Houston, TX 77094 · CMS Certification Number 670077. 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 | $14,946 | $159,247 | 10.7× | $12,145 |
| Shoulder replacement | $24,221 | $308,892 | 12.8× | $16,282 |
| Hip replacement after a fracture (DRG 522) | $16,237 | $134,901 | 8.3× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $28,686 | 1.9× | $23,614–$81,422 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| MultiPlan/PHCS (rental network) | $88,050 | 5.9× | 1 |
| Uae | $81,422 | 5.4× | 1 |
| UnitedHealthcare | $41,561 | 2.8× | 1 |
| Texas Annual Conference | $28,742 | 1.9× | 1 |
| BCBS TX | $28,630 | 1.9× | 1 |
| Entrust | $28,554 | 1.9× | 1 |
| Cigna | $23,614 | 1.6× | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Complications after hip or knee replacement: 5% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 302 beds
Texas has no certificate-of-need law.
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In 2024 the average total payment to Houston Methodist West Hospital for an inpatient hip or knee replacement stay was $14,946 (MS-DRG 470, 27 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $12,145 per outpatient case (APC 5115, 255 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $159,247, 10.7× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Kingsland Surgery Center, an orthopedic surgery center 2.7 mi away, is paid about $9,060 by Medicare for a knee replacement (CPT 27447), $5,886 less than an inpatient stay at Houston Methodist West Hospital. Not every patient is a surgery-center candidate.
Houston Methodist West Hospital's average total payment per Medicare stay is higher than 60% of the 77 Texas hospitals that report inpatient hip or knee replacement.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $28,686 across 6 insurers, ranging from $23,614 to $81,422.