Newton, MA 02462 · CMS Certification Number 220101. 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 | $17,517 | $46,608 | 2.7× | $13,980 |
| Shoulder replacement | $22,889 | $67,808 | 3.0× | $19,966 |
| Hip replacement after a fracture (DRG 522) | $19,513 | $64,151 | 3.3× | — |
Complications after hip or knee replacement: 3.3% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 224 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Newton-Wellesley Hospital an average of $17,517 per inpatient hip or knee replacement stay (MS-DRG 470, 132 stays) and $13,980 per outpatient case (APC 5115, 675 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $46,608, 2.7× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Boston Out-Patient Surgical Suites, LLC, an orthopedic surgery center 4.8 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $8,251 less than an inpatient stay at Newton-Wellesley Hospital. Not every patient is a surgery-center candidate.
Medicare paid Newton-Wellesley Hospital more than 54% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.