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Saint Joseph Regional Medical Center: what a joint replacement costs

Mishawaka, IN 46545 · CMS Certification Number 150012. 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
$8,775
Allied Physicians Surgery Center LLC, 3.2 mi
Outpatient here
$11,901
267 Medicare cases, APC 5115
Inpatient here
$14,970
18 Medicare stays, MS-DRG 470

Medicare prices at Saint Joseph Regional Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$14,970$78,4485.2×$11,901
Shoulder replacement———$16,574
Hip replacement after a fracture (DRG 522)$17,667$79,2234.5×—

Quality

Complications after hip or knee replacement: 5.3% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 301 beds

Indiana has a certificate-of-need program that does not cover surgery centers.

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Questions

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

In 2024 Medicare paid Saint Joseph Regional Medical Center an average of $14,970 per inpatient hip or knee replacement stay (MS-DRG 470, 18 stays) and $11,901 per outpatient case (APC 5115, 267 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $78,448, 5.2× 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 Saint Joseph Regional Medical Center?

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.

How does Saint Joseph Regional Medical Center compare with other Indiana hospitals?

Medicare paid Saint Joseph Regional Medical Center more than 65% of the 34 Indiana hospitals that report inpatient hip or knee replacement.