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Berkeley Medical Center: what a joint replacement costs

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.

Surgery center nearby
$8,432
Tri State Surgical Center LLC, same ZIP
Outpatient here
$11,402
47 Medicare cases, APC 5115
Inpatient here
$13,690
26 Medicare stays, MS-DRG 470

Medicare prices at Berkeley Medical Center

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,690$69,6515.1×$11,402
Shoulder replacement———$17,075
Hip replacement after a fracture (DRG 522)$19,613$61,5043.1×—

Quality

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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Questions

How much does Medicare pay Berkeley Medical Center for a knee or hip replacement?

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).

What is Berkeley Medical Center's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near Berkeley Medical Center?

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.

How does Berkeley Medical Center compare with other West Virginia hospitals?

Medicare paid Berkeley Medical Center less than 60% of the 10 West Virginia hospitals that report inpatient hip or knee replacement.