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.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient 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× | — |
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
Washington requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Overlake Hospital Medical Center an average of $15,766 per inpatient hip or knee replacement stay (MS-DRG 470, 23 stays) and $13,290 per outpatient case (APC 5115, 459 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $129,908, 8.2× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
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.
Medicare paid Overlake Hospital Medical Center less than 77% of the 26 Washington hospitals that report inpatient hip or knee replacement.