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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $19,759 | $45,610 | 2.3× | $13,523 |
| Shoulder replacement | — | — | — | $19,711 |
| Hip replacement after a fracture (DRG 522) | $20,584 | $48,505 | 2.4× | — |
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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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).
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.
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.
Medicare paid Highland Hospital more than 54% of the 56 New York hospitals that report inpatient hip or knee replacement.