Hospital for Special Surgery: what a joint replacement costs

In 2024 the average total payment to Hospital for Special Surgery for an inpatient hip or knee replacement stay was $25,507 (MS-DRG 470, 1332 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $14,605 per outpatient case (APC 5115, 2670 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $120,505, 4.7× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Yes for Medicare facility payments. New York Center for Ambulatory Surgery, an orthopedic surgery center 0.4 mi away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447), $14,772 less than an inpatient stay at Hospital for Special Surgery. Not every patient is a surgery-center candidate.

Hospital for Special Surgery's average total payment per Medicare stay is higher than 89% of the 56 New York hospitals that report inpatient hip or knee replacement.

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $68,940 across 13 insurers, ranging from $61,800 to $76,712.