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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient 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× | — |
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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In 2024 Medicare paid Upmc Presbyterian Shadyside an average of $18,146 per inpatient hip or knee replacement stay (MS-DRG 470, 68 stays) and $11,598 per outpatient case (APC 5115, 213 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $126,828, 7.0× 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), $9,892 less than an inpatient stay at Upmc Presbyterian Shadyside. Not every patient is a surgery-center candidate.
Medicare paid Upmc Presbyterian Shadyside more than 88% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.