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Northern Light Mercy Hospital: what a joint replacement costs

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.

Surgery center nearby
$8,975
Oa ASC LLC, 2.1 mi
Outpatient here
$12,197
355 Medicare cases, APC 5115
Inpatient here
$14,614
11 Medicare stays, MS-DRG 470

Medicare prices at Northern Light Mercy Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$14,614$72,1664.9×$12,197
Shoulder replacement———$17,471

Quality

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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Questions

How much does Medicare pay Northern Light Mercy Hospital for a knee or hip replacement?

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).

What is Northern Light Mercy Hospital's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near Northern Light Mercy Hospital?

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.

How does Northern Light Mercy Hospital compare with other Maine hospitals?

Medicare paid Northern Light Mercy Hospital less than 67% of the 3 Maine hospitals that report inpatient hip or knee replacement.