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Avera St Mary's Hospital: what a joint replacement costs

Pierre, SD 57501 · CMS Certification Number 430015. 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
—
No orthopedic surgery center within 25 miles
Outpatient here
$13,067
Medicare allowed amount, 91 cases, APC 5115
Inpatient here
$16,664
Avg total payment (incl. patient share), 18 Medicare stays, MS-DRG 470

Medicare prices at Avera St Mary's Hospital

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$16,664$56,6843.4×$13,067
Shoulder replacement————

Quality

Complications after hip or knee replacement: 5.3% (no different from the national rate). Readmissions: 5.5%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 60 beds

South Dakota has no certificate-of-need law.

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Questions

How much does Medicare pay Avera St Mary's Hospital for a knee or hip replacement?

In 2024 the average total payment to Avera St Mary's Hospital for an inpatient hip or knee replacement stay was $16,664 (MS-DRG 470, 18 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $13,067 per outpatient case (APC 5115, 91 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $56,684, 3.4× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

How does Avera St Mary's Hospital compare with other South Dakota hospitals?

Avera St Mary's Hospital's average total payment per Medicare stay is higher than 89% of the 9 South Dakota hospitals that report inpatient hip or knee replacement.