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Community Hospital East: what a joint replacement costs

Indianapolis, IN 46219 · CMS Certification Number 150074. 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
$8,860
Community Surgery Center East, 3.3 mi
Outpatient here
$11,642
93 Medicare cases, APC 5115
Inpatient here
$15,500
15 Medicare stays, MS-DRG 470

Medicare prices at Community Hospital East

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$15,500$84,9415.5×$11,642
Shoulder replacement———$16,944
Hip replacement after a fracture (DRG 522)$17,007$93,7925.5×—

Quality

Complications after hip or knee replacement: 4.4% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 263 beds

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

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Questions

How much does Medicare pay Community Hospital East for a knee or hip replacement?

In 2024 Medicare paid Community Hospital East an average of $15,500 per inpatient hip or knee replacement stay (MS-DRG 470, 15 stays) and $11,642 per outpatient case (APC 5115, 93 cases).

What is Community Hospital East's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $84,941, 5.5× 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 Community Hospital East?

Yes for Medicare facility payments. Community Surgery Center East, an orthopedic surgery center 3.3 mi away, is paid about $8,860 by Medicare for a knee replacement (CPT 27447), $6,640 less than an inpatient stay at Community Hospital East. Not every patient is a surgery-center candidate.

How does Community Hospital East compare with other Indiana hospitals?

Medicare paid Community Hospital East more than 74% of the 34 Indiana hospitals that report inpatient hip or knee replacement.