San Jose, CA 95128 · CMS Certification Number 050038. 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 | $28,442 | $91,504 | 3.2× | $18,490 |
| Shoulder replacement | — | — | — | — |
| Hip replacement after a fracture (DRG 522) | $31,519 | $133,438 | 4.2× | — |
Complications after hip or knee replacement: 5.4% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 2 of 5 stars. Government · Acute · 1337 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Santa Clara Valley Medical Center an average of $28,442 per inpatient hip or knee replacement stay (MS-DRG 470, 18 stays) and $18,490 per outpatient case (APC 5115, 19 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $91,504, 3.2× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Advanced Surgery Center, an orthopedic surgery center same ZIP away, is paid about $13,221 by Medicare for a knee replacement (CPT 27447), $15,221 less than an inpatient stay at Santa Clara Valley Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Santa Clara Valley Medical Center more than 94% of the 119 California hospitals that report inpatient hip or knee replacement.