Palm Coast, FL 32164 · CMS Certification Number 100118. 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 | $15,743 | $103,105 | 6.5× | $11,906 |
| Shoulder replacement | $24,662 | $119,411 | 4.8× | $16,567 |
| Hip replacement after a fracture (DRG 522) | $17,684 | $92,864 | 5.3× | — |
Complications after hip or knee replacement: 5.3% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 99 beds
Florida has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Adventhealth Palm Coast an average of $15,743 per inpatient hip or knee replacement stay (MS-DRG 470, 14 stays) and $11,906 per outpatient case (APC 5115, 96 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $103,105, 6.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. East Coast Surgery Center, an orthopedic surgery center 19.3 mi away, is paid about $8,150 by Medicare for a knee replacement (CPT 27447), $7,593 less than an inpatient stay at Adventhealth Palm Coast. Not every patient is a surgery-center candidate.
Medicare paid Adventhealth Palm Coast more than 59% of the 88 Florida hospitals that report inpatient hip or knee replacement.