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Billings Clinic Hospital: what a joint replacement costs

Billings, MT 59101 · CMS Certification Number 270004. 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
$8,592
Northern Rockies Surgery Center, same ZIP
Outpatient here
$10,666
294 Medicare cases, APC 5115
Inpatient here
$15,365
54 Medicare stays, MS-DRG 470

Medicare prices at Billings Clinic Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$15,365$39,6742.6×$10,666
Shoulder replacement———$16,650
Hip replacement after a fracture (DRG 522)$16,457$40,6972.5×—

Quality

Complications after hip or knee replacement: 3.9% (no different from the national rate). Readmissions: 5.2%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 304 beds

Montana has a certificate-of-need program that does not cover surgery centers.

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Questions

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

In 2024 Medicare paid Billings Clinic Hospital an average of $15,365 per inpatient hip or knee replacement stay (MS-DRG 470, 54 stays) and $10,666 per outpatient case (APC 5115, 294 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $39,674, 2.6× what Medicare paid. 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 Billings Clinic Hospital?

Yes for Medicare facility payments. Northern Rockies Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,592 by Medicare for a knee replacement (CPT 27447), $6,773 less than an inpatient stay at Billings Clinic Hospital. Not every patient is a surgery-center candidate.

How does Billings Clinic Hospital compare with other Montana hospitals?

Medicare paid Billings Clinic Hospital more than 100% of the 6 Montana hospitals that report inpatient hip or knee replacement.