Clovis, CA 93611 · CMS Certification Number 050492. 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 | $18,514 | $102,192 | 5.5× | $15,896 |
| Shoulder replacement | — | — | — | $20,322 |
| Hip replacement after a fracture (DRG 522) | $22,571 | $93,454 | 4.1× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $13,834 | 0.7× | $11,946–$22,323 | 7 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Kaiser Permanente | $22,323 | 1.2× | 1 |
| Network by Design | $14,482 | 0.8× | 1 |
| Cigna | $14,195 | 0.8× | 1 |
| Aetna | $13,834 | 0.7× | 1 |
| UnitedHealthcare | $12,070 | 0.7× | 1 |
| Blue Shield of California | $11,989 | 0.6× | 1 |
| Humana | $11,946 | 0.6× | 1 |
From the hospital's price-transparency file (2026-06-15); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-06-15); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.2%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 352 beds
California has no certificate-of-need law.
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In 2024 the average total payment to Clovis Community Medical Center for an inpatient hip or knee replacement stay was $18,514 (MS-DRG 470, 24 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $15,896 per outpatient case (APC 5115, 106 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $102,192, 5.5× 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. Kaizen Surgery Center, an orthopedic surgery center same ZIP away, is paid about $9,494 by Medicare for a knee replacement (CPT 27447), $9,020 less than an inpatient stay at Clovis Community Medical Center. Not every patient is a surgery-center candidate.
Clovis Community Medical Center's average total payment per Medicare stay is lower than 80% of the 119 California hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $13,834 across 7 insurers, ranging from $11,946 to $22,323.