Boca Raton, FL 33486 · CMS Certification Number 100168. 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 | $14,385 | $121,769 | 8.5× | $11,839 |
| Shoulder replacement | $20,076 | $204,316 | 10.2× | $16,845 |
| Hip replacement after a fracture (DRG 522) | $16,043 | $106,112 | 6.6× | — |
Complications after hip or knee replacement: 4.3% (no different from the national rate). Readmissions: 6.2%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 400 beds
Florida has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Boca Raton Regional Hospital an average of $14,385 per inpatient hip or knee replacement stay (MS-DRG 470, 41 stays) and $11,839 per outpatient case (APC 5115, 272 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $121,769, 8.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Boca Raton Outpatient Surgery & Laser Center, an orthopedic surgery center 2.0 mi away, is paid about $8,612 by Medicare for a knee replacement (CPT 27447), $5,773 less than an inpatient stay at Boca Raton Regional Hospital. Not every patient is a surgery-center candidate.
Medicare paid Boca Raton Regional Hospital less than 60% of the 88 Florida hospitals that report inpatient hip or knee replacement.