Riverhead, NY 11901 · CMS Certification Number 330107. 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 | $18,856 | $72,227 | 3.8× | $13,252 |
| Shoulder replacement | — | — | — | $19,965 |
| Hip replacement after a fracture (DRG 522) | $17,879 | $105,301 | 5.9× | — |
Complications after hip or knee replacement: 2.3% (no different from the national rate). Readmissions: 4.7%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 122 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Peconic Bay Medical Center an average of $18,856 per inpatient hip or knee replacement stay (MS-DRG 470, 229 stays) and $13,252 per outpatient case (APC 5115, 348 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $72,227, 3.8× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Suffolk Surgery Center LLC, an orthopedic surgery center 14.9 mi away, is paid about $10,559 by Medicare for a knee replacement (CPT 27447), $8,297 less than an inpatient stay at Peconic Bay Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Peconic Bay Medical Center less than 55% of the 56 New York hospitals that report inpatient hip or knee replacement.