Saint Helena, CA 94574 · CMS Certification Number 050013. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $20,123 | $234,889 | 11.7× | $16,667 |
| Shoulder replacement | — | — | — | — |
Complications after hip or knee replacement: 3.9% (no different from the national rate). Readmissions: 5.2%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 181 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Adventist Health St Helena an average of $20,123 per inpatient hip or knee replacement stay (MS-DRG 470, 16 stays) and $16,667 per outpatient case (APC 5115, 626 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $234,889, 11.7× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Norcal Specialty Surgery Center, an orthopedic surgery center 14.7 mi away, is paid about $12,516 by Medicare for a knee replacement (CPT 27447), $7,607 less than an inpatient stay at Adventist Health St Helena. Not every patient is a surgery-center candidate.
Medicare paid Adventist Health St Helena less than 54% of the 119 California hospitals that report inpatient hip or knee replacement.