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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $18,145 | $107,799 | 5.9× | $15,420 |
| Shoulder replacement | — | — | — | $22,851 |
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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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).
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.
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.
Medicare paid Tri-City Medical Center less than 87% of the 119 California hospitals that report inpatient hip or knee replacement.