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Prohealth Oconomowoc Memorial Hospital: what a joint replacement costs

Oconomowoc, WI 53066 · CMS Certification Number 520062. 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
$8,881
The Orthopaedic Surgery Center LLC, 11.5 mi
Outpatient here
$11,922
403 Medicare cases, APC 5115
Inpatient here
$12,643
29 Medicare stays, MS-DRG 470

Medicare prices at Prohealth Oconomowoc Memorial Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$12,643$73,2715.8×$11,922
Shoulder replacement$18,836$93,6395.0×$16,941

Quality

Complications after hip or knee replacement: 3.8% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 156 beds

Wisconsin has a certificate-of-need program that does not cover surgery centers.

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Questions

How much does Medicare pay Prohealth Oconomowoc Memorial Hospital for a knee or hip replacement?

In 2024 Medicare paid Prohealth Oconomowoc Memorial Hospital an average of $12,643 per inpatient hip or knee replacement stay (MS-DRG 470, 29 stays) and $11,922 per outpatient case (APC 5115, 403 cases).

What is Prohealth Oconomowoc Memorial Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $73,271, 5.8× 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 Prohealth Oconomowoc Memorial Hospital?

Yes for Medicare facility payments. The Orthopaedic Surgery Center LLC, an orthopedic surgery center 11.5 mi away, is paid about $8,881 by Medicare for a knee replacement (CPT 27447), $3,762 less than an inpatient stay at Prohealth Oconomowoc Memorial Hospital. Not every patient is a surgery-center candidate.

How does Prohealth Oconomowoc Memorial Hospital compare with other Wisconsin hospitals?

Medicare paid Prohealth Oconomowoc Memorial Hospital less than 85% of the 20 Wisconsin hospitals that report inpatient hip or knee replacement.