New York, NY 10003 · CMS Certification Number 330169. 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 | $23,380 | $102,724 | 4.4× | $14,797 |
| Shoulder replacement | — | — | — | — |
Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 1111 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Mount Sinai Beth Israel an average of $23,380 per inpatient hip or knee replacement stay (MS-DRG 470, 11 stays) and $14,797 per outpatient case (APC 5115, 11 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $102,724, 4.4× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Gramercy Surgery Center Inc, an orthopedic surgery center 0.6 mi away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $12,645 less than an inpatient stay at Mount Sinai Beth Israel. Not every patient is a surgery-center candidate.
Medicare paid Mount Sinai Beth Israel more than 77% of the 56 New York hospitals that report inpatient hip or knee replacement.