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Presence Saint Francis Hospital: what a joint replacement costs

Evanston, IL 60202 · CMS Certification Number 140080. 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
$9,238
North Shore Surgical Center, 2.9 mi
Outpatient here
$12,781
15 Medicare cases, APC 5115
Inpatient here
$19,112
24 Medicare stays, MS-DRG 470

Medicare prices at Presence Saint Francis Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$19,112$120,1056.3×$12,781
Shoulder replacement————

Quality

Complications after hip or knee replacement: 4.7% (no different from the national rate). Readmissions: 6%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 427 beds

Illinois requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Presence Saint Francis Hospital for a knee or hip replacement?

In 2024 Medicare paid Presence Saint Francis Hospital an average of $19,112 per inpatient hip or knee replacement stay (MS-DRG 470, 24 stays) and $12,781 per outpatient case (APC 5115, 15 cases).

What is Presence Saint Francis Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $120,105, 6.3× 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 Presence Saint Francis Hospital?

Yes for Medicare facility payments. North Shore Surgical Center, an orthopedic surgery center 2.9 mi away, is paid about $9,238 by Medicare for a knee replacement (CPT 27447), $9,874 less than an inpatient stay at Presence Saint Francis Hospital. Not every patient is a surgery-center candidate.

How does Presence Saint Francis Hospital compare with other Illinois hospitals?

Medicare paid Presence Saint Francis Hospital more than 84% of the 45 Illinois hospitals that report inpatient hip or knee replacement.