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Virginia: one knee, three prices

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

Surgery center
$8,552
Median Medicare knee rate, 38 orthopedic surgery centers
Hospital, same day
$11,467
Median Medicare allowed amount
Hospital, overnight
$14,955
Median avg total payment (incl. patient share), 34 hospitals

Virginia requires a certificate of need for new surgery centers.

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Lowest average total payment per stay

HospitalCityInpatient avg total paymentList priceOutpatient allowed
Riverside Walter Reed HospitalGloucester$12,729$41,246$11,318
Sentara Virginia Beach General HospitalVirginia Beach$13,000$67,784$11,343
Sentara Obici HospitalSuffolk$13,089$61,180$11,067
Bon Secours Mary Immaculate HospitalNewport News$13,161$87,028$11,199
Fauquier HospitalWarrenton$13,482$113,941$12,237
Sentara Martha Jefferson HospitalCharlottesville$13,484$41,178$11,196
Cjw Medical CenterRichmond$13,531$312,023$11,256
Chesapeake General HospitalChesapeake$13,635$65,126$11,198
Henrico Doctors' HospitalRichmond$13,850$308,171$11,330
Sentara Leigh HospitalNorfolk$13,976$54,979$11,313

Highest average total payment per stay

HospitalCityInpatient avg total paymentList priceOutpatient allowed
Uva Health Sciences CenterCharlottesville$24,333$67,781$8,957
Medical College of Virginia HospitalsRichmond$20,543$86,175$11,161
Augusta HealthFishersville$17,894$89,738$12,558
Warren Memorial HospitalFront Royal$17,389$46,004$12,060
Lewisgale Medical CenterSalem$16,652$196,582$11,117
Sentara Williamsburg Regional Medical CenterWilliamsburg$16,577$52,734$11,232
Lewisgale Hospital MontgomeryBlacksburg$16,184$236,696$11,251
Stonesprings Hospital CenterDulles$15,958$114,985$12,044
Sentara Rmh Medical CenterHarrisonburg$15,874$45,221$12,581
Winchester Medical CenterWinchester$15,714$38,953$12,584

Every Virginia hospital (55)

Orthopedic surgery centers (38)

Questions

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

In 2024 the median average total payment to Virginia hospitals was $14,955 per Medicare inpatient hip or knee replacement stay (MS-DRG 470, 34 hospitals; Medicare's payment plus the patient's share), and the median Medicare allowed amount was $11,467 per outpatient case. An orthopedic surgery center is paid about $8,552 for a knee.

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

Riverside Walter Reed Hospital ($12,729), Sentara Virginia Beach General Hospital ($13,000), Sentara Obici Hospital ($13,089) (average total payment per inpatient stay, patient share included).

What do Virginia hospitals list for a joint replacement?

The median list (chargemaster) price is $67,783, about 4.5× the median average total payment for a Medicare stay.

Does Virginia have a certificate-of-need law?

Virginia requires a certificate of need for new surgery centers. A Certificate of Public Need is required to establish a medical care facility, including outpatient surgical hospitals and ASCs.