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Alton Memorial Hospital: what a joint replacement costs

Alton, IL 62002 · CMS Certification Number 140002. 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.

Surgery center nearby
$8,800
Anderson Surgery Center LLC, 13.3 mi
Outpatient here
$12,002
Medicare allowed amount, 202 cases, APC 5115
Inpatient here
$14,616
Avg total payment (incl. patient share), 35 Medicare stays, MS-DRG 470

Medicare prices at Alton Memorial Hospital

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$14,616$64,1014.4×$12,002
Shoulder replacement———$17,185

Commercial negotiated rates (beta)

MS-DRG 470Median across insurers× Medicare total paymentLowest–highest insurerInsurers
Hip or knee replacement$22,5241.5×$16,466–$37,9128
InsurerMedian negotiated, MS-DRG 470× Medicare total paymentPlans
Humana$37,9122.6×1
Elevance/Anthem/Empire$29,7512.0×1
Aetna$24,7021.7×1
Sarah Bush Lincoln$23,2841.6×1
Consociate$21,7651.5×1
Health Alliance$21,4141.5×1
Cigna$18,7101.3×1
UnitedHealthcare$16,4661.1×1

From the hospital's price-transparency file (2025-12-15); commercial plans, dollar-amount contracts only.

From the hospital's price-transparency file (2025-12-15); commercial plans, dollar-amount contracts only.

Quality

Complications after hip or knee replacement: 3.7% (no different from the national rate). Readmissions: 6.6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 222 beds

Illinois requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Alton Memorial Hospital for a knee or hip replacement?

In 2024 the average total payment to Alton Memorial Hospital for an inpatient hip or knee replacement stay was $14,616 (MS-DRG 470, 35 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,002 per outpatient case (APC 5115, 202 cases).

What is Alton Memorial Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $64,101, 4.4× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Is a knee replacement cheaper at a surgery center near Alton Memorial Hospital?

Yes for Medicare facility payments. Anderson Surgery Center LLC, an orthopedic surgery center 13.3 mi away, is paid about $8,800 by Medicare for a knee replacement (CPT 27447), $5,816 less than an inpatient stay at Alton Memorial Hospital. Not every patient is a surgery-center candidate.

How does Alton Memorial Hospital compare with other Illinois hospitals?

Alton Memorial Hospital's average total payment per Medicare stay is lower than 64% of the 45 Illinois hospitals that report inpatient hip or knee replacement.

What do commercial insurers pay Alton Memorial Hospital for a hip or knee replacement?

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $22,524 across 8 insurers, ranging from $16,466 to $37,912.