Fall River, MA 02720 · CMS Certification Number 220074. 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 paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $16,911 | $56,416 | 3.3× | $13,979 |
| Shoulder replacement | — | — | — | $19,966 |
| Hip replacement after a fracture (DRG 522) | $17,669 | $56,756 | 3.2× | — |
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.5%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 695 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Southcoast Hospital Group, Inc an average of $16,911 per inpatient hip or knee replacement stay (MS-DRG 470, 203 stays) and $13,979 per outpatient case (APC 5115, 186 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $56,416, 3.3× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Same Day Surgiclinic, an orthopedic surgery center same ZIP away, is paid about $9,054 by Medicare for a knee replacement (CPT 27447), $7,857 less than an inpatient stay at Southcoast Hospital Group, Inc. Not every patient is a surgery-center candidate.
Medicare paid Southcoast Hospital Group, Inc more than 51% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.