Urbana, IL 61801 · CMS Certification Number 140091. 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 | $15,199 | $71,597 | 4.7× | $11,979 |
| Shoulder replacement | — | — | — | $16,840 |
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 316 beds
Illinois requires a certificate of need for new surgery centers.
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In 2024 Medicare paid The Carle Foundation Hospital an average of $15,199 per inpatient hip or knee replacement stay (MS-DRG 470, 15 stays) and $11,979 per outpatient case (APC 5115, 279 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $71,597, 4.7× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Champaign Surgicenter, LLC, an orthopedic surgery center 5.1 mi away, is paid about $8,550 by Medicare for a knee replacement (CPT 27447), $6,649 less than an inpatient stay at The Carle Foundation Hospital. Not every patient is a surgery-center candidate.
Medicare paid The Carle Foundation Hospital more than 56% of the 45 Illinois hospitals that report inpatient hip or knee replacement.