Bronx, NY 10467 · CMS Certification Number 330059. 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 | $31,015 | $121,570 | 3.9× | $14,435 |
| Shoulder replacement | $33,303 | $162,369 | 4.9× | — |
| Hip replacement after a fracture (DRG 522) | $29,625 | $162,176 | 5.5× | — |
| Payer | Median negotiated, MS-DRG 470 | × Medicare | Plans |
|---|---|---|---|
| EmblemHealth | $18,537 | 0.6× | 1 |
| Other | $15,071 | 0.5× | 1 |
| Healthfirst | $6,330 | 0.2× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 2.8% (no different from the national rate). Readmissions: 5.2%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 1491 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Montefiore Medical Center an average of $31,015 per inpatient hip or knee replacement stay (MS-DRG 470, 186 stays) and $14,435 per outpatient case (APC 5115, 36 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $121,570, 3.9× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Empire State Ambulatory Surgery Center , an orthopedic surgery center same ZIP away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $20,280 less than an inpatient stay at Montefiore Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Montefiore Medical Center more than 100% of the 56 New York hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' median negotiated rates for MS-DRG 470 range from $6,330 (Healthfirst) to $18,537 (EmblemHealth).