Saint Francis Hospital & Medical Center: what a joint replacement costs

In 2024 the average total payment to Saint Francis Hospital & Medical Center for an inpatient hip or knee replacement stay was $19,552 (MS-DRG 470, 37 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,484 per outpatient case (APC 5115, 303 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $64,145, 3.3× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Yes for Medicare facility payments. Lighthouse Surgery Center, LLC, an orthopedic surgery center same ZIP away, is paid about $9,533 by Medicare for a knee replacement (CPT 27447), $10,019 less than an inpatient stay at Saint Francis Hospital & Medical Center. Not every patient is a surgery-center candidate.

Saint Francis Hospital & Medical Center's average total payment per Medicare stay is higher than 75% of the 12 Connecticut 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 $39,793 across 26 insurers, ranging from $22,791 to $46,934.