New York, NY 10019 · CMS Certification Number 330046. 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 | $24,680 | $74,061 | 3.0× | $14,289 |
| Shoulder replacement | $31,534 | $117,013 | 3.7× | $19,812 |
| Hip replacement after a fracture (DRG 522) | $28,145 | $134,149 | 4.8× | — |
Complications after hip or knee replacement: 3.1% (no different from the national rate). Readmissions: 5.6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 1028 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Mount Sinai West an average of $24,680 per inpatient hip or knee replacement stay (MS-DRG 470, 99 stays) and $14,289 per outpatient case (APC 5115, 129 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $74,061, 3.0× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Hss West Side ASC, an orthopedic surgery center same ZIP away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $13,945 less than an inpatient stay at Mount Sinai West. Not every patient is a surgery-center candidate.
Medicare paid Mount Sinai West more than 84% of the 56 New York hospitals that report inpatient hip or knee replacement.