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Mon Health Medical Center: what a joint replacement costs

Morgantown, WV 26505 · CMS Certification Number 510024. 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
$7,906
Mon Health Center for Outpatient Surgery, same ZIP
Outpatient here
$11,059
Medicare allowed amount, 125 cases, APC 5115
Inpatient here
$14,337
Avg total payment (incl. patient share), 29 Medicare stays, MS-DRG 470

Medicare prices at Mon Health Medical Center

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$14,337$82,7515.8×$11,059
Shoulder replacement———$14,469
Hip replacement after a fracture (DRG 522)$13,557$85,4036.3×—

Quality

Complications after hip or knee replacement: 5% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 189 beds

West Virginia requires a certificate of need for new surgery centers.

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Questions

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

In 2024 the average total payment to Mon Health Medical Center for an inpatient hip or knee replacement stay was $14,337 (MS-DRG 470, 29 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,059 per outpatient case (APC 5115, 125 cases).

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

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $82,751, 5.8× 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 Mon Health Medical Center?

Yes for Medicare facility payments. Mon Health Center for Outpatient Surgery, an orthopedic surgery center same ZIP away, is paid about $7,906 by Medicare for a knee replacement (CPT 27447), $6,431 less than an inpatient stay at Mon Health Medical Center. Not every patient is a surgery-center candidate.

How does Mon Health Medical Center compare with other West Virginia hospitals?

Mon Health Medical Center's average total payment per Medicare stay is higher than 60% of the 10 West Virginia hospitals that report inpatient hip or knee replacement.