Klamath Falls, OR 97601 · CMS Certification Number 380050. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $21,325 | $71,871 | 3.4× | $17,077 |
| Shoulder replacement | — | — | — | $24,168 |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $19,733 | 0.9× | $10,415–$44,835 | 11 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Regence BlueShield | $44,835 | 2.1× | 1 |
| Providence Health Plan | $31,048 | 1.5× | 1 |
| Moda Health | $26,000 | 1.2× | 1 |
| Alignment Health Plan | $19,733 | 0.9× | 1 |
| Cigna | $19,733 | 0.9× | 1 |
| Humana | $19,733 | 0.9× | 1 |
| Kaiser Permanente | $19,733 | 0.9× | 1 |
| Pacificsource Med Adv PPO | $19,733 | 0.9× | 1 |
| Pyramid Todays Option Premier | $19,733 | 0.9× | 1 |
| Scan Health Plan | $19,733 | 0.9× | 1 |
| Cco Cascade Health Alliance | $10,415 | 0.5× | 1 |
From the hospital's price-transparency file (2026-03-25); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-03-25); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 3.4% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 176 beds
Oregon has a certificate-of-need program that does not cover surgery centers.
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In 2024 the average total payment to Sky Lakes Medical Center for an inpatient hip or knee replacement stay was $21,325 (MS-DRG 470, 19 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $17,077 per outpatient case (APC 5115, 140 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $71,871, 3.4× 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. Klamath Surgery Center, an orthopedic surgery center same ZIP away, is paid about $9,143 by Medicare for a knee replacement (CPT 27447), $12,182 less than an inpatient stay at Sky Lakes Medical Center. Not every patient is a surgery-center candidate.
Sky Lakes Medical Center's average total payment per Medicare stay is higher than 92% of the 13 Oregon 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 $19,733 across 11 insurers, ranging from $10,415 to $44,835.