Little Falls Hospital
140 Burwell Street, Little Falls, NY 13365 · 117 Priced Procedures · 80% Patient Recommendation
Typical commercial prices here are 9% below the fair benchmark (0.91×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.91× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Little Falls Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.90× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.99× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 9% below peer Fair BaseRate (0.91×)
- Self-pay cash beats commercial insurance on 77% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 80% patient recommendation (75/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (30.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Commercial insurance median sits at 0.90× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (0.91× 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.
- Consolidated metro market (HHI 6,063) 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 Little Falls Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $3,682 | 0.2× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $3,308 | 0.4× |
| Trauma team activation HCPCS Code: G0390 | $1,677 | 1.2× |
| Total hip replacement CPT Code: 27130 | $1,485 | 0.1× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,289 | 1.3× |
| Total knee replacement CPT Code: 27447 | $1,296 | 0.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,188 | 1.2× |
| C-section delivery (full package) CPT Code: 59510 | $1,046 | 0.4× |
| Vaginal delivery (full package) CPT Code: 59400 | $940 | 0.4× |
| Cataract surgery with lens implant CPT Code: 66984 | $810 | 0.3× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $667 | 0.2× |
| Blood transfusion CPT Code: 36430 | $554 | 1.1× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $486 | 0.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $453 | 0.9× |
| Bunion correction surgery CPT Code: 28296 | $416 | 0.1× |
| MRI, lower back (no contrast) CPT Code: 72148 | $306 | 0.9× |
| MRI, brain (no contrast) CPT Code: 70551 | $306 | 0.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $306 | 0.8× |
| Inguinal hernia repair CPT Code: 49505 | $324 | 0.1× |
| Breast lump removal CPT Code: 19120 | $280 | 0.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $242 | 0.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $226 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $245 | 0.5× |
| Colonoscopy with biopsy CPT Code: 45380 | $251 | 0.2× |
| CT scan, head (with contrast) CPT Code: 70460 | $212 | 0.9× |
Audit a Bill or Quote at Little Falls Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,087
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (30.0% of gross = $4,087).
Self-Pay Cash Rate ($3,682) Beats Your Bill
Little Falls Hospital's published 45 CFR § 180 self-pay cash rate is $3,682 (vs. $3,682 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,087).
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (30.0% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Little Falls Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-06-03·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (177 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 Little Falls Hospital.
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.