Richmond, VA 23226 · CMS Certification Number 490059. 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 | $14,111 | $104,299 | 7.4× | $11,984 |
| Shoulder replacement | — | — | — | $16,403 |
| Hip replacement after a fracture (DRG 522) | $15,534 | $98,357 | 6.3× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $49,407 | 3.5× | $44,837–$49,768 | 5 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Aetna | $49,768 | 3.5× | 1 |
| BCBS (other) | $49,407 | 3.5× | 1 |
| Elevance/Anthem/Empire | $49,407 | 3.5× | 1 |
| Cigna | $46,410 | 3.3× | 1 |
| UnitedHealthcare | $44,837 | 3.2× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 2.8% (no different from the national rate). Readmissions: 4.3%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 391 beds
Virginia requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Bon Secours St Marys Hospital for an inpatient hip or knee replacement stay was $14,111 (MS-DRG 470, 72 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,984 per outpatient case (APC 5115, 495 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $104,299, 7.4× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Saint Mary's Ambulatory Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,665 by Medicare for a knee replacement (CPT 27447), $5,446 less than an inpatient stay at Bon Secours St Marys Hospital. Not every patient is a surgery-center candidate.
Bon Secours St Marys Hospital's average total payment per Medicare stay is lower than 56% of the 34 Virginia 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 $49,407 across 5 insurers, ranging from $44,837 to $49,768.