Trinity Health Muskegon Hospital: what a joint replacement costs

In 2024 the average total payment to Trinity Health Muskegon Hospital for an inpatient hip or knee replacement stay was $15,950 (MS-DRG 470, 19 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,079 per outpatient case (APC 5115, 137 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $66,759, 4.2× 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. Shoreline ASC, Inc., an orthopedic surgery center 4.4 mi away, is paid about $8,528 by Medicare for a knee replacement (CPT 27447), $7,422 less than an inpatient stay at Trinity Health Muskegon Hospital. Not every patient is a surgery-center candidate.

Trinity Health Muskegon Hospital's average total payment per Medicare stay is lower than 54% of the 37 Michigan 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 $40,289 across 23 insurers, ranging from $10,522 to $40,289.