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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $27,622 | $70,474 | 2.6× | $14,891 |
| Shoulder replacement | $36,593 | $100,467 | 2.7× | $21,153 |
| Hip replacement after a fracture (DRG 522) | $34,435 | $128,903 | 3.7× | — |
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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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).
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.
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.
Medicare paid Mount Sinai Hospital more than 95% of the 56 New York hospitals that report inpatient hip or knee replacement.