OBJECTIVES The number of hip fracture hospitalizations in the U.S. was approximately 352,000 in 2011 and expected to rise. The consequences of hip fractures are significant regarding the associated negative impacts on functioning and quality of life.  Intertrochanteric hip fractures are frequently stabilized surgically using cephalomedullary nails (CM). Complications may include post-operative femoral-shaft fracture, mechanical complications, and delayed/non-union, requiring reoperations that increase risk to the patient and cost to the healthcare system. METHODS A retrospective analysis of the Premier research database was conducted.   Patients diagnosed with open and/or closed intertrochanteric fractures (ICD-9-CM codes 820.2x or 820.3x) and treated for Hip Fracture (MS-DRG 480-482) from 1-JAN-2008 through 30-JUN-2012 were included in the study.  Among this population, patients treated with IM were identified using standard charge descriptions within orthopedic-implant hardware charges.   To identify patients who had a reoperation, patient-level admission records starting from index admission up to 12-months post-index procedure were investigated within the same MS-DRG classifications. RESULTS Overall, 73,745 patients qualified for the study (71% female; 74% ≥ 75-years-old).  Of these, 32,175 (44%) were treated using CM.  The average hospital cost of the index procedure was $15,798USD per patient (inclusive of fixed and variable costs), of which the average cost of the orthopedic nails was $1,704USD.   Among these patients, a total of 419 (1.3%) patients were readmitted at 427 occasions within the 12-month study period.  The mean hospital cost of treating these readmissions was $16,352USD, and the primary diagnoses codes for these readmissions included femoral fractures, nonunions, and device/mechanical complications. CONCLUSIONS Although the incidence of readmission following a hip fracture is low, the economic burden placed on the healthcare system and the humanistic burden are both significant.  The incidence rate and long-term sequelae for hip fractures are well documented in the literature; however, the mean costs to a hospital have not yet been published.