Magee Womens Hospital of Upmc Health System: what a joint replacement costs

In 2024 the average total payment to Magee Womens Hospital of Upmc Health System for an inpatient hip or knee replacement stay was $16,105 (MS-DRG 470, 38 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,684 per outpatient case (APC 5115, 180 cases).

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $68,131, 4.2× the average total payment for a Medicare stay. 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 3.7 mi away, is paid about $8,254 by Medicare for a knee replacement (CPT 27447), $7,851 less than an inpatient stay at Magee Womens Hospital of Upmc Health System. Not every patient is a surgery-center candidate.

Magee Womens Hospital of Upmc Health System's average total payment per Medicare stay is higher than 70% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $29,486 across 2 insurers, ranging from $19,822 to $39,151.