Meriden, CT 06450 · CMS Certification Number 070017. 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 | $16,516 | $40,623 | 2.5× | $14,417 |
| Shoulder replacement | $22,354 | $61,217 | 2.7× | $20,512 |
| Hip replacement after a fracture (DRG 522) | $18,028 | $55,811 | 3.1× | — |
Complications after hip or knee replacement: 5.3% (no different from the national rate). Readmissions: 5.6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 144 beds
Connecticut requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Midstate Medical Center an average of $16,516 per inpatient hip or knee replacement stay (MS-DRG 470, 66 stays) and $14,417 per outpatient case (APC 5115, 622 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $40,623, 2.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Middlesex Endoscopy Center, an orthopedic surgery center 6.1 mi away, is paid about $9,533 by Medicare for a knee replacement (CPT 27447), $6,983 less than an inpatient stay at Midstate Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Midstate Medical Center less than 92% of the 12 Connecticut hospitals that report inpatient hip or knee replacement.