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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $13,126 | $73,623 | 5.6× | $11,741 |
| Shoulder replacement | $23,768 | $111,255 | 4.7× | $16,606 |
| Hip replacement after a fracture (DRG 522) | $14,918 | $66,906 | 4.5× | — |
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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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).
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.
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.
Medicare paid Rex Hospital less than 95% of the 41 North Carolina hospitals that report inpatient hip or knee replacement.