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Upmc 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.

Surgery center nearby
$8,254
Upmc East Side Surgery Center, 3.7 mi
Outpatient here
$11,598
213 Medicare cases, APC 5115
Inpatient here
$18,146
68 Medicare stays, MS-DRG 470

Medicare prices at Upmc Presbyterian Shadyside

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$18,146$126,8287.0×$11,598
Shoulder replacement————
Hip replacement after a fracture (DRG 522)$20,680$183,6878.9×—

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 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).

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× what Medicare paid. 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?

Medicare paid Upmc Presbyterian Shadyside more than 88% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.