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Kaleida Health: what a joint replacement costs

Buffalo, NY 14210 · CMS Certification Number 330005. 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
$9,292
Center for Ambulatory Surgery, LLC, 4.4 mi
Outpatient here
$13,688
355 Medicare cases, APC 5115
Inpatient here
$19,772
17 Medicare stays, MS-DRG 470

Medicare prices at Kaleida Health

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$19,772$64,5453.3×$13,688
Shoulder replacement———$19,318
Hip replacement after a fracture (DRG 522)$24,393$66,5452.7×—

Quality

Complications after hip or knee replacement: 3.6% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 986 beds

New York requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Kaleida Health for a knee or hip replacement?

In 2024 Medicare paid Kaleida Health an average of $19,772 per inpatient hip or knee replacement stay (MS-DRG 470, 17 stays) and $13,688 per outpatient case (APC 5115, 355 cases).

What is Kaleida Health's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $64,545, 3.3× 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 Kaleida Health?

Yes for Medicare facility payments. Center for Ambulatory Surgery, LLC, an orthopedic surgery center 4.4 mi away, is paid about $9,292 by Medicare for a knee replacement (CPT 27447), $10,480 less than an inpatient stay at Kaleida Health. Not every patient is a surgery-center candidate.

How does Kaleida Health compare with other New York hospitals?

Medicare paid Kaleida Health more than 55% of the 56 New York hospitals that report inpatient hip or knee replacement.