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Rex Hospital: what a joint replacement costs

Raleigh, NC 27607 · CMS Certification Number 340114. 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
$8,762
Healthsouth Blue Ridge Surgery, same ZIP
Outpatient here
$11,741
1077 Medicare cases, APC 5115
Inpatient here
$13,126
41 Medicare stays, MS-DRG 470

Medicare prices at Rex Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,126$73,6235.6×$11,741
Shoulder replacement$23,768$111,2554.7×$16,606
Hip replacement after a fracture (DRG 522)$14,918$66,9064.5×—

Quality

Complications after hip or knee replacement: 3.6% (no different from the national rate). Readmissions: 6.5%. Overall Care Compare rating: 5 of 5 stars. Government · Acute · 425 beds

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

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Questions

How much does Medicare pay Rex Hospital for a knee or hip replacement?

In 2024 Medicare paid Rex Hospital an average of $13,126 per inpatient hip or knee replacement stay (MS-DRG 470, 41 stays) and $11,741 per outpatient case (APC 5115, 1077 cases).

What is Rex Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $73,623, 5.6× 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 Rex Hospital?

Yes for Medicare facility payments. Healthsouth Blue Ridge Surgery, an orthopedic surgery center same ZIP away, is paid about $8,762 by Medicare for a knee replacement (CPT 27447), $4,364 less than an inpatient stay at Rex Hospital. Not every patient is a surgery-center candidate.

How does Rex Hospital compare with other North Carolina hospitals?

Medicare paid Rex Hospital less than 95% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.