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Upmc East: what a joint replacement costs

Monroeville, PA 15146 · CMS Certification Number 390328. 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
Allegheny Health Network Monroeville Surgery Center, same ZIP
Outpatient here
$11,740
103 Medicare cases, APC 5115
Inpatient here
$13,290
23 Medicare stays, MS-DRG 470

Medicare prices at Upmc East

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,290$100,2997.5×$11,740
Shoulder replacement———$16,610

Quality

Complications after hip or knee replacement: 8.2% (worse than the national rate). Readmissions: 6.6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 155 beds

Pennsylvania has no certificate-of-need law.

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Questions

How much does Medicare pay Upmc East for a knee or hip replacement?

In 2024 Medicare paid Upmc East an average of $13,290 per inpatient hip or knee replacement stay (MS-DRG 470, 23 stays) and $11,740 per outpatient case (APC 5115, 103 cases).

What is Upmc East's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $100,299, 7.5× 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 East?

Yes for Medicare facility payments. Allegheny Health Network Monroeville Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,254 by Medicare for a knee replacement (CPT 27447), $5,036 less than an inpatient stay at Upmc East. Not every patient is a surgery-center candidate.

How does Upmc East compare with other Pennsylvania hospitals?

Medicare paid Upmc East less than 80% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.