Irvine, CA 92618 · CMS Certification Number 050769. 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 | $17,493 | $85,751 | 4.9× | $15,979 |
| Shoulder replacement | $23,031 | $147,991 | 6.4× | $22,852 |
| Hip replacement after a fracture (DRG 522) | $18,581 | $100,602 | 5.4× | — |
Complications after hip or knee replacement: 3.9% (no different from the national rate). Readmissions: 3.8%. For-profit · Acute · 70 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Hoag Orthopedic Institute an average of $17,493 per inpatient hip or knee replacement stay (MS-DRG 470, 303 stays) and $15,979 per outpatient case (APC 5115, 1238 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $85,751, 4.9× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Post Surgery Center LLC, an orthopedic surgery center same ZIP away, is paid about $10,036 by Medicare for a knee replacement (CPT 27447), $7,457 less than an inpatient stay at Hoag Orthopedic Institute. Not every patient is a surgery-center candidate.
Medicare paid Hoag Orthopedic Institute less than 96% of the 119 California hospitals that report inpatient hip or knee replacement.