Gastonia, NC 28052 · CMS Certification Number 340032. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $14,038 | $81,108 | 5.8× | $11,508 |
| Shoulder replacement | — | — | — | $16,396 |
| Hip replacement after a fracture (DRG 522) | $18,071 | $97,065 | 5.4× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $38,443 | 2.7× | $27,570–$51,374 | 8 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| UnitedHealthcare | $51,374 | 3.7× | 1 |
| MedCost | $46,375 | 3.3× | 1 |
| Carolina Caring | $39,587 | 2.8× | 1 |
| Cigna | $38,916 | 2.8× | 1 |
| Aetna | $37,970 | 2.7× | 1 |
| BCBS NC | $37,768 | 2.7× | 1 |
| Surgery Plus | $27,711 | 2.0× | 1 |
| Corporate Benefits Service | $27,570 | 2.0× | 1 |
From the hospital's price-transparency file (2026-05-11); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-05-11); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 7.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 442 beds
North Carolina requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Caromont Regional Medical Center for an inpatient hip or knee replacement stay was $14,038 (MS-DRG 470, 50 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,508 per outpatient case (APC 5115, 303 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $81,108, 5.8× 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. Caromont Speciality Surgery, an orthopedic surgery center 5.2 mi away, is paid about $8,806 by Medicare for a knee replacement (CPT 27447), $5,232 less than an inpatient stay at Caromont Regional Medical Center. Not every patient is a surgery-center candidate.
Caromont Regional Medical Center's average total payment per Medicare stay is lower than 63% of the 41 North Carolina 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 $38,443 across 8 insurers, ranging from $27,570 to $51,374.