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Avera McKennan Hospital & University Health Center: what a joint replacement costs

Sioux Falls, SD 57117 · CMS Certification Number 430016. 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
$12,213
Medicare allowed amount, 586 cases, APC 5115
Inpatient here
$14,573
Avg total payment (incl. patient share), 69 Medicare stays, MS-DRG 470

Medicare prices at Avera McKennan Hospital & University Health Center

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$14,573$78,5605.4×$12,213
Shoulder replacement$19,068$90,2994.7×$17,434
Hip replacement after a fracture (DRG 522)$16,317$79,7214.9×—

Quality

Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 6.2%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 505 beds

South Dakota has no certificate-of-need law.

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Questions

How much does Medicare pay Avera McKennan Hospital & University Health Center for a knee or hip replacement?

In 2024 the average total payment to Avera McKennan Hospital & University Health Center for an inpatient hip or knee replacement stay was $14,573 (MS-DRG 470, 69 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,213 per outpatient case (APC 5115, 586 cases).

What is Avera McKennan Hospital & University Health Center's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $78,560, 5.4× 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 McKennan Hospital & University Health Center compare with other South Dakota hospitals?

Avera McKennan Hospital & University Health Center's average total payment per Medicare stay is lower than 56% of the 9 South Dakota hospitals that report inpatient hip or knee replacement.