Price AtlasInteractive atlas · All states · techysurgeon.comUpmc Presbyterian Shadyside: what a joint replacement costs
Pittsburgh, PA 15213 · CMS Certification Number 390164. 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 Presbyterian Shadyside
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $18,146 | $126,828 | 7.0× | $11,598 |
| Shoulder replacement | — | — | — | — |
| Hip replacement after a fracture (DRG 522) | $20,680 | $183,687 | 8.9× | — |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $28,054 | 1.5× | $23,215–$32,892 | 2 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Highmark BCBS | $32,892 | 1.8× | 1 |
| UPMC Health Plan | $23,215 | 1.3× | 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: 4.6% (no different from the national rate). Readmissions: 4.6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 1577 beds
Pennsylvania has no certificate-of-need law.
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Questions
How much does Medicare pay Upmc Presbyterian Shadyside for a knee or hip replacement?
In 2024 the average total payment to Upmc Presbyterian Shadyside for an inpatient hip or knee replacement stay was $18,146 (MS-DRG 470, 68 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,598 per outpatient case (APC 5115, 213 cases).
What is Upmc Presbyterian Shadyside's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $126,828, 7.0× 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 Presbyterian Shadyside?
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), $9,892 less than an inpatient stay at Upmc Presbyterian Shadyside. Not every patient is a surgery-center candidate.
How does Upmc Presbyterian Shadyside compare with other Pennsylvania hospitals?
Upmc Presbyterian Shadyside's average total payment per Medicare stay is higher than 88% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Upmc Presbyterian Shadyside 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 $28,054 across 2 insurers, ranging from $23,215 to $32,892.