Washington, DC 20016 · CMS Certification Number 090005. 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 | $14,929 | $66,616 | 4.5× | $13,356 |
| Shoulder replacement | — | — | — | $19,023 |
| Hip replacement after a fracture (DRG 522) | $17,127 | $70,361 | 4.1× | — |
Complications after hip or knee replacement: 5.7% (no different from the national rate). Readmissions: 6%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 362 beds
District of Columbia requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Sibley Memorial Hospital an average of $14,929 per inpatient hip or knee replacement stay (MS-DRG 470, 51 stays) and $13,356 per outpatient case (APC 5115, 402 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $66,616, 4.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Surgery Center of Chevy Chase,, an orthopedic surgery center 3.3 mi away, is paid about $8,884 by Medicare for a knee replacement (CPT 27447), $6,045 less than an inpatient stay at Sibley Memorial Hospital. Not every patient is a surgery-center candidate.
Medicare paid Sibley Memorial Hospital less than 75% of the 4 District of Columbia hospitals that report inpatient hip or knee replacement.