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Peconic Bay Medical Center: what a joint replacement costs

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.

Surgery center nearby
$10,559
Suffolk Surgery Center LLC, 14.9 mi
Outpatient here
$13,252
348 Medicare cases, APC 5115
Inpatient here
$18,856
229 Medicare stays, MS-DRG 470

Medicare prices at Peconic Bay Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$18,856$72,2273.8×$13,252
Shoulder replacement———$19,965
Hip replacement after a fracture (DRG 522)$17,879$105,3015.9×—

Quality

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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Questions

How much does Medicare pay Peconic Bay Medical Center for a knee or hip replacement?

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).

What is Peconic Bay Medical Center's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near Peconic Bay Medical Center?

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.

How does Peconic Bay Medical Center compare with other New York hospitals?

Medicare paid Peconic Bay Medical Center less than 55% of the 56 New York hospitals that report inpatient hip or knee replacement.