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Carolinas Medical Center/Behav Health: what a joint replacement costs

Charlotte, NC 28203 · CMS Certification Number 340113. 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
$8,806
Charlotte Surgery Center, 2.1 mi
Outpatient here
$11,505
427 Medicare cases, APC 5115
Inpatient here
$21,264
44 Medicare stays, MS-DRG 470

Medicare prices at Carolinas Medical Center/Behav Health

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$21,264$115,8325.4×$11,505
Shoulder replacement$23,741$143,4696.0×$16,540
Hip replacement after a fracture (DRG 522)$21,260$120,2715.7×—

Quality

Complications after hip or knee replacement: 3.1% (no different from the national rate). Readmissions: 5.4%. Overall Care Compare rating: 4 of 5 stars. Government · Acute · 843 beds

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

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Questions

How much does Medicare pay Carolinas Medical Center/Behav Health for a knee or hip replacement?

In 2024 Medicare paid Carolinas Medical Center/Behav Health an average of $21,264 per inpatient hip or knee replacement stay (MS-DRG 470, 44 stays) and $11,505 per outpatient case (APC 5115, 427 cases).

What is Carolinas Medical Center/Behav Health's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $115,832, 5.4× 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 Carolinas Medical Center/Behav Health?

Yes for Medicare facility payments. Charlotte Surgery Center, an orthopedic surgery center 2.1 mi away, is paid about $8,806 by Medicare for a knee replacement (CPT 27447), $12,458 less than an inpatient stay at Carolinas Medical Center/Behav Health. Not every patient is a surgery-center candidate.

How does Carolinas Medical Center/Behav Health compare with other North Carolina hospitals?

Medicare paid Carolinas Medical Center/Behav Health more than 95% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.