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Midwest Orthopedic Specialty Hospital: what a joint replacement costs

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.

Surgery center nearby
$8,881
Surgery Center LLC, same ZIP
Outpatient here
$11,733
257 Medicare cases, APC 5115
Inpatient here
$13,197
83 Medicare stays, MS-DRG 470

Medicare prices at Midwest Orthopedic Specialty Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$13,197$52,3644.0×$11,733
Shoulder replacement$20,323$83,2984.1×$16,234

Quality

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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Questions

How much does Medicare pay Midwest Orthopedic Specialty Hospital for a knee or hip replacement?

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).

What is Midwest Orthopedic Specialty Hospital's list price for a joint replacement?

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.

Is a knee replacement cheaper at a surgery center near Midwest Orthopedic Specialty Hospital?

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.

How does Midwest Orthopedic Specialty Hospital compare with other Wisconsin hospitals?

Medicare paid Midwest Orthopedic Specialty Hospital less than 70% of the 20 Wisconsin hospitals that report inpatient hip or knee replacement.