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Falmouth Hospital: what a joint replacement costs

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.

Surgery center nearby
$9,585
Cape Cod Surgery Center, 7.7 mi
Outpatient here
$14,028
Medicare allowed amount, 152 cases, APC 5115
Inpatient here
$15,138
Avg total payment (incl. patient share), 35 Medicare stays, MS-DRG 470

Medicare prices at Falmouth Hospital

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$15,138$42,2422.8×$14,028
Shoulder replacement$20,212$65,4183.2×$19,132
Hip replacement after a fracture (DRG 522)$16,654$53,2423.2×—

Quality

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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Questions

How much does Medicare pay Falmouth Hospital for a knee or hip replacement?

In 2024 the average total payment to Falmouth Hospital for an inpatient hip or knee replacement stay was $15,138 (MS-DRG 470, 35 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,028 per outpatient case (APC 5115, 152 cases).

What is Falmouth Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $42,242, 2.8× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Is a knee replacement cheaper at a surgery center near Falmouth Hospital?

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.

How does Falmouth Hospital compare with other Massachusetts hospitals?

Falmouth Hospital's average total payment per Medicare stay is lower than 97% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.