Winchester, MA 01890 · CMS Certification Number 220105. 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 | $16,109 | $31,714 | 2.0× | $14,022 |
| Shoulder replacement | — | — | — | $19,966 |
| Hip replacement after a fracture (DRG 522) | $16,599 | $32,666 | 2.0× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $17,842 | 1.1× | — | 1 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Elevance/Anthem/Empire | $17,842 | 1.1× | 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: 5.9%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 189 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Winchester Hospital for an inpatient hip or knee replacement stay was $16,109 (MS-DRG 470, 64 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,022 per outpatient case (APC 5115, 283 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $31,714, 2.0× 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 2.7 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $6,843 less than an inpatient stay at Winchester Hospital. Not every patient is a surgery-center candidate.
Winchester Hospital's average total payment per Medicare stay is lower than 69% 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 $17,842 across 1 insurer.