Reston, VA 20190 · CMS Certification Number 490107. 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 | $15,125 | $118,059 | 7.8× | $12,201 |
| Shoulder replacement | $18,538 | $162,316 | 8.8× | $17,432 |
| Hip replacement after a fracture (DRG 522) | $15,823 | $121,271 | 7.7× | — |
Complications after hip or knee replacement: 3.6% (no different from the national rate). Readmissions: 5.6%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 187 beds
Virginia requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Reston Hospital Center an average of $15,125 per inpatient hip or knee replacement stay (MS-DRG 470, 47 stays) and $12,201 per outpatient case (APC 5115, 467 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $118,059, 7.8× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Reston Surgery Center, L.P., an orthopedic surgery center same ZIP away, is paid about $9,158 by Medicare for a knee replacement (CPT 27447), $5,967 less than an inpatient stay at Reston Hospital Center. Not every patient is a surgery-center candidate.
Medicare paid Reston Hospital Center more than 59% of the 34 Virginia hospitals that report inpatient hip or knee replacement.