San Antonio, TX 78229 · CMS Certification Number 450388. 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 | $14,724 | $146,742 | 10.0× | $11,309 |
| Shoulder replacement | $18,424 | $198,435 | 10.8× | $16,137 |
| Hip replacement after a fracture (DRG 522) | $15,813 | $154,391 | 9.8× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $25,679 | 1.7× | $15,563–$35,777 | 13 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| BCBS TX | $35,777 | 2.4× | 1 |
| Cigna | $30,383 | 2.1× | 1 |
| UnitedHealthcare | $28,583 | 1.9× | 1 |
| Valenz | $27,460 | 1.9× | 1 |
| Focus Health Solutions | $26,401 | 1.8× | 1 |
| Curative Administrators | $26,326 | 1.8× | 1 |
| Evry Health | $25,679 | 1.7× | 1 |
| Healthcare Highways (rental network) | $25,461 | 1.7× | 1 |
| Oscar | $19,231 | 1.3× | 1 |
| American Health Plan of Texas | $17,337 | 1.2× | 1 |
| Devoted Health | $16,450 | 1.1× | 1 |
| Texas Independent Health Plan | $16,450 | 1.1× | 1 |
| Gonzaba Medical Group | $15,967 | 1.1× | 1 |
| Humana | $15,563 | 1.1× | 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: 3.6% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 4 of 5 stars. For-profit · Acute · 2465 beds
Texas has no certificate-of-need law.
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In 2024 the average total payment to Methodist Hospital for an inpatient hip or knee replacement stay was $14,724 (MS-DRG 470, 162 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,309 per outpatient case (APC 5115, 288 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $146,742, 10.0× 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. Texas Spine and Joint Surgical Center, an orthopedic surgery center same ZIP away, is paid about $8,437 by Medicare for a knee replacement (CPT 27447), $6,287 less than an inpatient stay at Methodist Hospital. Not every patient is a surgery-center candidate.
Methodist Hospital's average total payment per Medicare stay is higher than 57% of the 77 Texas 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 $25,679 across 13 insurers, ranging from $15,563 to $35,777.