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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $18,640 | $86,988 | 4.7× | $12,212 |
| Shoulder replacement | $21,430 | $93,939 | 4.4× | $17,471 |
| Hip replacement after a fracture (DRG 522) | $21,344 | $71,298 | 3.3× | — |
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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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).
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.
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.
Medicare paid Mainehealth Maine Medical Center more than 67% of the 3 Maine hospitals that report inpatient hip or knee replacement.