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Shoulder replacement in Massachusetts: what insurers pay

Posted commercial rates at 13 Massachusetts hospitals, each next to its own Medicare base rate.

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CPT 23472

HospitalMedian across insurers× MedicareInsurersFile date
South Shore Hospital South Weymouth$10,8450.5×12026-04-01
Winchester Hospital Winchester$14,4710.7×22026-04-01
Beverly Hospital Corporation Beverly$15,6930.8×12026-04-01
Beth Israel Deaconess Hospital - Plymouth Plymouth$18,1880.9×12026-04-01
Beth Israel Deaconess Hospital - Needham Needham$18,2640.9×12026-04-01
Mount Auburn Hospital Cambridge$18,5240.9×12026-04-01
Lahey Hospital & Medical Center, Burlington Burlington$20,9421.0×12026-04-01
Beth Israel Deaconess Medical Center Boston$22,7321.1×12026-04-01
New England Baptist Hospital Boston$22,9341.1×32026-04-01
Anna Jaques Hospital Newburyport$24,0841.1×22026-04-01

MS-DRG 483

HospitalMedian across insurers× MedicareInsurersFile date
Emerson Hospital - W Concord$19,6570.8×12026-05-18
Anna Jaques Hospital Newburyport$20,8230.9×12026-04-01
Beth Israel Deaconess Hospital - Needham Needham$21,4380.9×22026-04-01
Beth Israel Deaconess Hospital - Plymouth Plymouth$23,6331.0×12026-04-01
Mount Auburn Hospital Cambridge$24,5511.0×12026-04-01
Beverly Hospital Corporation Beverly$25,6401.1×12026-04-01
Winchester Hospital Winchester$25,6401.1×12026-04-01
Beth Israel Deaconess Medical Center Boston$27,6031.1×22026-04-01
New England Baptist Hospital Boston$29,5481.2×32026-04-01
Lowell General Hospital Lowell$34,5681.4×32026-04-01
Tufts Medical Center Boston$35,0841.5×32026-04-01
Lahey Hospital & Medical Center, Burlington Burlington$40,4001.7×42026-04-01

Questions

How much do insurers pay for shoulder replacement in Massachusetts?

13 Massachusetts hospitals post usable commercial rates for shoulder replacement in their federal price-transparency files. For CPT 23472, hospital outpatient, the median across 10 hospitals is $18,394, 0.9× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.