Lenoir, NC 28645 · CMS Certification Number 340041. 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 | $13,300 | $47,970 | 3.6× | $11,257 |
| Shoulder replacement | — | — | — | $16,184 |
| Hip replacement after a fracture (DRG 522) | $14,831 | $49,433 | 3.3× | — |
Complications after hip or knee replacement: 4.5% (no different from the national rate). Readmissions: 6.2%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 110 beds
North Carolina requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Caldwell Memorial Hospital an average of $13,300 per inpatient hip or knee replacement stay (MS-DRG 470, 16 stays) and $11,257 per outpatient case (APC 5115, 54 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $47,970, 3.6× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Viewmont Surgery Center, an orthopedic surgery center 18.9 mi away, is paid about $8,274 by Medicare for a knee replacement (CPT 27447), $5,026 less than an inpatient stay at Caldwell Memorial Hospital. Not every patient is a surgery-center candidate.
Medicare paid Caldwell Memorial Hospital less than 85% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.