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Highland Hospital: what a joint replacement costs

Rochester, NY 14617 · CMS Certification Number 330164. 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
$8,661
Rochester Surgery Center, 6.8 mi
Outpatient here
$13,523
211 Medicare cases, APC 5115
Inpatient here
$19,759
51 Medicare stays, MS-DRG 470

Medicare prices at Highland Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$19,759$45,6102.3×$13,523
Shoulder replacement———$19,711
Hip replacement after a fracture (DRG 522)$20,584$48,5052.4×—

Quality

Complications after hip or knee replacement: 3.7% (no different from the national rate). Readmissions: 5%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 262 beds

New York requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Highland Hospital for a knee or hip replacement?

In 2024 Medicare paid Highland Hospital an average of $19,759 per inpatient hip or knee replacement stay (MS-DRG 470, 51 stays) and $13,523 per outpatient case (APC 5115, 211 cases).

What is Highland Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $45,610, 2.3× 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 Highland Hospital?

Yes for Medicare facility payments. Rochester Surgery Center, an orthopedic surgery center 6.8 mi away, is paid about $8,661 by Medicare for a knee replacement (CPT 27447), $11,098 less than an inpatient stay at Highland Hospital. Not every patient is a surgery-center candidate.

How does Highland Hospital compare with other New York hospitals?

Medicare paid Highland Hospital more than 54% of the 56 New York hospitals that report inpatient hip or knee replacement.