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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $12,492 | $42,319 | 3.4× | $11,671 |
| Shoulder replacement | $16,519 | $65,594 | 4.0× | $16,281 |
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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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).
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.
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.
Medicare paid North Carolina Specialty Hospital less than 98% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.