Melbourne, FL 32901 · CMS Certification Number 100019. 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 | $13,743 | $112,880 | 8.2× | $11,906 |
| Shoulder replacement | — | — | — | $16,845 |
| Hip replacement after a fracture (DRG 522) | $15,258 | $115,951 | 7.6× | — |
Complications after hip or knee replacement: 4.7% (no different from the national rate). Readmissions: 5.8%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 514 beds
Florida has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Holmes Regional Medical Center an average of $13,743 per inpatient hip or knee replacement stay (MS-DRG 470, 39 stays) and $11,906 per outpatient case (APC 5115, 196 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $112,880, 8.2× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Melbourne Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,450 by Medicare for a knee replacement (CPT 27447), $5,293 less than an inpatient stay at Holmes Regional Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Holmes Regional Medical Center less than 75% of the 88 Florida hospitals that report inpatient hip or knee replacement.