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Mainehealth Pen Bay Hospital: what a joint replacement costs

Rockport, ME 04856 · CMS Certification Number 200063. 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
$12,078
Medicare allowed amount, 68 cases, APC 5115
Inpatient here
—
Under 11 stays

Medicare prices at Mainehealth Pen Bay Hospital

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement———$12,078
Shoulder replacement$24,793$83,7723.4×—

Commercial negotiated rates (beta)

MS-DRG 470Median across insurers× Medicare total paymentLowest–highest insurerInsurers
Hip or knee replacement$38,270——1
InsurerMedian negotiated, MS-DRG 470× Medicare total paymentPlans
Elevance/Anthem/Empire$38,270—1

From the hospital's price-transparency file (2025-09-09); commercial plans, dollar-amount contracts only.

From the hospital's price-transparency file (2025-09-09); commercial plans, dollar-amount contracts only.

Quality

Complications after hip or knee replacement: 4.8% (no different from the national rate). Readmissions: 6.3%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 109 beds

Maine requires a certificate of need for new surgery centers.

Open the interactive price tagBuild a reportAll Maine hospitals

Questions

How much does Medicare pay Mainehealth Pen Bay Hospital for a knee or hip replacement?

The Medicare allowed amount averaged $12,078 per outpatient hip or knee replacement case (APC 5115, 68 cases) in 2024. Inpatient stays were too few to report.

What do commercial insurers pay Mainehealth Pen Bay Hospital for a hip or knee replacement?

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $38,270 across 1 insurer.