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Penn Highlands Dubois: what a joint replacement costs

Dubois, PA 15801 · CMS Certification Number 390086. 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
—
No orthopedic surgery center within 25 miles
Outpatient here
$12,571
Medicare allowed amount, 56 cases, APC 5115
Inpatient here
$13,703
Avg total payment (incl. patient share), 39 Medicare stays, MS-DRG 470

Medicare prices at Penn Highlands Dubois

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$13,703$36,3452.7×$12,571
Shoulder replacement————
Hip replacement after a fracture (DRG 522)$15,229$42,7672.8×—

Quality

Complications after hip or knee replacement: 4.2% (no different from the national rate). Readmissions: 5.6%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 244 beds

Pennsylvania has no certificate-of-need law.

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Questions

How much does Medicare pay Penn Highlands Dubois for a knee or hip replacement?

In 2024 the average total payment to Penn Highlands Dubois for an inpatient hip or knee replacement stay was $13,703 (MS-DRG 470, 39 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,571 per outpatient case (APC 5115, 56 cases).

What is Penn Highlands Dubois's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $36,345, 2.7× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

How does Penn Highlands Dubois compare with other Pennsylvania hospitals?

Penn Highlands Dubois's average total payment per Medicare stay is lower than 64% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.