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North Carolina Specialty Hospital: what a joint replacement costs

Durham, NC 27704 · CMS Certification Number 340049. 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
$8,842
James E Davis Ambulatory Surg, same ZIP
Outpatient here
$11,671
415 Medicare cases, APC 5115
Inpatient here
$12,492
40 Medicare stays, MS-DRG 470

Medicare prices at North Carolina Specialty Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$12,492$42,3193.4×$11,671
Shoulder replacement$16,519$65,5944.0×$16,281

Quality

Complications after hip or knee replacement: 4.1% (no different from the national rate). Readmissions: 5.6%. For-profit · Acute · 24 beds

North Carolina requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay North Carolina Specialty Hospital for a knee or hip replacement?

In 2024 Medicare paid North Carolina Specialty Hospital an average of $12,492 per inpatient hip or knee replacement stay (MS-DRG 470, 40 stays) and $11,671 per outpatient case (APC 5115, 415 cases).

What is North Carolina Specialty Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $42,319, 3.4× 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 North Carolina Specialty Hospital?

Yes for Medicare facility payments. James E Davis Ambulatory Surg, an orthopedic surgery center same ZIP away, is paid about $8,842 by Medicare for a knee replacement (CPT 27447), $3,650 less than an inpatient stay at North Carolina Specialty Hospital. Not every patient is a surgery-center candidate.

How does North Carolina Specialty Hospital compare with other North Carolina hospitals?

Medicare paid North Carolina Specialty Hospital less than 98% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.