Issaquah, WA 98029 · CMS Certification Number 500152. 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 | — | — | — | $13,270 |
| Shoulder replacement | — | — | — | $18,987 |
| Hip replacement after a fracture (DRG 522) | $19,417 | $130,090 | 6.7× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $43,778 | — | $25,739–$53,505 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Cigna | $53,505 | — | 1 |
| UnitedHealthcare | $52,682 | — | 1 |
| First Choice | $49,280 | — | 1 |
| Premera Blue Cross | $38,275 | — | 1 |
| Providence Health Plan | $36,106 | — | 1 |
| Kaiser Permanente | $25,739 | — | 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.
Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 120 beds
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The Medicare allowed amount averaged $13,270 per outpatient hip or knee replacement case (APC 5115, 79 cases) in 2024. Inpatient stays were too few to report.
Yes for Medicare facility payments. Overlake Surgery Center LLC, an orthopedic surgery center 10.0 mi away, is paid about $9,864 by Medicare for a knee replacement (CPT 27447). Not every patient is a surgery-center candidate.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $43,778 across 6 insurers, ranging from $25,739 to $53,505.