Falmouth, MA 02540 · CMS Certification Number 220135. 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 | $15,138 | $42,242 | 2.8× | $14,028 |
| Shoulder replacement | $20,212 | $65,418 | 3.2× | $19,132 |
| Hip replacement after a fracture (DRG 522) | $16,654 | $53,242 | 3.2× | — |
Complications after hip or knee replacement: 4.8% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 95 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Falmouth Hospital an average of $15,138 per inpatient hip or knee replacement stay (MS-DRG 470, 35 stays) and $14,028 per outpatient case (APC 5115, 152 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $42,242, 2.8× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Cape Cod Surgery Center, an orthopedic surgery center 7.7 mi away, is paid about $9,585 by Medicare for a knee replacement (CPT 27447), $5,553 less than an inpatient stay at Falmouth Hospital. Not every patient is a surgery-center candidate.
Medicare paid Falmouth Hospital less than 97% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.