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The Carle Foundation Hospital: what a joint replacement costs

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.

Surgery center nearby
$8,550
Champaign Surgicenter, LLC, 5.1 mi
Outpatient here
$11,979
279 Medicare cases, APC 5115
Inpatient here
$15,199
15 Medicare stays, MS-DRG 470

Medicare prices at The Carle Foundation Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$15,199$71,5974.7×$11,979
Shoulder replacement———$16,840

Quality

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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Questions

How much does Medicare pay The Carle Foundation Hospital for a knee or hip replacement?

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).

What is The Carle Foundation Hospital's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near The Carle Foundation Hospital?

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.

How does The Carle Foundation Hospital compare with other Illinois hospitals?

Medicare paid The Carle Foundation Hospital more than 56% of the 45 Illinois hospitals that report inpatient hip or knee replacement.