How many shoppable procedure prices are published for Hospital for Special Surgery?

Hospital for Special Surgery in New York, NY currently has 98 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Hospital for Special Surgery's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Hospital for Special Surgery's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

What is Hospital for Special Surgery's CMS Care Compare overall star rating?

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

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 166 Beds · rural Updated: 2026-04-01

Hospital for Special Surgery

535 East 70Th Street, New York, NY 10021 · 98 Priced Procedures · 88% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

High Markup · Shop Alternatives

1.76×vs. Fair Market Price

Typical commercial prices here are +76% above the fair benchmark (1.76×) even after accounting for local nurse/doctor wages and patient complexity.

50/100 · Caution

50/100Self-Pay Cash Beats Insurance 17% of the Time

File Completeness90

Price Logic49

Peer Alignment59

Clean Billing38

Real Cash Discount7

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 1.76× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +40% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Hospital for Special Surgery prices routine shoppable procedures at 2.6× Medicare (median 1.81× Fair BaseRate) while upper-quartile commercial rates jump +40% to 2.54× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#84 of 92 in NY · 90th State Percentile#2,933 of 3,385 in U.S. · 86th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.85× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 17% of shoppable procedures (25/100 Cash Honesty)
5-Star CMS clinical rating with 88% patient recommendation (79/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (51.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.2× markup over Medicare rates
Commercial insurance median sits at 1.81× Fair BaseRate (2.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.54×) jump +40% above the median procedure ratio (Q50 1.81×)
Unnegotiated chargemaster list prices average 12.0× Medicare (20¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.6× Medicare

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

Back-Door Captive & ER0.69× Divergence

1.8× Medicare

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

Quantile Tail Spread+40% Upper Tail

Q25 0.85× · Q50 1.81× · Q75 2.54×

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

2.6× MedicareFair

Outpatient Surgery & ORBack-Door Captive

3.2× MedicareElevated

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

6.4× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

3.8× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

5.0× MedicareWatchout

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

1.4× MedicareGood

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

17% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 79/100Fair

Procedure Prices at Hospital for Special Surgery

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 98 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$79,244	$79,244	$19,432	unverified
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$117,579	$78,148	$30,775	2.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$28,376	$21,997	$8,223	unverified
Total knee replacement CPT Code: `27447`	—	—	$13,523	unverified
Total hip replacement CPT Code: `27130`	—	—	$13,413	unverified
Bunion correction surgery CPT Code: `28296`	$15,623	$12,177	$3,446	unverified
Breast lump removal CPT Code: `19120`	$12,750	$11,659	$3,875	unverified
Inguinal hernia repair CPT Code: `49505`	—	—	$3,629	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	—	$3,372	unverified
MRI, brain (no contrast) CPT Code: `70551`	$1,292	$964	$343	2.8×
MRI, knee or other leg joint CPT Code: `73721`	$2,144	$964	$369	2.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,431	$964	$511	1.9×
MRI, lower back (no contrast) CPT Code: `72148`	$2,185	$966	$338	unverified
CT scan, head (no contrast) CPT Code: `70450`	$1,189	$857	$160	unverified
CT scan, head (with contrast) CPT Code: `70460`	$1,219	$857	$242	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,237	$857	$258	unverified
CT scan, sinuses CPT Code: `70486`	$1,205	$857	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$1,222	$857	$167	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,266	$857	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,266	$857	$168	unverified
CT scan, pelvis CPT Code: `72192`	$1,218	$857	$163	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$586	$586	$64	9.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$539	$539	$201	unverified
Blood transfusion CPT Code: `36430`	—	—	$498	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$547	$520	$134	unverified
Ultrasound, pelvis CPT Code: `76856`	$533	$520	$130	unverified
X-ray, hip CPT Code: `73502`	$325	$325	$93	unverified
Orthotic fitting and training CPT Code: `97760`	$282	$282	$51	5.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,021	$307	$583	0.5×
X-ray, chest (single view) CPT Code: `71045`	$283	$283	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$295	$295	$93	unverified
X-ray, pelvis CPT Code: `72170`	$292	$292	$110	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$309	$309	$132	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$741	$245	$272	0.9×
Speech therapy (group session) CPT Code: `92508`	$218	$218	$27	8.1×
Physical therapy (gait training) CPT Code: `97116`	$221	$221	$33	6.7×
Physical therapy (manual therapy) CPT Code: `97140`	$221	$221	$34	6.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$221	$221	$35	6.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$221	$221	$38	5.8×
Occupational therapy (self-care training) CPT Code: `97535`	$221	$221	$38	5.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$221	$221	$40	5.5×
Prosthetic fitting and training CPT Code: `97761`	$221	$221	$45	4.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$182	$182	$38	4.8×
Speech therapy (language evaluation) CPT Code: `92507`	$353	$185	$86	2.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$250	$190	$185	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$200	$182	$181	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$363	$153	$123	1.2×
New patient office visit (30-44 min) CPT Code: `99203`	$495	$134	$110	1.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$300	$108	$87	1.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$180	$124	$166	0.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$483	$95	$126	0.8×
Neurobehavioral status check CPT Code: `96116`	$300	$104	$231	0.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,413	$94	$303	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,490	$93	$448	unverified
Blood test, vitamin D CPT Code: `82306`	$396	$396	$31	12.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$281	$281	$19	14.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$197	$197	$14	14.1×
Pneumococcal vaccine HCPCS Code: `90732`	$211	$211	$140	1.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$232	$232	$203	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$121	$121	$111	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$71	$49	$56	0.9×
Flu vaccine injection HCPCS Code: `G0008`	$96	$42	$48	0.9×
Psychological testing evaluation CPT Code: `96136`	$150	$47	$128	0.4×
Psychological testing by technician CPT Code: `96138`	$240	$42	$395	0.1×
Blood test, clotting time (PTT) CPT Code: `85730`	$177	$14	$6	2.3×
Extended office visit (prolonged) HCPCS Code: `G2212`	$100	$37	$33	1.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$87	$9	$4	2.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$82	$9	$4	2.3×
Blood test, calcium CPT Code: `82310`	$96	$11	$5	2.2×
Blood test, sodium CPT Code: `84295`	$90	$11	$5	2.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$270	$23	$11	2.1×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$132	$6	$3	2.0×
Blood test, basic metabolic panel CPT Code: `80048`	$197	$17	$9	1.9×
Blood test, liver function panel CPT Code: `80076`	$200	$17	$9	1.9×
Blood test, vitamin B12 CPT Code: `82607`	$197	$30	$16	1.9×
Blood test, lipase CPT Code: `83690`	$167	$13	$7	1.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$35	$35	$25	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$96	$42	$49	0.9×
Blood test, creatinine (kidney) CPT Code: `82565`	$113	$9	$5	1.8×
Blood test, potassium CPT Code: `84132`	$97	$9	$5	1.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$124	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$22	$5	$3	1.7×
Blood test, amylase CPT Code: `82150`	$151	$11	$7	1.6×
Blood test, magnesium CPT Code: `83735`	$155	$11	$7	1.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$197	$10	$10	1.0×
Culture, bacterial CPT Code: `87070`	$284	$8	$9	0.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$175	$7	$8	0.9×
Culture, blood CPT Code: `87040`	$275	$8	$11	0.7×
Hepatitis C antibody test CPT Code: `86803`	$242	$9	$15	0.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$236	$8	$14	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$19	$19	$37	0.5×
Blood test, thyroid (TSH) CPT Code: `84443`	$249	$9	$18	0.5×
X-ray, lower back CPT Code: `72110`	$329	$30	$112	0.3×
X-ray, foot CPT Code: `73630`	$531	$21	$92	0.2×
X-ray, hand CPT Code: `73130`	$531	$21	$93	0.2×
X-ray, ankle CPT Code: `73610`	$531	$21	$93	0.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$295	$18	$93	unverified
X-ray, shoulder CPT Code: `73030`	$665	$16	$92	unverified

Showing top 25 high-impact procedures of 98 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 51.5%

Audit a Bill or Quote at Hospital for Special Surgery (Zero PHI Required)

CMS CCN: 330270

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $79,244

Insurer Median $79,244

1. Amount on Your Bill or Quote ($) Pre-filled with Hospital for Special Surgery’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: $97,946 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $97,946

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (51.5% of gross = $97,946).

Step 2 · Cash vs. Insurance Arbitrage Save $110,942 Paying Cash

Self-Pay Cash Rate ($79,244) Beats Your Bill

Hospital for Special Surgery's published 45 CFR § 180 self-pay cash rate is $79,244 (vs. $79,244 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$170,754 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($190,186) is $170,754 above the denoised Fair BaseRate ($19,432) and 13.5× the $14,044 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)

EIN: 131624135

Filing Period: 194601

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 (51.5% 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 Overall4/5 Stars (4/5)

Safety Composite79/100

Would Recommend88%

Rated 9 or 10 (HCAHPS)83%

30-Day Mortality vs U.S.same

Unplanned Readmissionbetter

Hip/Knee Complication Rate3.3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

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 Hospital for Special Surgery. Prior administrative notices do not necessarily reflect current compliance status.

2025-05-22·administrative_or_closure
Closure Notice
Recorded
2025-03-11·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (922 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.42× regional baseline

Quality: 80/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Horizon

-73.8%

Emblem

-68.1%

Fidelis Care

-62.9%

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 50/100 · Caution CMS CCN 330270 EIN 131624135

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 330270) ↗ Verify IRS Form 990 (EIN 131624135) ↗ CMS HCRIS Cost Reports ↗

Published MRF File131624135-1184038663_ny-society-for-the-relief-of-ruptured-and-crippled-maintaing-the-hospital-for-special-surgery_standardcharges.json

Publication / Vintage2026-04-01 · 7861.85 MB

Validated Rate Rows10,870 (CMS v3.0.0)

File Integrity Digest1959b415370cbd42f04c…

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.

Submit MRF Update Correction Policy