Brighton, MA 02135 · CMS Certification Number 220036. 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 | $21,739 | $47,804 | 2.2× | $13,698 |
| Shoulder replacement | — | — | — | — |
Complications after hip or knee replacement: 2.9% (no different from the national rate). Readmissions: 6.4%. Overall Care Compare rating: 3 of 5 stars. For-profit · Acute · 252 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 the average total payment to St Elizabeth's Medical Center for an inpatient hip or knee replacement stay was $21,739 (MS-DRG 470, 27 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $13,698 per outpatient case (APC 5115, 30 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $47,804, 2.2× 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 5.6 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $12,473 less than an inpatient stay at St Elizabeth's Medical Center. Not every patient is a surgery-center candidate.
St Elizabeth's Medical Center's average total payment per Medicare stay is higher than 82% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.