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Lakes Regional Healthcare: what a joint replacement costs

Spirit Lake, IA 51360 · CMS Certification Number 160124. 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
—
No orthopedic surgery center within 25 miles
Outpatient here
$11,245
Medicare allowed amount, 66 cases, APC 5115
Inpatient here
$13,677
Avg total payment (incl. patient share), 34 Medicare stays, MS-DRG 470

Medicare prices at Lakes Regional Healthcare

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$13,677$43,3623.2×$11,245
Shoulder replacement———$15,909

Quality

Complications after hip or knee replacement: 6.5% (no different from the national rate). Readmissions: 5.9%. Overall Care Compare rating: 2 of 5 stars. Government · Acute · 49 beds

Iowa requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Lakes Regional Healthcare for a knee or hip replacement?

In 2024 the average total payment to Lakes Regional Healthcare for an inpatient hip or knee replacement stay was $13,677 (MS-DRG 470, 34 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,245 per outpatient case (APC 5115, 66 cases).

What is Lakes Regional Healthcare's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $43,362, 3.2× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

How does Lakes Regional Healthcare compare with other Iowa hospitals?

Lakes Regional Healthcare's average total payment per Medicare stay is higher than 67% of the 15 Iowa hospitals that report inpatient hip or knee replacement.