Worcester, MA 01608 · CMS Certification Number 220176. 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 | $20,826 | $124,798 | 6.0× | $13,950 |
| Shoulder replacement | — | — | — | $19,966 |
Complications after hip or knee replacement: 4.2% (no different from the national rate). Readmissions: 4.4%. Overall Care Compare rating: 2 of 5 stars. For-profit · Acute · 283 beds
Massachusetts requires a certificate of need for new surgery centers.
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In 2024 Medicare paid St Vincent Hospital an average of $20,826 per inpatient hip or knee replacement stay (MS-DRG 470, 50 stays) and $13,950 per outpatient case (APC 5115, 153 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $124,798, 6.0× 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 2.0 mi away, is paid about $9,380 by Medicare for a knee replacement (CPT 27447), $11,446 less than an inpatient stay at St Vincent Hospital. Not every patient is a surgery-center candidate.
Medicare paid St Vincent Hospital more than 77% of the 39 Massachusetts hospitals that report inpatient hip or knee replacement.