Miami Beach, FL 33140 · CMS Certification Number 100034. 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 | $17,026 | $61,522 | 3.6× | $11,730 |
| Shoulder replacement | — | — | — | — |
| Hip replacement after a fracture (DRG 522) | $18,805 | $79,444 | 4.2× | — |
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 672 beds
Florida has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Mount Sinai Medical Center of Florida, Inc an average of $17,026 per inpatient hip or knee replacement stay (MS-DRG 470, 21 stays) and $11,730 per outpatient case (APC 5115, 108 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $61,522, 3.6× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Key Biscayne Surgery Center, an orthopedic surgery center 7.3 mi away, is paid about $8,709 by Medicare for a knee replacement (CPT 27447), $8,317 less than an inpatient stay at Mount Sinai Medical Center of Florida, Inc. Not every patient is a surgery-center candidate.
Medicare paid Mount Sinai Medical Center of Florida, Inc more than 78% of the 88 Florida hospitals that report inpatient hip or knee replacement.