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Tri-City Medical Center: what a joint replacement costs

Oceanside, CA 92056 · CMS Certification Number 050128. 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
$10,395
North Coast Surgery Center, same ZIP
Outpatient here
$15,420
74 Medicare cases, APC 5115
Inpatient here
$18,145
14 Medicare stays, MS-DRG 470

Medicare prices at Tri-City Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$18,145$107,7995.9×$15,420
Shoulder replacement———$22,851

Quality

Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 6.8%. Overall Care Compare rating: 1 of 5 stars. Government · Acute · 397 beds

California has no certificate-of-need law.

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Questions

How much does Medicare pay Tri-City Medical Center for a knee or hip replacement?

In 2024 Medicare paid Tri-City Medical Center an average of $18,145 per inpatient hip or knee replacement stay (MS-DRG 470, 14 stays) and $15,420 per outpatient case (APC 5115, 74 cases).

What is Tri-City Medical Center's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $107,799, 5.9× 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 Tri-City Medical Center?

Yes for Medicare facility payments. North Coast Surgery Center, an orthopedic surgery center same ZIP away, is paid about $10,395 by Medicare for a knee replacement (CPT 27447), $7,750 less than an inpatient stay at Tri-City Medical Center. Not every patient is a surgery-center candidate.

How does Tri-City Medical Center compare with other California hospitals?

Medicare paid Tri-City Medical Center less than 87% of the 119 California hospitals that report inpatient hip or knee replacement.