Holyoke, MA 01040 · CMS Certification Number 220024. 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 | $16,103 | $38,895 | 2.4× | $14,110 |
| Shoulder replacement | — | — | — | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $19,142 | 1.2× | $18,872–$25,627 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Aetna | $25,627 | 1.6× | 1 |
| UnitedHealthcare | $20,121 | 1.2× | 1 |
| Fallon | $19,232 | 1.2× | 1 |
| Wellsense Sco | $19,052 | 1.2× | 1 |
| Commonwealth Care Alliance | $18,872 | 1.2× | 1 |
| Tufts Health Public Plans | $18,872 | 1.2× | 1 |
From the hospital's price-transparency file (2026-05-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-05-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4.5% (no different from the national rate). Readmissions: 6.5%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 164 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Holyoke Medical Center for an inpatient hip or knee replacement stay was $16,103 (MS-DRG 470, 15 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,110 per outpatient case (APC 5115, 48 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $38,895, 2.4× 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. Baystate New England Orthopedic Surgery Center, an orthopedic surgery center 6.5 mi away, is paid about $8,827 by Medicare for a knee replacement (CPT 27447), $7,276 less than an inpatient stay at Holyoke Medical Center. Not every patient is a surgery-center candidate.
Holyoke Medical Center's average total payment per Medicare stay is lower than 72% 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 $19,142 across 6 insurers, ranging from $18,872 to $25,627.