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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $22,350 | $100,873 | 4.5× | $18,221 |
| Shoulder replacement | — | — | — | $25,953 |
| Hip replacement after a fracture (DRG 522) | $23,262 | $108,727 | 4.7× | — |
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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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).
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.
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.
Medicare paid Novato Community Hospital more than 77% of the 119 California hospitals that report inpatient hip or knee replacement.