Duke Health Raleigh Hospital: what a joint replacement costs

In 2024 the average total payment to Duke Health Raleigh Hospital for an inpatient hip or knee replacement stay was $14,527 (MS-DRG 470, 20 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,558 per outpatient case (APC 5115, 111 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $58,644, 4.0× 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. Healthsouth Blue Ridge Surgery, an orthopedic surgery center 5.6 mi away, is paid about $8,762 by Medicare for a knee replacement (CPT 27447), $5,765 less than an inpatient stay at Duke Health Raleigh Hospital. Not every patient is a surgery-center candidate.

Duke Health Raleigh Hospital's average total payment per Medicare stay is higher than 51% 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 $31,260 across 4 insurers, ranging from $19,138 to $35,662.