Price AtlasInteractive atlas · All states · techysurgeon.comUpmc Carlisle: what a joint replacement costs
Carlisle, PA 17015 · CMS Certification Number 390058. 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.
Medicare prices at Upmc Carlisle
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $12,867 | $40,417 | 3.1× | $11,693 |
| Shoulder replacement | — | — | — | $16,837 |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $40,785 | 3.2× | $22,238–$45,329 | 7 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Cigna | $45,329 | 3.5× | 1 |
| Highmark BCBS | $41,591 | 3.2× | 1 |
| Capital Blue Cross | $41,427 | 3.2× | 1 |
| UnitedHealthcare | $40,785 | 3.2× | 1 |
| Independence Blue Cross | $38,790 | 3.0× | 1 |
| UPMC Health Plan | $27,445 | 2.1× | 1 |
| Keystone Autism Services | $22,238 | 1.7× | 1 |
From the hospital's price-transparency file (2026-03-06); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-03-06); commercial plans, dollar-amount contracts only.
Quality
Complications after hip or knee replacement: 4.3% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 165 beds
Pennsylvania has no certificate-of-need law.
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Questions
How much does Medicare pay Upmc Carlisle for a knee or hip replacement?
In 2024 the average total payment to Upmc Carlisle for an inpatient hip or knee replacement stay was $12,867 (MS-DRG 470, 14 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,693 per outpatient case (APC 5115, 148 cases).
What is Upmc Carlisle's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $40,417, 3.1× the average total payment for a Medicare stay. 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 Upmc Carlisle?
Yes for Medicare facility payments. Ophthalmology & Surgical Institute of Central Pa, an orthopedic surgery center same ZIP away, is paid about $8,816 by Medicare for a knee replacement (CPT 27447), $4,051 less than an inpatient stay at Upmc Carlisle. Not every patient is a surgery-center candidate.
How does Upmc Carlisle compare with other Pennsylvania hospitals?
Upmc Carlisle's average total payment per Medicare stay is lower than 91% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Upmc Carlisle for a hip or knee replacement?
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $40,785 across 7 insurers, ranging from $22,238 to $45,329.