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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $13,043 | $150,721 | 11.6× | $11,795 |
| Shoulder replacement | — | — | — | — |
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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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).
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.
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.
Medicare paid Pinnacle Hospital less than 94% of the 34 Indiana hospitals that report inpatient hip or knee replacement.