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Upmc Pinnacle Hospitals: what a joint replacement costs

Harrisburg, PA 17104 · CMS Certification Number 390067. 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
$8,816
Susquehanna Valley Surgical Center, 3.3 mi
Outpatient here
$11,761
578 Medicare cases, APC 5115
Inpatient here
$16,138
117 Medicare stays, MS-DRG 470

Medicare prices at Upmc Pinnacle Hospitals

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$16,138$50,8063.1×$11,761
Shoulder replacement$21,366$63,0172.9×$16,511
Hip replacement after a fracture (DRG 522)$17,538$67,2333.8×—

Quality

Complications after hip or knee replacement: 4.5% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 737 beds

Pennsylvania has no certificate-of-need law.

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Questions

How much does Medicare pay Upmc Pinnacle Hospitals for a knee or hip replacement?

In 2024 Medicare paid Upmc Pinnacle Hospitals an average of $16,138 per inpatient hip or knee replacement stay (MS-DRG 470, 117 stays) and $11,761 per outpatient case (APC 5115, 578 cases).

What is Upmc Pinnacle Hospitals's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $50,806, 3.1× 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 Upmc Pinnacle Hospitals?

Yes for Medicare facility payments. Susquehanna Valley Surgical Center, an orthopedic surgery center 3.3 mi away, is paid about $8,816 by Medicare for a knee replacement (CPT 27447), $7,322 less than an inpatient stay at Upmc Pinnacle Hospitals. Not every patient is a surgery-center candidate.

How does Upmc Pinnacle Hospitals compare with other Pennsylvania hospitals?

Medicare paid Upmc Pinnacle Hospitals more than 72% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.