Worcester, MA 01655 · CMS Certification Number 220163. 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 | $23,151 | $89,894 | 3.9× | $13,796 |
| Shoulder replacement | $32,324 | $127,699 | 4.0× | $19,966 |
| Hip replacement after a fracture (DRG 522) | $25,678 | $92,229 | 3.6× | — |
Complications after hip or knee replacement: 3.6% (no different from the national rate). Readmissions: 6.2%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 325 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Umass Memorial Medical Center Inc an average of $23,151 per inpatient hip or knee replacement stay (MS-DRG 470, 73 stays) and $13,796 per outpatient case (APC 5115, 187 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $89,894, 3.9× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Worcester Surgical Center, Inc, an orthopedic surgery center 1.7 mi away, is paid about $9,380 by Medicare for a knee replacement (CPT 27447), $13,771 less than an inpatient stay at Umass Memorial Medical Center Inc. Not every patient is a surgery-center candidate.
Medicare paid Umass Memorial Medical Center Inc more than 85% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.