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Mainegeneral Medical Center: what a joint replacement costs

Augusta, ME 04330 · CMS Certification Number 200039. 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
$12,731
66 Medicare cases, APC 5115
Inpatient here
$19,194
11 Medicare stays, MS-DRG 470

Medicare prices at Mainegeneral Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$19,194$59,9993.1×$12,731
Shoulder replacement———$18,256
Hip replacement after a fracture (DRG 522)$21,385$65,1053.0×—

Quality

Complications after hip or knee replacement: 4% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 287 beds

Maine requires a certificate of need for new surgery centers.

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Questions

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

In 2024 Medicare paid Mainegeneral Medical Center an average of $19,194 per inpatient hip or knee replacement stay (MS-DRG 470, 11 stays) and $12,731 per outpatient case (APC 5115, 66 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $59,999, 3.1× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

How does Mainegeneral Medical Center compare with other Maine hospitals?

Medicare paid Mainegeneral Medical Center more than 100% of the 3 Maine hospitals that report inpatient hip or knee replacement.