Franklin, WI 53132 · CMS Certification Number 520205. 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 | $13,197 | $52,364 | 4.0× | $11,733 |
| Shoulder replacement | $20,323 | $83,298 | 4.1× | $16,234 |
Complications after hip or knee replacement: 4.2% (no different from the national rate). Readmissions: 6.8%. Physician-owned · Acute · 16 beds
Wisconsin has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Midwest Orthopedic Specialty Hospital an average of $13,197 per inpatient hip or knee replacement stay (MS-DRG 470, 83 stays) and $11,733 per outpatient case (APC 5115, 257 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $52,364, 4.0× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Surgery Center LLC, an orthopedic surgery center same ZIP away, is paid about $8,881 by Medicare for a knee replacement (CPT 27447), $4,316 less than an inpatient stay at Midwest Orthopedic Specialty Hospital. Not every patient is a surgery-center candidate.
Medicare paid Midwest Orthopedic Specialty Hospital less than 70% of the 20 Wisconsin hospitals that report inpatient hip or knee replacement.