Summit, WI 53066 · CMS Certification Number 520206. 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 avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | — | — | — | $11,759 |
| Shoulder replacement | — | — | — | $16,956 |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $33,609 | — | $26,116–$41,481 | 15 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Cigna | $41,481 | — | 1 |
| Quartz Group | $40,595 | — | 1 |
| Elevance/Anthem/Empire | $40,234 | — | 1 |
| Wisconsin Physician Service | $37,537 | — | 1 |
| Health Payment Systems | $34,882 | — | 1 |
| Quartz One | $34,693 | — | 1 |
| HS Technology | $33,952 | — | 1 |
| Aurora Caregiver | $33,609 | — | 1 |
| HealthPartners | $33,256 | — | 1 |
| Trilogy | $33,087 | — | 1 |
| Common Ground | $29,076 | — | 1 |
| Aetna | $28,354 | — | 1 |
| Everpointe Elite | $27,349 | — | 1 |
| Centivo | $26,785 | — | 1 |
| UnitedHealthcare | $26,116 | — | 1 |
From the hospital's price-transparency file (2025-11-21); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2025-11-21); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 3.9% (no different from the national rate). Readmissions: 5.8%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 66 beds
Wisconsin has a certificate-of-need program that does not cover surgery centers.
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The Medicare allowed amount averaged $11,759 per outpatient hip or knee replacement case (APC 5115, 92 cases) in 2024. Inpatient stays were too few to report.
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). Not every patient is a surgery-center candidate.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $33,609 across 15 insurers, ranging from $26,116 to $41,481.