Price AtlasInteractive atlas · All states · techysurgeon.comOverlake Hospital Medical Center: what a joint replacement costs
Bellevue, WA 98004 · CMS Certification Number 500051. 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.
Medicare prices at Overlake Hospital Medical Center
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $15,766 | $129,908 | 8.2× | $13,290 |
| Shoulder replacement | — | — | — | $18,728 |
| Hip replacement after a fracture (DRG 522) | $18,127 | $137,950 | 7.6× | — |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $38,114 | 2.4× | $34,334–$51,887 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| UnitedHealthcare | $51,887 | 3.3× | 1 |
| First Choice | $47,771 | 3.0× | 1 |
| Kaiser Permanente | $38,238 | 2.4× | 1 |
| Cigna | $37,990 | 2.4× | 1 |
| Premera Blue Cross | $37,144 | 2.4× | 1 |
| MultiPlan/PHCS (rental network) | $35,058 | 2.2× | 1 |
| Aetna | $34,334 | 2.2× | 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.
Quality
Complications after hip or knee replacement: 4.1% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 2 of 5 stars. Nonprofit · Acute · 218 beds
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Questions
How much does Medicare pay Overlake Hospital Medical Center for a knee or hip replacement?
In 2024 the average total payment to Overlake Hospital Medical Center for an inpatient hip or knee replacement stay was $15,766 (MS-DRG 470, 23 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $13,290 per outpatient case (APC 5115, 459 cases).
What is Overlake Hospital Medical Center's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $129,908, 8.2× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Is a knee replacement cheaper at a surgery center near Overlake Hospital Medical Center?
Yes for Medicare facility payments. Overlake Surgery Center LLC, an orthopedic surgery center same ZIP away, is paid about $9,864 by Medicare for a knee replacement (CPT 27447), $5,902 less than an inpatient stay at Overlake Hospital Medical Center. Not every patient is a surgery-center candidate.
How does Overlake Hospital Medical Center compare with other Washington hospitals?
Overlake Hospital Medical Center's average total payment per Medicare stay is lower than 77% of the 26 Washington hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Overlake Hospital Medical Center for a hip or knee replacement?
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $38,114 across 6 insurers, ranging from $34,334 to $51,887.