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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $12,269 | $47,230 | 3.8× | $11,740 |
| Shoulder replacement | — | — | — | $16,610 |
| Hip replacement after a fracture (DRG 522) | $13,874 | $59,728 | 4.3× | — |
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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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).
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.
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.
Medicare paid St Clair Hospital less than 98% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.