Boston, MA 02120 · CMS Certification Number 220088. 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 | $16,418 | $36,463 | 2.2× | $14,017 |
| Shoulder replacement | $22,411 | $57,764 | 2.6× | $19,906 |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $20,562 | 1.3× | $19,540–$21,558 | 3 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Cigna | $21,558 | 1.3× | 1 |
| Elevance/Anthem/Empire | $20,562 | 1.3× | 1 |
| UnitedHealthcare | $19,540 | 1.2× | 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: 3.1% (no different from the national rate). Readmissions: 3.7%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 118 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 the average total payment to New England Baptist Hospital for an inpatient hip or knee replacement stay was $16,418 (MS-DRG 470, 882 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,017 per outpatient case (APC 5115, 1432 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $36,463, 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 6.4 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $7,152 less than an inpatient stay at New England Baptist Hospital. Not every patient is a surgery-center candidate.
New England Baptist Hospital's average total payment per Medicare stay is lower than 56% 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 $20,562 across 3 insurers, ranging from $19,540 to $21,558.