Hermitage, TN 37076 · CMS Certification Number 440150. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $13,158 | $122,156 | 9.3× | $10,298 |
| Shoulder replacement | — | — | — | $14,389 |
| Hip replacement after a fracture (DRG 522) | $14,294 | $147,029 | 10.3× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $16,284 | 1.2× | $10,315–$37,751 | 10 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| BCBS TN | $37,751 | 2.9× | 1 |
| MultiPlan/PHCS (rental network) | $26,405 | 2.0× | 1 |
| UnitedHealthcare | $25,715 | 2.0× | 1 |
| Oscar | $22,178 | 1.7× | 1 |
| Cigna | $19,062 | 1.4× | 1 |
| Bright Health | $16,360 | 1.2× | 1 |
| Zing | $16,209 | 1.2× | 1 |
| Aetna | $14,883 | 1.1× | 1 |
| Humana | $14,735 | 1.1× | 1 |
| Odyssey Healthcare | $14,735 | 1.1× | 1 |
| Elevance/Anthem/Empire | $10,315 | 0.8× | 1 |
From the hospital's price-transparency file (2026-09-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-09-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4.1% (no different from the national rate). Readmissions: 6.4%. Overall Care Compare rating: 4 of 5 stars. For-profit · Acute · 200 beds
Tennessee requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Tristar Summit Medical Center for an inpatient hip or knee replacement stay was $13,158 (MS-DRG 470, 15 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $10,298 per outpatient case (APC 5115, 252 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $122,156, 9.3× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Summit Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,497 by Medicare for a knee replacement (CPT 27447), $4,661 less than an inpatient stay at Tristar Summit Medical Center. Not every patient is a surgery-center candidate.
Tristar Summit Medical Center's average total payment per Medicare stay is lower than 69% of the 29 Tennessee hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $16,284 across 10 insurers, ranging from $10,315 to $37,751.