Holy Cross Hospital: what a joint replacement costs

In 2024 the average total payment to Holy Cross Hospital for an inpatient hip or knee replacement stay was $15,532 (MS-DRG 470, 64 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,823 per outpatient case (APC 5115, 624 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $76,813, 4.9× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Yes for Medicare facility payments. Coral Ridge Outpatient Center, an orthopedic surgery center 1.8 mi away, is paid about $8,913 by Medicare for a knee replacement (CPT 27447), $6,619 less than an inpatient stay at Holy Cross Hospital. Not every patient is a surgery-center candidate.

Holy Cross Hospital's average total payment per Medicare stay is higher than 57% of the 88 Florida hospitals that report inpatient hip or knee replacement.

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $31,416 across 27 insurers, ranging from $12,893 to $31,416.