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New YorkXin Lu - Division of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaBrian R Wolf - Department of Orthopaedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, IowaJohn J Callaghan - Department of Orthopaedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, IowaPeter Cram - Division of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.28(9), pp.1513-1520
- DOI
- 10.1016/j.arth.2013.06.001
- PMID
- 23845765
- PMCID
- PMC3795823
- NLM abbreviation
- J Arthroplasty
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Publisher
- Elsevier Inc
- Grant note
- AR062133 / NIAMS R01 AG033035 / NIA at the NIH R01 HL085347 / NHLBI Department of Veterans Affairs
- Language
- English
- Date published
- 10/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Internal Medicine
- Record Identifier
- 9984040317502771
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