Rochester, NY 14626 · CMS Certification Number 330226. 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 | $18,194 | $36,464 | 2.0× | $13,578 |
| Shoulder replacement | $22,927 | $43,711 | 1.9× | $19,711 |
Complications after hip or knee replacement: 4.2% (no different from the national rate). Readmissions: 6.8%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 311 beds
New York requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Unity Hospital of Rochester an average of $18,194 per inpatient hip or knee replacement stay (MS-DRG 470, 58 stays) and $13,578 per outpatient case (APC 5115, 175 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $36,464, 2.0× 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 8.0 mi away, is paid about $8,661 by Medicare for a knee replacement (CPT 27447), $9,533 less than an inpatient stay at Unity Hospital of Rochester. Not every patient is a surgery-center candidate.
Medicare paid Unity Hospital of Rochester less than 63% of the 56 New York hospitals that report inpatient hip or knee replacement.