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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $13,290 | $100,299 | 7.5× | $11,740 |
| Shoulder replacement | — | — | — | $16,610 |
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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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).
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.
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.
Medicare paid Upmc East less than 80% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.