Carmichael, CA 95608 · CMS Certification Number 050516. 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 | $20,087 | $147,072 | 7.3× | $16,773 |
| Shoulder replacement | — | — | — | $23,737 |
| Hip replacement after a fracture (DRG 522) | $22,896 | $149,884 | 6.5× | — |
Complications after hip or knee replacement: 4.3% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 370 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Mercy San Juan Medical Center an average of $20,087 per inpatient hip or knee replacement stay (MS-DRG 470, 23 stays) and $16,773 per outpatient case (APC 5115, 116 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $147,072, 7.3× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Greater Sacramento Surgery Center, an orthopedic surgery center 2.9 mi away, is paid about $12,209 by Medicare for a knee replacement (CPT 27447), $7,878 less than an inpatient stay at Mercy San Juan Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Mercy San Juan Medical Center less than 55% of the 119 California hospitals that report inpatient hip or knee replacement.