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Adventist Health St Helena: what a joint replacement costs

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.

Surgery center nearby
$12,516
Norcal Specialty Surgery Center, 14.7 mi
Outpatient here
$16,667
626 Medicare cases, APC 5115
Inpatient here
$20,123
16 Medicare stays, MS-DRG 470

Medicare prices at Adventist Health St Helena

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$20,123$234,88911.7×$16,667
Shoulder replacement————

Quality

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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Questions

How much does Medicare pay Adventist Health St Helena for a knee or hip replacement?

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).

What is Adventist Health St Helena's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near Adventist Health St Helena?

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.

How does Adventist Health St Helena compare with other California hospitals?

Medicare paid Adventist Health St Helena less than 54% of the 119 California hospitals that report inpatient hip or knee replacement.