Oakland, CA 94609 · CMS Certification Number 050043. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $25,441 | $128,716 | 5.1× | $18,234 |
| Shoulder replacement | $28,442 | $115,953 | 4.1× | — |
| Hip replacement after a fracture (DRG 522) | $23,583 | $124,767 | 5.3× | — |
Complications after hip or knee replacement: 3.8% (no different from the national rate). Readmissions: 4.5%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 569 beds
California has no certificate-of-need law.
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In 2024 the average total payment to Alta Bates Summit Medical Center for an inpatient hip or knee replacement stay was $25,441 (MS-DRG 470, 68 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $18,234 per outpatient case (APC 5115, 15 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $128,716, 5.1× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Bay Surgery Center, an orthopedic surgery center same ZIP away, is paid about $13,116 by Medicare for a knee replacement (CPT 27447), $12,325 less than an inpatient stay at Alta Bates Summit Medical Center. Not every patient is a surgery-center candidate.
Alta Bates Summit Medical Center's average total payment per Medicare stay is higher than 87% of the 119 California hospitals that report inpatient hip or knee replacement.