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Allegheny General Hospital: what a joint replacement costs

Pittsburgh, PA 15212 · CMS Certification Number 390050. 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
$8,254
Upmc East Side Surgery Center, 4.4 mi
Outpatient here
$11,345
128 Medicare cases, APC 5115
Inpatient here
$17,676
18 Medicare stays, MS-DRG 470

Medicare prices at Allegheny General Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$17,676$91,3345.2×$11,345
Shoulder replacement———$16,610
Hip replacement after a fracture (DRG 522)$20,570$91,5184.4×—

Quality

Complications after hip or knee replacement: 4.3% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 524 beds

Pennsylvania has no certificate-of-need law.

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Questions

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

In 2024 Medicare paid Allegheny General Hospital an average of $17,676 per inpatient hip or knee replacement stay (MS-DRG 470, 18 stays) and $11,345 per outpatient case (APC 5115, 128 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $91,334, 5.2× 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 Allegheny General Hospital?

Yes for Medicare facility payments. Upmc East Side Surgery Center, an orthopedic surgery center 4.4 mi away, is paid about $8,254 by Medicare for a knee replacement (CPT 27447), $9,422 less than an inpatient stay at Allegheny General Hospital. Not every patient is a surgery-center candidate.

How does Allegheny General Hospital compare with other Pennsylvania hospitals?

Medicare paid Allegheny General Hospital more than 86% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.