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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $19,112 | $120,105 | 6.3× | $12,781 |
| Shoulder replacement | — | — | — | — |
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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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).
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.
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.
Medicare paid Presence Saint Francis Hospital more than 84% of the 45 Illinois hospitals that report inpatient hip or knee replacement.