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Mount Sinai Hospital: what a joint replacement costs

New York, NY 10029 · CMS Certification Number 330024. 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
$10,735
Fifth Avenue Surgery Center, 1.1 mi
Outpatient here
$14,891
230 Medicare cases, APC 5115
Inpatient here
$27,622
158 Medicare stays, MS-DRG 470

Medicare prices at Mount Sinai Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$27,622$70,4742.6×$14,891
Shoulder replacement$36,593$100,4672.7×$21,153
Hip replacement after a fracture (DRG 522)$34,435$128,9033.7×—

Quality

Complications after hip or knee replacement: 2.7% (no different from the national rate). Readmissions: 4.2%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 1171 beds

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

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Questions

How much does Medicare pay Mount Sinai Hospital for a knee or hip replacement?

In 2024 Medicare paid Mount Sinai Hospital an average of $27,622 per inpatient hip or knee replacement stay (MS-DRG 470, 158 stays) and $14,891 per outpatient case (APC 5115, 230 cases).

What is Mount Sinai Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $70,474, 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 Mount Sinai Hospital?

Yes for Medicare facility payments. Fifth Avenue Surgery Center, an orthopedic surgery center 1.1 mi away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $16,887 less than an inpatient stay at Mount Sinai Hospital. Not every patient is a surgery-center candidate.

How does Mount Sinai Hospital compare with other New York hospitals?

Medicare paid Mount Sinai Hospital more than 95% of the 56 New York hospitals that report inpatient hip or knee replacement.