Martinsburg, WV 25401 · CMS Certification Number 510008. 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 | $13,690 | $69,651 | 5.1× | $11,402 |
| Shoulder replacement | — | — | — | $17,075 |
| Hip replacement after a fracture (DRG 522) | $19,613 | $61,504 | 3.1× | — |
Complications after hip or knee replacement: 5.4% (no different from the national rate). Readmissions: 6.4%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 241 beds
West Virginia requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Berkeley Medical Center an average of $13,690 per inpatient hip or knee replacement stay (MS-DRG 470, 26 stays) and $11,402 per outpatient case (APC 5115, 47 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $69,651, 5.1× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Tri State Surgical Center LLC, an orthopedic surgery center same ZIP away, is paid about $8,432 by Medicare for a knee replacement (CPT 27447), $5,258 less than an inpatient stay at Berkeley Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Berkeley Medical Center less than 60% of the 10 West Virginia hospitals that report inpatient hip or knee replacement.