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Novato Community Hospital: what a joint replacement costs

Novato, CA 94945 · CMS Certification Number 050131. 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
$12,874
North Bay Regional Surgery Center, LLC, same ZIP
Outpatient here
$18,221
284 Medicare cases, APC 5115
Inpatient here
$22,350
30 Medicare stays, MS-DRG 470

Medicare prices at Novato Community Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$22,350$100,8734.5×$18,221
Shoulder replacement———$25,953
Hip replacement after a fracture (DRG 522)$23,262$108,7274.7×—

Quality

Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 75 beds

California has no certificate-of-need law.

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Questions

How much does Medicare pay Novato Community Hospital for a knee or hip replacement?

In 2024 Medicare paid Novato Community Hospital an average of $22,350 per inpatient hip or knee replacement stay (MS-DRG 470, 30 stays) and $18,221 per outpatient case (APC 5115, 284 cases).

What is Novato Community Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $100,873, 4.5× 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 Novato Community Hospital?

Yes for Medicare facility payments. North Bay Regional Surgery Center, LLC, an orthopedic surgery center same ZIP away, is paid about $12,874 by Medicare for a knee replacement (CPT 27447), $9,476 less than an inpatient stay at Novato Community Hospital. Not every patient is a surgery-center candidate.

How does Novato Community Hospital compare with other California hospitals?

Medicare paid Novato Community Hospital more than 77% of the 119 California hospitals that report inpatient hip or knee replacement.