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Carle Health Proctor Hospital: what a joint replacement costs

Peoria, IL 61614 · CMS Certification Number 140013. 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
$8,266
Springfield Clinic Peoria ASC, same ZIP
Outpatient here
$12,022
662 Medicare cases, APC 5115
Inpatient here
$13,162
30 Medicare stays, MS-DRG 470

Medicare prices at Carle Health Proctor Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,162$95,4307.3×$12,022
Shoulder replacement$17,308$136,8557.9×$17,185
Hip replacement after a fracture (DRG 522)$14,407$83,7205.8×—

Quality

Complications after hip or knee replacement: 4% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 305 beds

Illinois requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Carle Health Proctor Hospital for a knee or hip replacement?

In 2024 Medicare paid Carle Health Proctor Hospital an average of $13,162 per inpatient hip or knee replacement stay (MS-DRG 470, 30 stays) and $12,022 per outpatient case (APC 5115, 662 cases).

What is Carle Health Proctor Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $95,430, 7.3× what Medicare paid. 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 Carle Health Proctor Hospital?

Yes for Medicare facility payments. Springfield Clinic Peoria ASC, an orthopedic surgery center same ZIP away, is paid about $8,266 by Medicare for a knee replacement (CPT 27447), $4,896 less than an inpatient stay at Carle Health Proctor Hospital. Not every patient is a surgery-center candidate.

How does Carle Health Proctor Hospital compare with other Illinois hospitals?

Medicare paid Carle Health Proctor Hospital less than 98% of the 45 Illinois hospitals that report inpatient hip or knee replacement.