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St Clair Hospital: what a joint replacement costs

Pittsburgh, PA 15243 · CMS Certification Number 390228. 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
Radiance - A Private Outpatient Surgery Center, 3.6 mi
Outpatient here
$11,740
197 Medicare cases, APC 5115
Inpatient here
$12,269
13 Medicare stays, MS-DRG 470

Medicare prices at St Clair Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$12,269$47,2303.8×$11,740
Shoulder replacement———$16,610
Hip replacement after a fracture (DRG 522)$13,874$59,7284.3×—

Quality

Complications after hip or knee replacement: 3% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 328 beds

Pennsylvania has no certificate-of-need law.

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Questions

How much does Medicare pay St Clair Hospital for a knee or hip replacement?

In 2024 Medicare paid St Clair Hospital an average of $12,269 per inpatient hip or knee replacement stay (MS-DRG 470, 13 stays) and $11,740 per outpatient case (APC 5115, 197 cases).

What is St Clair Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $47,230, 3.8× 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 St Clair Hospital?

Yes for Medicare facility payments. Radiance - A Private Outpatient Surgery Center, an orthopedic surgery center 3.6 mi away, is paid about $8,254 by Medicare for a knee replacement (CPT 27447), $4,015 less than an inpatient stay at St Clair Hospital. Not every patient is a surgery-center candidate.

How does St Clair Hospital compare with other Pennsylvania hospitals?

Medicare paid St Clair Hospital less than 98% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.