Hampton, VA 23666 · CMS Certification Number 490093. 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 paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $14,084 | $57,166 | 4.1× | $11,322 |
| Shoulder replacement | — | — | — | $16,182 |
| Hip replacement after a fracture (DRG 522) | $14,837 | $55,030 | 3.7× | — |
Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 224 beds
Virginia requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Sentara Careplex Hospital an average of $14,084 per inpatient hip or knee replacement stay (MS-DRG 470, 11 stays) and $11,322 per outpatient case (APC 5115, 169 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $57,166, 4.1× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Careplex Orthopaedic Ambulatory Surgical Ctr, an orthopedic surgery center same ZIP away, is paid about $8,466 by Medicare for a knee replacement (CPT 27447), $5,618 less than an inpatient stay at Sentara Careplex Hospital. Not every patient is a surgery-center candidate.
Medicare paid Sentara Careplex Hospital less than 62% of the 34 Virginia hospitals that report inpatient hip or knee replacement.