New York, NY 10021 · CMS Certification Number 330119. 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 | $26,238 | $99,541 | 3.8× | $14,530 |
| Shoulder replacement | — | — | — | $19,560 |
| Hip replacement after a fracture (DRG 522) | $25,798 | $130,681 | 5.1× | — |
Complications after hip or knee replacement: 2.8% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 652 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Lenox Hill Hospital an average of $26,238 per inpatient hip or knee replacement stay (MS-DRG 470, 136 stays) and $14,530 per outpatient case (APC 5115, 61 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $99,541, 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. New York Center for Ambulatory Surgery, an orthopedic surgery center 0.4 mi away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $15,503 less than an inpatient stay at Lenox Hill Hospital. Not every patient is a surgery-center candidate.
Medicare paid Lenox Hill Hospital more than 93% of the 56 New York hospitals that report inpatient hip or knee replacement.