Boston, MA 02111 · CMS Certification Number 220116. 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 | $24,723 | $54,114 | 2.2× | $13,769 |
| Shoulder replacement | — | — | — | $19,333 |
| Hip replacement after a fracture (DRG 522) | $25,036 | $54,543 | 2.2× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $20,886 | 0.8× | $18,481–$43,551 | 11 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Fallon Health | $43,551 | 1.8× | 1 |
| Fallon Health Connectorcare | $43,551 | 1.8× | 1 |
| Elevance/Anthem/Empire | $40,019 | 1.6× | 1 |
| Aetna | $24,414 | 1.0× | 1 |
| BCBS Massachusetts | $23,957 | 1.0× | 1 |
| Middlesex County | $20,886 | 0.8× | 1 |
| Suffolk County | $20,886 | 0.8× | 1 |
| Tewksbury Hospital | $20,886 | 0.8× | 1 |
| Tufts Health Public Plan | $20,886 | 0.8× | 1 |
| Commonwealth Care Alliance | $18,565 | 0.8× | 1 |
| Wellsense Clarity Connectorcare | $18,481 | 0.7× | 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: 4% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 415 beds
Massachusetts requires a certificate of need for new surgery centers.
Open the interactive price tagBuild a reportAll Massachusetts hospitals
In 2024 the average total payment to Tufts Medical Center for an inpatient hip or knee replacement stay was $24,723 (MS-DRG 470, 26 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $13,769 per outpatient case (APC 5115, 110 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $54,114, 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 5.6 mi away, is paid about $9,266 by Medicare for a knee replacement (CPT 27447), $15,457 less than an inpatient stay at Tufts Medical Center. Not every patient is a surgery-center candidate.
Tufts Medical Center's average total payment per Medicare stay is higher than 95% 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 $20,886 across 11 insurers, ranging from $18,481 to $43,551.