Rochester, NY 14621 · CMS Certification Number 330125. 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 | $20,121 | $45,903 | 2.3× | $13,437 |
| Shoulder replacement | — | — | — | $17,808 |
| Hip replacement after a fracture (DRG 522) | $21,938 | $46,049 | 2.1× | — |
Complications after hip or knee replacement: 3.3% (no different from the national rate). Readmissions: 7.7%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 528 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Rochester General Hospital an average of $20,121 per inpatient hip or knee replacement stay (MS-DRG 470, 23 stays) and $13,437 per outpatient case (APC 5115, 65 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $45,903, 2.3× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Rochester Surgery Center, an orthopedic surgery center 4.3 mi away, is paid about $8,661 by Medicare for a knee replacement (CPT 27447), $11,460 less than an inpatient stay at Rochester General Hospital. Not every patient is a surgery-center candidate.
Medicare paid Rochester General Hospital more than 59% of the 56 New York hospitals that report inpatient hip or knee replacement.