Saint Joseph Regional Medical Center: what a joint replacement costs

In 2024 the average total payment to Saint Joseph Regional Medical Center for an inpatient hip or knee replacement stay was $14,970 (MS-DRG 470, 18 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,901 per outpatient case (APC 5115, 267 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $78,448, 5.2× 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. Allied Physicians Surgery Center LLC, an orthopedic surgery center 3.2 mi away, is paid about $8,775 by Medicare for a knee replacement (CPT 27447), $6,195 less than an inpatient stay at Saint Joseph Regional Medical Center. Not every patient is a surgery-center candidate.

Saint Joseph Regional Medical Center's average total payment per Medicare stay is higher than 65% of the 34 Indiana 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 $38,989 across 33 insurers, ranging from $16,593 to $57,512.