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Cambridge Health Alliance: what a joint replacement costs

Cambridge, MA 02138 · CMS Certification Number 220011. 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
$9,266
Shields Surgery Center, 3.4 mi
Outpatient here
$13,750
34 Medicare cases, APC 5115
Inpatient here
$27,365
21 Medicare stays, MS-DRG 470

Medicare prices at Cambridge Health Alliance

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$27,365$20,9650.8×$13,750
Shoulder replacement————

Quality

Complications after hip or knee replacement: 5.4% (no different from the national rate). Readmissions: 7.3%. Overall Care Compare rating: 3 of 5 stars. Government · Acute · 159 beds

Massachusetts requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Cambridge Health Alliance for a knee or hip replacement?

In 2024 Medicare paid Cambridge Health Alliance an average of $27,365 per inpatient hip or knee replacement stay (MS-DRG 470, 21 stays) and $13,750 per outpatient case (APC 5115, 34 cases).

What is Cambridge Health Alliance's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $20,965, 0.8× 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 Cambridge Health Alliance?

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), $18,099 less than an inpatient stay at Cambridge Health Alliance. Not every patient is a surgery-center candidate.

How does Cambridge Health Alliance compare with other Massachusetts hospitals?

Medicare paid Cambridge Health Alliance more than 97% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.