Crouse Hospital
736 Irving Avenue, Syracuse, NY 13210 · 111 Priced Procedures · 68% Patient Recommendation
Typical commercial prices here are +24% above the fair benchmark (1.24×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.24× fair market pricing.
Consolidated System Premium Pricer
Operating in a concentrated regional market (CBSA HHI 3,031), Crouse Hospital commands a 1.24× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.10× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 19% of shoppable procedures (25/100 Cash Honesty)
- 2-Star CMS clinical rating with 68% patient recommendation (66/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.8% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
- Captive ER (2.0×) & laboratory (1.8×) services average 1.07× higher multiples than routine shoppable care (1.4×)
- Upper-quartile procedures (Q75 1.40×) jump +18% above the median procedure ratio (Q50 1.19×)
- Consolidated metro market (HHI 3,031) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Crouse Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 111 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $32,154 | 1.0× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $19,335 | 1.0× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $19,199 | 1.0× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $17,548 | 1.0× |
| Total knee replacement CPT Code: 27447 | $16,026 | 1.2× |
| Total hip replacement CPT Code: 27130 | $16,026 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $7,760 | 0.9× |
| Breast lump removal CPT Code: 19120 | $4,888 | 1.3× |
| Inguinal hernia repair CPT Code: 49505 | $4,469 | 1.2× |
| Bunion correction surgery CPT Code: 28296 | $4,139 | 1.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,084 | 1.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $3,773 | 0.6× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,696 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,316 | 2.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,494 | 1.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $916 | 1.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $790 | 0.8× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $759 | 0.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $643 | 1.1× |
| Rabies immune globulin HCPCS Code: 90375 | $614 | 1.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $580 | 1.1× |
| Blood transfusion CPT Code: 36430 | $551 | 1.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $486 | 1.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $435 | 1.0× |
| MRI, lower back (no contrast) CPT Code: 72148 | $385 | 1.1× |
Audit a Bill or Quote at Crouse Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $28,414
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.8% of gross = $28,414).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Crouse Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($77,170) is $46,395 above the denoised Fair BaseRate ($30,775) and 3.3× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (36.8% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (599 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Crouse Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.