Frisco, TX 75034 · CMS Certification Number 450853. 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 | $13,670 | $67,551 | 4.9× | $11,727 |
| Shoulder replacement | $16,596 | $83,500 | 5.0× | $16,735 |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $24,917 | 1.8× | $17,711–$38,671 | 9 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| UnitedHealthcare | $38,671 | 2.8× | 1 |
| HealthSmart (rental network) | $37,762 | 2.8× | 1 |
| MultiPlan/PHCS (rental network) | $37,529 | 2.7× | 1 |
| Humana | $37,122 | 2.7× | 1 |
| Aetna | $36,226 | 2.7× | 1 |
| Cigna | $28,671 | 2.1× | 1 |
| BCBS TX | $24,917 | 1.8× | 1 |
| Employers Health Network | $24,571 | 1.8× | 1 |
| Imagine Health | $20,558 | 1.5× | 1 |
| Baylor Scott & White Health Plan | $19,368 | 1.4× | 1 |
| University of Mary Hardin-Baylor | $17,711 | 1.3× | 1 |
From the hospital's price-transparency file (2026-06-29); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-06-29); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 4.2% (no different from the national rate). Readmissions: 6.8%. Overall Care Compare rating: 3 of 5 stars. For-profit · Acute · 25 beds
Texas has no certificate-of-need law.
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In 2024 the average total payment to Baylor Medical Center at Frisco for an inpatient hip or knee replacement stay was $13,670 (MS-DRG 470, 30 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,727 per outpatient case (APC 5115, 303 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $67,551, 4.9× 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. Baylor Scott and White Sports Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,879 by Medicare for a knee replacement (CPT 27447), $4,791 less than an inpatient stay at Baylor Medical Center at Frisco. Not every patient is a surgery-center candidate.
Baylor Medical Center at Frisco's average total payment per Medicare stay is lower than 74% 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 $24,917 across 9 insurers, ranging from $17,711 to $38,671.