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Montana: one knee, three prices

What Medicare pays Montana hospitals and surgery centers for knee, hip and shoulder replacement, what hospitals list, and which cost the most and the least.

Surgery center
$8,267
Median Medicare knee rate, 14 orthopedic surgery centers
Hospital, same day
$12,278
Median Medicare allowed amount
Hospital, overnight
$14,153
Median avg total payment (incl. patient share), 6 hospitals

Montana has a certificate-of-need program that does not cover surgery centers.

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Lowest average total payment per stay

HospitalCityInpatient avg total paymentList priceOutpatient allowed
Logan Health Medical CenterKalispell$12,855$57,419$13,139
Great Falls Clinic HospitalGreat Falls$13,276$81,696$12,043
Bozeman Health Deaconess Regional Medical CenterBozeman$13,973$69,308$13,022
Intermountain Health St Vincent Regional HospitalBillings$14,332$55,475$12,172
St Peters HealthHelena$14,352$39,830$12,898
Billings Clinic HospitalBillings$15,365$39,674$10,666

Highest average total payment per stay

HospitalCityInpatient avg total paymentList priceOutpatient allowed
Billings Clinic HospitalBillings$15,365$39,674$10,666
St Peters HealthHelena$14,352$39,830$12,898
Intermountain Health St Vincent Regional HospitalBillings$14,332$55,475$12,172
Bozeman Health Deaconess Regional Medical CenterBozeman$13,973$69,308$13,022
Great Falls Clinic HospitalGreat Falls$13,276$81,696$12,043
Logan Health Medical CenterKalispell$12,855$57,419$13,139

Every Montana hospital (10)

Orthopedic surgery centers (14)

Questions

How much does Medicare pay for a knee replacement in Montana?

In 2024 the median average total payment to Montana hospitals was $14,153 per Medicare inpatient hip or knee replacement stay (MS-DRG 470, 6 hospitals; Medicare's payment plus the patient's share), and the median Medicare allowed amount was $12,278 per outpatient case. An orthopedic surgery center is paid about $8,267 for a knee.

Which Montana hospitals have the lowest Medicare payment for a joint replacement?

Logan Health Medical Center ($12,855), Great Falls Clinic Hospital ($13,276), Bozeman Health Deaconess Regional Medical Center ($13,973) (average total payment per inpatient stay, patient share included).

What do Montana hospitals list for a joint replacement?

The median list (chargemaster) price is $56,447, about 4.0× the median average total payment for a Medicare stay.

Does Montana have a certificate-of-need law?

Montana has a certificate-of-need program that does not cover surgery centers. A 2021 law (HB 231) repealed CON for everything except long-term care beds and swing beds.