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Plainview Hospital: what a joint replacement costs

Plainview, NY 11803 · CMS Certification Number 330331. 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
$10,559
Day-Op Center of Long Island Inc, 2.7 mi
Outpatient here
$14,223
50 Medicare cases, APC 5115
Inpatient here
$18,833
23 Medicare stays, MS-DRG 470

Medicare prices at Plainview Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$18,833$81,8624.3×$14,223
Shoulder replacement————

Quality

Complications after hip or knee replacement: 3.4% (no different from the national rate). Readmissions: 6.5%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 204 beds

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

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Questions

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

In 2024 Medicare paid Plainview Hospital an average of $18,833 per inpatient hip or knee replacement stay (MS-DRG 470, 23 stays) and $14,223 per outpatient case (APC 5115, 50 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $81,862, 4.3× 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 Plainview Hospital?

Yes for Medicare facility payments. Day-Op Center of Long Island Inc, an orthopedic surgery center 2.7 mi away, is paid about $10,559 by Medicare for a knee replacement (CPT 27447), $8,274 less than an inpatient stay at Plainview Hospital. Not every patient is a surgery-center candidate.

How does Plainview Hospital compare with other New York hospitals?

Medicare paid Plainview Hospital less than 57% of the 56 New York hospitals that report inpatient hip or knee replacement.