Fairfax, VA 22033 · CMS Certification Number 490101. 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 | $14,251 | $52,541 | 3.7× | $12,116 |
| Shoulder replacement | $18,586 | $70,247 | 3.8× | $17,288 |
| Hip replacement after a fracture (DRG 522) | $16,432 | $57,114 | 3.5× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $38,634 | 2.7× | $32,488–$50,367 | 7 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| UnitedHealthcare | $50,367 | 3.5× | 1 |
| Cigna | $40,978 | 2.9× | 1 |
| Sentara Health | $39,413 | 2.8× | 1 |
| Elevance/Anthem/Empire | $38,634 | 2.7× | 1 |
| Aetna | $36,967 | 2.6× | 1 |
| Innovation | $34,564 | 2.4× | 1 |
| CareFirst BCBS | $32,488 | 2.3× | 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: 4.9% (no different from the national rate). Readmissions: 6.4%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 182 beds
Virginia requires a certificate of need for new surgery centers.
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In 2024 the average total payment to Inova Fair Oaks Hospital for an inpatient hip or knee replacement stay was $14,251 (MS-DRG 470, 17 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,116 per outpatient case (APC 5115, 309 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $52,541, 3.7× 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. Northern Virginia Surgery Center, LLC, an orthopedic surgery center same ZIP away, is paid about $9,158 by Medicare for a knee replacement (CPT 27447), $5,093 less than an inpatient stay at Inova Fair Oaks Hospital. Not every patient is a surgery-center candidate.
Inova Fair Oaks Hospital's average total payment per Medicare stay is lower than 53% 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 $38,634 across 7 insurers, ranging from $32,488 to $50,367.