Cambridge, MA 02138 · CMS Certification Number 220002. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $19,315 | $26,689 | 1.4× | $13,915 |
| Shoulder replacement | — | — | — | $19,966 |
| Hip replacement after a fracture (DRG 522) | $22,054 | $29,464 | 1.3× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $17,084 | 0.9× | — | 1 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Elevance/Anthem/Empire | $17,084 | 0.9× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4% (no different from the national rate). Readmissions: 5.5%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 217 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Mount Auburn Hospital for an inpatient hip or knee replacement stay was $19,315 (MS-DRG 470, 45 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $13,915 per outpatient case (APC 5115, 64 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $26,689, 1.4× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Shields Surgery Center, an orthopedic surgery center 3.4 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $10,049 less than an inpatient stay at Mount Auburn Hospital. Not every patient is a surgery-center candidate.
Mount Auburn Hospital's average total payment per Medicare stay is higher than 67% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $17,084 across 1 insurer.