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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $17,676 | $91,334 | 5.2× | $11,345 |
| Shoulder replacement | — | — | — | $16,610 |
| Hip replacement after a fracture (DRG 522) | $20,570 | $91,518 | 4.4× | — |
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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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).
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.
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.
Medicare paid Allegheny General Hospital more than 86% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.