Indianapolis, IN 46278 · CMS Certification Number 150160. 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 paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $12,814 | $45,843 | 3.6× | $11,674 |
| Shoulder replacement | $16,858 | $49,589 | 2.9× | $16,547 |
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5%. Physician-owned · Acute · 38 beds
Indiana has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Orthoindy Hospital an average of $12,814 per inpatient hip or knee replacement stay (MS-DRG 470, 142 stays) and $11,674 per outpatient case (APC 5115, 815 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $45,843, 3.6× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Eagle Highlands Surgery Center, an orthopedic surgery center 3.4 mi away, is paid about $8,860 by Medicare for a knee replacement (CPT 27447), $3,954 less than an inpatient stay at Orthoindy Hospital. Not every patient is a surgery-center candidate.
Medicare paid Orthoindy Hospital less than 97% of the 34 Indiana hospitals that report inpatient hip or knee replacement.