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HCHospitalCostData

Updated April 2026

Major Hip and Knee Joint Replacement in North Dakota

33 North Dakota hospitals report Medicare totals for this DRG, averaging $21,474 (below the $24,455 national mean), with a 3× spread from $12,068 to $31,084. 1 carry an A grade, 0 carry an F.

Major Hip and Knee Joint Replacement (DRG 470) is a Orthopedic procedure tracked in CMS Inpatient Payment files. Across North Dakota, 3,348 hospitals report payment data for 682,992 total discharges, with an average Medicare payment of $24,455 (median $23,685). A $58,650 maximum and $7,200 minimum on the same DRG procedure is normal for the Medicare payment system — DRG codes bundle cases that may differ in complexity, and hospital wage-index adjustments alone can move payments by 30% across regions.

Within North Dakota, the 3,348 hospitals reporting this procedure span the full range of ownership types and hospital sizes. The state-specific average ($24,455) is shaped by which hospitals in the state see enough volume to report the DRG code at all. For patients with elective scheduling on Major Hip and Knee Joint Replacement, the cost-comparison logic is straightforward: the per-procedure payment range is meaningfully wide, so the hospital chosen affects total cost. For patients in an emergency, the choice is functionally fixed — but the listed prices still matter for insurance-coverage and out-of-pocket planning.

About This Procedure

Musculoskeletal DRGs include hip and knee replacement, spine fusion, fracture repair, and major joint revision. Implant cost, length of stay, and rehab intensity drive most of the price variation across hospitals — DRGs 469/470 (joint replacement) are among the most-watched price benchmarks in Medicare.

Major Hip and Knee Joint Replacement is Medicare DRG 470 in the Orthopedic category. National Medicare average for this DRG is $24,455 across 3,348 reporting hospitals. The state-level view here filters that universe down to North Dakota only.

Cost Picture in North Dakota

North Dakota's average for this DRG sits below the national Medicare mean. State-level differences are explained primarily by the regional Medicare wage index — the multiplier CMS applies to standardize DRG payments to local labor costs — alongside hospital case mix and the concentration of academic referral centers in the state's larger metros.

Within the state, the 3× spread between the lowest- and highest-reporting facility usually reflects length-of-stay differences, complication adjustments for sicker patients, teaching-status add-ons, and outlier payments for unusually long stays. Two hospitals reporting the same DRG can post meaningfully different totals without anything “wrong” happening at either site. For non-Medicare patients, the more relevant figure is the negotiated commercial rate published in each hospital's machine-readable file under the CMS Hospital Price Transparency Rule.

Quality Alongside Price

For a planned admission, the most useful complement to the cost view is the hospital-specific quality data on CMS Care Compare. The site publishes risk-adjusted measures of mortality, readmission, complication, infection, and patient experience for every Medicare-participating hospital. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators feed many of these CMS measures.

For complex procedures, hospital-level case volume correlates with outcomes in published research, even after risk adjustment. CMS publishes case counts on Care Compare alongside outcome measures.

Hospitals in North Dakota Reporting Major Hip and Knee Joint Replacement

Sorted lowest to highest Medicare total payment. Pricing is informational and should be considered alongside CMS quality measures.

#HospitalPaymentGrade
1Chi Oakes Hospital
Oakes
$12,068C
2Linton Hospital - Cah
Linton
$14,578D
3Smp Health St Aloisius
Harvey
$15,633C
4Northwood Deaconess Health Center
Northwood
$15,944C
5North Dakota State Hospital
Jamestown
$16,845B
6Altru Hospital
Grand Forks
$16,908B
7Chi St Alexius Health Dickinson
Dickinson
$17,515C
8Sakakawea Medical Center - Cah
Hazen
$17,597C
9Fargo Va Medical Center
Fargo
$18,198A
10P H S Indian Hosp At Belcourt-Quentin N Burdick
Belcourt
$18,607B
11Heart Of America Medical Center
Rugby
$18,658B
12Prairie St John's
Fargo
$18,982C
13Sanford Medical Center Bismarck
Bismarck
$19,246B
14Sanford Medical Center Fargo
Fargo
$19,520B
15St Andrew's Hospital
Bottineau
$20,060C
16Cavalier County Memorial Hospital Association
Langdon
$21,447B
17Ashley Medical Center
Ashley
$21,784C
18Cooperstown Medical Center
Cooperstown
$21,811C
19Standing Rock Service Unit
Fort Yates,
$22,380C
20Chi St Alexius Health Turtle Lake
Turtle Lake
$22,643C
21Chi St Alexius Health Devils Lake
Devils Lake
$22,747C
22Chi St Alexius Health
Bismarck
$23,211C
23Chi St Alexius Health Williston
Williston
$23,583C
24Nelson County Health System
Mcville
$23,994C
25Pembina County Memorial Hospital
Cavalier
$24,583C
26Sanford Hillsboro
Hillsboro
$24,963C
27Trinity Kenmare Community Hospital
Kenmare
$25,100C
28Southwest Healthcare Services
Bowman
$25,623C
29Lisbon Area Health Services
Lisbon
$26,329C
30Sanford Mayville
Mayville
$28,129C
31Mckenzie County Healthcare Systems Inc
Watford City
$28,439C
32Presentation Medical Center
Rolla
$30,438C
33Towner County Medical Center
Cando
$31,084C

Frequently Asked Questions

How much does major hip and knee joint replacement cost in North Dakota?

Major Hip and Knee Joint Replacement (DRG 470) averages $21,474 in total Medicare payment across 33 North Dakota hospitals reporting this code. Within the state, payments span $12,068 to $31,084 — about 3× from cheapest to most expensive.

Is Major Hip and Knee Joint Replacement more or less expensive in North Dakota than nationally?

North Dakota's state-level average of $21,474 sits below the national Medicare average of $24,455 for this DRG. State differences are driven primarily by the regional Medicare wage index, case mix, and the share of high-acuity referral hospitals.

Why is the spread between hospitals so wide?

Variation within a state runs 3× because the same DRG can come with different lengths of stay, complication adjustments, teaching-status add-ons, and outlier payments. The CMS Hospital Price Transparency Rule publishes machine-readable rate files that allow direct comparisons against negotiated commercial rates, which often differ from Medicare totals.

Are these the prices a privately insured patient would pay?

No. Figures here are Medicare DRG payments. Privately insured patients are billed under their plan's negotiated network rate, published in each hospital's price-transparency file. Uninsured patients should ask the hospital for the cash-pay rate, also disclosed under federal price-transparency rules.

Should I choose a hospital based only on price?

No. HospitalCostData is informational. Surgeon experience, hospital volume for the procedure, complication rates, and your specific clinical situation matter at least as much as price. Always discuss options with your physician and review CMS Care Compare quality data alongside any pricing benchmark.

See the methodology page for DRG sourcing and Medicare wage-index context.

Sources & Citations

  • CMS Medicare Inpatient Hospital Payments (IPPS). DRG-level average covered charges, total payments, and Medicare payments per facility. data.cms.gov
  • CMS Hospital Compare (Care Compare). Star ratings, mortality, readmission, safety-of-care, and patient-experience measures. medicare.gov/care-compare
  • CMS Hospital Price Transparency Rule. Standard charge files required from every Medicare-participating hospital. cms.gov/hospital-price-transparency
  • Agency for Healthcare Research and Quality (AHRQ). National benchmarks, quality indicators, and clinical context for hospital outcome measures. ahrq.gov

Dataset last refreshed: April 2026. Underlying CMS files are public domain. Suggested citation: “HospitalCostData, hospitalcostdata.com, accessed May 24, 2026.”

This page is informational only and does not constitute medical, legal, or financial advice. Care decisions should be made with a licensed physician.

Source: CMS Hospital Price Transparency, 2026.