Miami, FL 33136 · CMS Certification Number 100022. 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 | $25,737 | $71,818 | 2.8× | $11,730 |
| Shoulder replacement | — | — | — | $16,845 |
| Hip replacement after a fracture (DRG 522) | $25,722 | $74,709 | 2.9× | — |
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 4.9%. Overall Care Compare rating: 1 of 5 stars. Government · Acute · 2255 beds
Florida has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Jackson Memorial Hospital an average of $25,737 per inpatient hip or knee replacement stay (MS-DRG 470, 11 stays) and $11,730 per outpatient case (APC 5115, 99 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $71,818, 2.8× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Coral Gables Surgery Center, an orthopedic surgery center 4.2 mi away, is paid about $8,709 by Medicare for a knee replacement (CPT 27447), $17,028 less than an inpatient stay at Jackson Memorial Hospital. Not every patient is a surgery-center candidate.
Medicare paid Jackson Memorial Hospital more than 100% of the 88 Florida hospitals that report inpatient hip or knee replacement.