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St Joseph Medical Center: what a joint replacement costs

Bloomington, IL 61701 · CMS Certification Number 140162. 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
$8,405
Eastland Medical Plaza Surgicenter, same ZIP
Outpatient here
$12,146
146 Medicare cases, APC 5115
Inpatient here
$13,472
25 Medicare stays, MS-DRG 470

Medicare prices at St Joseph Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,472$80,6866.0×$12,146
Shoulder replacement————
Hip replacement after a fracture (DRG 522)$15,145$78,2565.2×—

Quality

Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 6%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 180 beds

Illinois requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay St Joseph Medical Center for a knee or hip replacement?

In 2024 Medicare paid St Joseph Medical Center an average of $13,472 per inpatient hip or knee replacement stay (MS-DRG 470, 25 stays) and $12,146 per outpatient case (APC 5115, 146 cases).

What is St Joseph Medical Center's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $80,686, 6.0× 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 St Joseph Medical Center?

Yes for Medicare facility payments. Eastland Medical Plaza Surgicenter, an orthopedic surgery center same ZIP away, is paid about $8,405 by Medicare for a knee replacement (CPT 27447), $5,067 less than an inpatient stay at St Joseph Medical Center. Not every patient is a surgery-center candidate.

How does St Joseph Medical Center compare with other Illinois hospitals?

Medicare paid St Joseph Medical Center less than 93% of the 45 Illinois hospitals that report inpatient hip or knee replacement.