WASHINGTON — For the first time, the government is publicly revealing how much hospitals charge, and the differences are astounding: Some bill tens of thousands of dollars more than others for the same treatment, even within the same city.

Why does a joint replacement cost 40 times as much at one hospital as at another across the country? It's a mystery, federal health officials say.

"It doesn't make sense," Jonathan Blum, Medicare deputy administrator, said Wednesday. The higher charges don't reflect better care, he said.

And the amounts are too huge to be explained by obvious differences among hospitals, such as a more expensive regional economy, older or sicker patients, or the extra costs of running a teaching hospital, he said.

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