Portland, ME 04101 · CMS Certification Number 200008. 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 | $14,614 | $72,166 | 4.9× | $12,197 |
| Shoulder replacement | — | — | — | $17,471 |
Complications after hip or knee replacement: 4.5% (no different from the national rate). Readmissions: 5.5%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 230 beds
Maine requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Northern Light Mercy Hospital an average of $14,614 per inpatient hip or knee replacement stay (MS-DRG 470, 11 stays) and $12,197 per outpatient case (APC 5115, 355 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $72,166, 4.9× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Oa ASC LLC, an orthopedic surgery center 2.1 mi away, is paid about $8,975 by Medicare for a knee replacement (CPT 27447), $5,639 less than an inpatient stay at Northern Light Mercy Hospital. Not every patient is a surgery-center candidate.
Medicare paid Northern Light Mercy Hospital less than 67% of the 3 Maine hospitals that report inpatient hip or knee replacement.