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Mainehealth Maine Medical Center: what a joint replacement costs

Portland, ME 04102 · CMS Certification Number 200009. 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, same ZIP
Outpatient here
$12,212
551 Medicare cases, APC 5115
Inpatient here
$18,640
43 Medicare stays, MS-DRG 470

Medicare prices at Mainehealth Maine Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$18,640$86,9884.7×$12,212
Shoulder replacement$21,430$93,9394.4×$17,471
Hip replacement after a fracture (DRG 522)$21,344$71,2983.3×—

Quality

Complications after hip or knee replacement: 2.7% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 606 beds

Maine requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Mainehealth Maine Medical Center for a knee or hip replacement?

In 2024 Medicare paid Mainehealth Maine Medical Center an average of $18,640 per inpatient hip or knee replacement stay (MS-DRG 470, 43 stays) and $12,212 per outpatient case (APC 5115, 551 cases).

What is Mainehealth Maine Medical Center's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $86,988, 4.7× 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 Mainehealth Maine Medical Center?

Yes for Medicare facility payments. Oa ASC LLC, an orthopedic surgery center same ZIP away, is paid about $8,975 by Medicare for a knee replacement (CPT 27447), $9,665 less than an inpatient stay at Mainehealth Maine Medical Center. Not every patient is a surgery-center candidate.

How does Mainehealth Maine Medical Center compare with other Maine hospitals?

Medicare paid Mainehealth Maine Medical Center more than 67% of the 3 Maine hospitals that report inpatient hip or knee replacement.