Price AtlasInteractive atlas · All states · techysurgeon.comProvidence Mission Hospital: what a joint replacement costs
Mission Viejo, CA 92691 · CMS Certification Number 050567. 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.
Medicare prices at Providence Mission Hospital
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $18,347 | $115,641 | 6.3× | $16,148 |
| Shoulder replacement | — | — | — | $22,852 |
| Hip replacement after a fracture (DRG 522) | $23,230 | $118,191 | 5.1× | — |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $29,906 | 1.6× | $20,713–$43,593 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Healthnet | $43,593 | 2.4× | 1 |
| UnitedHealthcare | $39,903 | 2.2× | 1 |
| Blue Shield of California | $30,974 | 1.7× | 1 |
| Cigna | $28,839 | 1.6× | 1 |
| Elevance/Anthem/Empire | $24,290 | 1.3× | 1 |
| Oscar | $20,713 | 1.1× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Quality
Complications after hip or knee replacement: 4.8% (no different from the national rate). Readmissions: 6.3%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 565 beds
California has no certificate-of-need law.
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Questions
How much does Medicare pay Providence Mission Hospital for a knee or hip replacement?
In 2024 the average total payment to Providence Mission Hospital for an inpatient hip or knee replacement stay was $18,347 (MS-DRG 470, 20 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $16,148 per outpatient case (APC 5115, 365 cases).
What is Providence Mission Hospital's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $115,641, 6.3× the average total payment for a Medicare stay. 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 Providence Mission Hospital?
Yes for Medicare facility payments. Mission Surgery Center, an orthopedic surgery center same ZIP away, is paid about $10,036 by Medicare for a knee replacement (CPT 27447), $8,311 less than an inpatient stay at Providence Mission Hospital. Not every patient is a surgery-center candidate.
How does Providence Mission Hospital compare with other California hospitals?
Providence Mission Hospital's average total payment per Medicare stay is lower than 83% of the 119 California hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Providence Mission Hospital for a hip or knee replacement?
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $29,906 across 6 insurers, ranging from $20,713 to $43,593.