Pittsburgh, PA 15213 · CMS Certification Number 390114. 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 | $16,105 | $68,131 | 4.2× | $11,684 |
| Shoulder replacement | — | — | — | — |
Complications after hip or knee replacement: 4.3% (no different from the national rate). Readmissions: 4.9%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 363 beds
Pennsylvania has no certificate-of-need law.
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In 2024 Medicare paid Magee Womens Hospital of Upmc Health System an average of $16,105 per inpatient hip or knee replacement stay (MS-DRG 470, 38 stays) and $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× 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 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.
Medicare paid Magee Womens Hospital of Upmc Health System more than 70% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.