How many shoppable procedure prices are published for Harlem Hospital Center?

Harlem Hospital Center in New York, NY currently has 139 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Harlem Hospital Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Harlem Hospital Center's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

What is Harlem Hospital Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Harlem Hospital Center an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 217 Beds · urban Updated: 2025-09-05

Harlem Hospital Center

506 Lenox Avenue, New York, NY 10037 · 139 Priced Procedures · 52% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Above Fair Market · Negotiate

1.25×vs. Fair Market Price

Typical commercial prices here are +25% above the fair benchmark (1.25×) even after accounting for local nurse/doctor wages and patient complexity.

78/100 · Corroborated

78/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness95

Price Logic59

Peer Alignment61

Clean Billing86

Real Cash Discount95

Regional Benchmark Tier

1-Star CMS clinical quality rating paired with 1.25× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Harlem Hospital Center prices routine shoppable procedures near 1.7× Medicare (p50 1.19×) while skewing captive emergency, lab, and upper-quartile codes to 2.1× Medicare (p75 1.79×, +50% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#70 of 92 in NY · 75th State Percentile#2,138 of 3,385 in U.S. · 63rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 0% of shoppable procedures (95/100 Cash Honesty)
2-Star CMS clinical rating with 52% patient recommendation (52/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (37.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.25× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (2.7×) & laboratory (1.1×) services average 1.24× higher multiples than routine shoppable care (1.7×)
Upper-quartile procedures (Q75 1.79×) jump +50% above the median procedure ratio (Q50 1.19×)
Unnegotiated chargemaster list prices average 4.9× Medicare (24¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.24× Divergence

2.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+50% Upper Tail

Q25 0.78× · Q50 1.19× · Q75 1.79×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.7× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

1.1× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

0% Cash Edge · 95/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 52/100Elevated

Procedure Prices at Harlem Hospital Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 139 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$50,521	$30,775	1.6×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$35,816	$19,087	1.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$34,814	$19,432	1.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$33,816	$17,936	1.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$20,354	$8,223	2.5×
Total hip replacement CPT Code: `27130`	—	$4,254	$13,413	0.3×
Total knee replacement CPT Code: `27447`	—	$4,254	$13,523	0.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$3,499	$6,109	0.6×
Bunion correction surgery CPT Code: `28296`	—	$2,940	$3,446	0.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,785	$2,680	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$2,649	$3,629	0.7×
C-section delivery (full package) CPT Code: `59510`	—	$2,536	$2,975	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,445	$2,540	1.0×
Breast lump removal CPT Code: `19120`	—	$2,365	$3,875	0.6×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$2,191	$3,372	0.6×
Trauma team activation HCPCS Code: `G0390`	—	$1,566	$1,453	1.1×
Upper endoscopy with biopsy CPT Code: `43239`	—	$1,177	$987	1.2×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$1,015	$1,021	1.0×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,028	$1,256	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$966	$981	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	—	$810	$511	1.6×
Blood transfusion CPT Code: `36430`	—	$707	$498	1.4×
Ultrasound, leg veins (duplex) CPT Code: `93970`	—	$720	$272	unverified
Injection procedure for pain management HCPCS Code: `G0260`	—	$674	$855	0.8×
MRI, brain (no contrast) CPT Code: `70551`	—	$547	$343	1.6×
MRI, lower back (no contrast) CPT Code: `72148`	—	$535	$338	1.6×
MRI, knee or other leg joint CPT Code: `73721`	—	$529	$369	1.4×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	—	$453	$448	1.0×
CT scan, head (with and without contrast) CPT Code: `70470`	—	$421	$258	1.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	—	$403	$303	1.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$414	$583	0.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	—	$422	$134	unverified
Residential mental health treatment HCPCS Code: `H2036`	—	—	$406	—
CT scan, head (with contrast) CPT Code: `70460`	—	$378	$242	unverified
CT scan, chest (no contrast) CPT Code: `71250`	—	$371	$167	unverified
CT scan, sinuses CPT Code: `70486`	—	$342	$166	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	—	$351	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	—	$351	$168	unverified
CT scan, pelvis CPT Code: `72192`	—	$325	$163	2.0×
Rabies immune globulin HCPCS Code: `90375`	—	—	$322	—
CT scan, head (no contrast) CPT Code: `70450`	—	$292	$160	1.8×
Mental health services (assessment) HCPCS Code: `H0031`	—	$260	$140	1.9×
Behavioral health assessment HCPCS Code: `H0001`	—	$260	$157	1.7×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$260	$185	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	—	$201	$86	2.3×
Psychological testing evaluation CPT Code: `96136`	—	$210	$128	1.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	—	$200	$126	1.6×
Ultrasound, thyroid and neck CPT Code: `76536`	—	$205	$132	1.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$210	$166	1.3×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$210	$181	1.2×
Neurobehavioral status check CPT Code: `96116`	—	$210	$231	0.9×
Behavioral health living support HCPCS Code: `H2019`	—	$179	$34	5.3×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$171	$88	1.9×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$188	$257	0.7×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$188	$269	0.7×
Psychological testing by technician CPT Code: `96138`	—	$212	$395	0.5×
Behavioral health day treatment HCPCS Code: `H0010`	—	$177	$343	0.5×
Behavioral health residential care HCPCS Code: `H0011`	—	$177	$364	0.5×
Physical therapy (manual therapy) CPT Code: `97140`	—	$123	$34	3.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	$140	$40	3.5×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$124	$38	3.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$123	$38	3.2×
Orthotic fitting and training CPT Code: `97760`	—	$146	$51	2.9×
Care planning with family CPT Code: `90887`	—	$169	$107	1.6×
Ultrasound, pelvis CPT Code: `76856`	—	$189	$130	1.5×
Screening mammogram (both breasts) CPT Code: `77067`	—	$175	$123	1.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$175	$148	1.2×
Family therapy session CPT Code: `90847`	—	$170	$173	1.0×
Prosthetic fitting and training CPT Code: `97761`	—	$126	$45	2.8×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$144	$86	1.7×
Hepatitis B immune globulin HCPCS Code: `90371`	—	—	$151	unverified
Group therapy session CPT Code: `90853`	—	$109	$100	1.1×
Breathing treatment (nebulizer) CPT Code: `94640`	—	$118	$201	0.6×
Review of medical records for care CPT Code: `90889`	—	—	$114	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$82	$25	3.3×
Occupational therapy (self-care training) CPT Code: `97535`	—	$96	$38	2.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$80	$64	1.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$105	$123	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	—	$90	$110	0.8×
Behavioral health day program HCPCS Code: `H2012`	—	—	$100	—
Typhoid vaccine HCPCS Code: `90675`	—	—	$347	—
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	—	$203	—
Pneumococcal vaccine HCPCS Code: `90732`	—	—	$140	—
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
Blood antibody screen CPT Code: `86850`	—	$86	$46	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	—	$111	—
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$52	$35	1.5×
Colorectal cancer screening HCPCS Code: `G0010`	—	$51	$49	1.0×
Flu vaccine injection HCPCS Code: `G0008`	—	$48	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$49	$49	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$72	$87	0.8×
X-ray, chest (single view) CPT Code: `71045`	—	$71	$92	0.8×
X-ray, foot CPT Code: `73630`	—	$71	$92	0.8×
X-ray, chest (two views) CPT Code: `71046`	—	$71	$93	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	—	$71	$93	0.8×
X-ray, hand CPT Code: `73130`	—	$71	$93	0.8×
X-ray, hip CPT Code: `73502`	—	$71	$93	0.8×
X-ray, ankle CPT Code: `73610`	—	$71	$93	0.8×
X-ray, shoulder CPT Code: `73030`	—	$67	$92	0.7×
X-ray, pelvis CPT Code: `72170`	—	$71	$110	0.6×
X-ray, lower back CPT Code: `72110`	—	$71	$112	0.6×
Mental health services (therapy) HCPCS Code: `H0032`	—	—	$65	unverified
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$33	$33	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	—	$39	—
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	—	$56	—
Blood test, clotting time (PT/INR) CPT Code: `85610`	—	—	$5	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	—	—	$6	—
Hepatitis C antibody test CPT Code: `86803`	—	—	$15	—
Hepatitis B vaccine HCPCS Code: `90744`	—	—	$37	—
Behavioral health outpatient services HCPCS Code: `H2015`	—	$11	$16	0.7×
Blood test, basic metabolic panel CPT Code: `80048`	—	—	$9	—
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	—	$11	—
Blood test, cholesterol (lipid panel) CPT Code: `80061`	—	—	$14	—
Blood test, liver function panel CPT Code: `80076`	—	—	$9	—
Blood test, vitamin D CPT Code: `82306`	—	—	$31	—
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	—	$3	unverified
Blood test, amylase CPT Code: `82150`	—	—	$7	—
Blood test, calcium CPT Code: `82310`	—	—	$5	—
Blood test, creatinine (kidney) CPT Code: `82565`	—	—	$5	—
Blood test, vitamin B12 CPT Code: `82607`	—	—	$16	—
Blood test, ferritin (iron stores) CPT Code: `82728`	—	—	$14	—
Blood test, glucose (blood sugar) CPT Code: `82947`	—	—	$4	—
Blood test, average blood sugar (A1c) CPT Code: `83036`	—	—	$10	—
Blood test, lipase CPT Code: `83690`	—	—	$7	—
Blood test, magnesium CPT Code: `83735`	—	—	$7	—
Blood test, potassium CPT Code: `84132`	—	—	$5	—
Blood test, PSA (prostate screen) CPT Code: `84153`	—	—	$19	—
Blood test, sodium CPT Code: `84295`	—	—	$5	—
Blood test, thyroid (TSH) CPT Code: `84443`	—	—	$18	—
Culture, blood CPT Code: `87040`	—	—	$11	—
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	—	$35	unverified
Culture, bacterial CPT Code: `87070`	—	—	$9	—
Flu vaccine (high dose) HCPCS Code: `90656`	—	—	$25	unverified
Physical therapy (gait training) CPT Code: `97116`	—	—	$33	—
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	—	$4	unverified
Blood test, hemoglobin CPT Code: `85018`	—	—	$3	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	—	$20	—
Electrical stimulation therapy HCPCS Code: `G0283`	—	—	$14	—
Community mental health services HCPCS Code: `H0038`	—	—	$16	unverified

Showing top 25 high-impact procedures of 139 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 37.5%

Audit a Bill or Quote at Harlem Hospital Center (Zero PHI Required)

CMS CCN: 330240

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $50,521

1. Amount on Your Bill or Quote ($) Pre-filled with Harlem Hospital Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $45,481 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $45,481

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (37.5% of gross = $45,481).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Harlem Hospital Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$90,475 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($121,250) is $90,475 above the denoised Fair BaseRate ($30,775) and 5.2× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (37.5% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall1/5 Stars (1/5)

Safety Composite52/100

Would Recommend52%

Rated 9 or 10 (HCAHPS)52%

Median ER Wait142 min

Left ER Before Seen3%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Harlem Hospital Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-18·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (378 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Harlem Hospital Center.

Price Index: 1.04× regional baseline

Quality: 33/100 CMS composite

Median Household Income$104,553U.S. Census ACS

Local Uninsured Share4.3%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 78/100 · Corroborated CMS CCN 330240

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 330240) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filebellevue

Publication / Vintage2025-09-05 · 753.09 MB

Validated Rate Rows9,370 (CMS v3.0.0)

File Integrity Digest28297c6a3866efd80c8d…

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.

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