Elmhurst, IL 60126 · CMS Certification Number 140200. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $14,795 | $87,778 | 5.9× | $12,158 |
| Shoulder replacement | $18,929 | $130,339 | 6.9× | $17,116 |
| Hip replacement after a fracture (DRG 522) | $15,414 | $99,223 | 6.4× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $22,923 | 1.5× | $20,671–$28,496 | 3 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Aetna | $28,496 | 1.9× | 1 |
| UnitedHealthcare | $22,923 | 1.5× | 1 |
| BCBS IL | $20,671 | 1.4× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4.6% (no different from the national rate). Readmissions: 6.2%. Overall Care Compare rating: 3 of 5 stars. For-profit · Acute · 247 beds
Illinois requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Elmhurst Memorial Hospital for an inpatient hip or knee replacement stay was $14,795 (MS-DRG 470, 165 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,158 per outpatient case (APC 5115, 339 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $87,778, 5.9× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Summit Center for Surgery, LLC, an orthopedic surgery center 2.3 mi away, is paid about $9,238 by Medicare for a knee replacement (CPT 27447), $5,557 less than an inpatient stay at Elmhurst Memorial Hospital. Not every patient is a surgery-center candidate.
Elmhurst Memorial Hospital's average total payment per Medicare stay is lower than 58% of the 45 Illinois hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $22,923 across 3 insurers, ranging from $20,671 to $28,496.