Madison, WI 53792 · CMS Certification Number 520098. 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 | $20,018 | $69,609 | 3.5× | $12,187 |
| Shoulder replacement | $26,370 | $100,097 | 3.8× | $17,359 |
| Hip replacement after a fracture (DRG 522) | $22,260 | $92,830 | 4.2× | — |
Complications after hip or knee replacement: 3.5% (no different from the national rate). Readmissions: 5.3%. Overall Care Compare rating: 5 of 5 stars. Government · Acute · 536 beds
Wisconsin has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid University of Wi Hospitals & Clinics Authority an average of $20,018 per inpatient hip or knee replacement stay (MS-DRG 470, 90 stays) and $12,187 per outpatient case (APC 5115, 759 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $69,609, 3.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Ssm Health Surgery Center, an orthopedic surgery center 2.6 mi away, is paid about $8,977 by Medicare for a knee replacement (CPT 27447), $11,041 less than an inpatient stay at University of Wi Hospitals & Clinics Authority. Not every patient is a surgery-center candidate.
Medicare paid University of Wi Hospitals & Clinics Authority more than 95% of the 20 Wisconsin hospitals that report inpatient hip or knee replacement.