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Pinnacle Hospital: what a joint replacement costs

Crown Point, IN 46307 · CMS Certification Number 150166. 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
$8,617
Uchicago Medicine Crown Point Ambulatory Surgery Center, same ZIP
Outpatient here
$11,795
19 Medicare cases, APC 5115
Inpatient here
$13,043
42 Medicare stays, MS-DRG 470

Medicare prices at Pinnacle Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,043$150,72111.6×$11,795
Shoulder replacement————

Quality

Complications after hip or knee replacement: 4.1% (no different from the national rate). Readmissions: 5.6%. Physician-owned · Acute · 18 beds

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

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Questions

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

In 2024 Medicare paid Pinnacle Hospital an average of $13,043 per inpatient hip or knee replacement stay (MS-DRG 470, 42 stays) and $11,795 per outpatient case (APC 5115, 19 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $150,721, 11.6× 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 Pinnacle Hospital?

Yes for Medicare facility payments. Uchicago Medicine Crown Point Ambulatory Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,617 by Medicare for a knee replacement (CPT 27447), $4,426 less than an inpatient stay at Pinnacle Hospital. Not every patient is a surgery-center candidate.

How does Pinnacle Hospital compare with other Indiana hospitals?

Medicare paid Pinnacle Hospital less than 94% of the 34 Indiana hospitals that report inpatient hip or knee replacement.