Maimonides Medical Center
4802 Tenth Avenue, Brooklyn, NY 11219 · 131 Priced Procedures · 62% Patient Recommendation
Typical commercial prices here are 6% below the fair benchmark (0.94×) after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 0.94× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Maimonides Medical Center prices routine shoppable procedures near 0.9× Medicare (p50 1.12×) while skewing captive emergency, lab, and upper-quartile codes to 1.4× Medicare (p75 1.21×, +8% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 6% below peer Fair BaseRate (0.94×)
- Self-pay cash beats commercial insurance on 6% of shoppable procedures (25/100 Cash Honesty)
- 2-Star CMS clinical rating with 62% patient recommendation (53/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (21.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.94× 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 (0.9×) & laboratory (0.9×) services average 1.56× higher multiples than routine shoppable care (0.9×)
- Even at low-cost facilities (0.94× 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.
- Unnegotiated chargemaster list prices average 4.0× Medicare (22¢ true HCRIS cost per $1 gross)
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 Maimonides Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 131 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $51,027 | 1.7× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $31,016 | 1.6× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $30,804 | 1.6× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $28,227 | 1.6× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $12,947 | 1.6× |
| Total knee replacement CPT Code: 27447 | $9,733 | 0.7× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $6,254 | 1.9× |
| Bunion correction surgery CPT Code: 28296 | $6,254 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $5,036 | 2.0× |
| C-section delivery (full package) CPT Code: 59510 | $4,826 | 1.6× |
| Vaginal delivery (full package) CPT Code: 59400 | $4,205 | 1.6× |
| Total hip replacement CPT Code: 27130 | $3,795 | 0.3× |
| Injection procedure for pain management HCPCS Code: G0260 | $2,376 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,985 | unverified |
| Trauma team activation HCPCS Code: G0390 | $1,830 | 1.3× |
| Breast lump removal CPT Code: 19120 | $1,260 | 0.3× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,065 | unverified |
| Blood transfusion CPT Code: 36430 | $965 | unverified |
| Inguinal hernia repair CPT Code: 49505 | $836 | 0.2× |
| Care planning with family CPT Code: 90887 | $391 | 3.7× |
| Breathing treatment (nebulizer) CPT Code: 94640 | $268 | 1.3× |
| Neurobehavioral status check CPT Code: 96116 | $289 | 1.3× |
| Rabies immune globulin HCPCS Code: 90375 | $280 | 0.9× |
| Family therapy session CPT Code: 90847 | $222 | 1.3× |
| CT scan, head (with contrast) CPT Code: 70460 | $247 | 1.0× |
Audit a Bill or Quote at Maimonides Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $25,754
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (21.0% of gross = $25,754).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Maimonides Medical Center'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 ($122,465) is $91,690 above the denoised Fair BaseRate ($30,775) and 5.2× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (21.0% 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
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Maimonides Medical Center. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-03-19·administrative_or_closure
Met Requirements
Recorded - 2022-02-02·administrative_or_closure
Closure Notice
Recorded - 2021-09-30·cap_corrective_action
CAP Request
Recorded - 2021-04-19·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (2,164 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 Maimonides Medical Center.
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.