Boston, MA 02115 · CMS Certification Number 220110. 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 | $23,665 | $85,392 | 3.6× | $13,866 |
| Shoulder replacement | $29,291 | $120,968 | 4.1× | $19,410 |
| Hip replacement after a fracture (DRG 522) | $26,753 | $117,020 | 4.4× | — |
Complications after hip or knee replacement: 3.4% (no different from the national rate). Readmissions: 5.6%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 663 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Brigham and Women's Hospital an average of $23,665 per inpatient hip or knee replacement stay (MS-DRG 470, 167 stays) and $13,866 per outpatient case (APC 5115, 194 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $85,392, 3.6× what Medicare paid. 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 5.9 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $14,399 less than an inpatient stay at Brigham and Women's Hospital. Not every patient is a surgery-center candidate.
Medicare paid Brigham and Women's Hospital more than 87% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.