How many shoppable procedure prices are published for Montefiore Mount Vernon Hospital?

Montefiore Mount Vernon Hospital in Mount Vernon, NY currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Montefiore Mount Vernon Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Montefiore Mount Vernon Hospital's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Montefiore Mount Vernon Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Montefiore Mount Vernon Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 63 Beds · urban Updated: 2026-04-01

Montefiore Mount Vernon Hospital

12 North 7Th Avenue, Mount Vernon, NY 10550 · 123 Priced Procedures · 61% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.10×vs. Fair Market Price

Typical commercial prices here are +10% above the fair benchmark (1.10×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 15% of the Time

File Completeness51

Price Logic95

Peer Alignment73

Clean Billing85

Real Cash Discount100

Regional Benchmark Tier

2-Star CMS clinical quality rating paired with 1.10× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Montefiore Mount Vernon Hospital prices routine shoppable procedures near 2.0× Medicare (p50 1.16×) while skewing captive emergency, lab, and upper-quartile codes to 8.1× Medicare (p75 1.23×, +6% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#60 of 92 in NY · 64th State Percentile#1,685 of 3,385 in U.S. · 49th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 15% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (59/100 safety score) with 61% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (13.1% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.0× markup over Medicare rates
Captive ER (2.9×) & laboratory (2.7×) services average 4.05× higher multiples than routine shoppable care (2.0×)
Specialty infusion drugs (J-codes) average 2.3× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 11.2× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.0× Medicare

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

Back-Door Captive & ER4.05× Divergence

8.1× Medicare

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

Quantile Tail Spread+6% Upper Tail

Q25 0.98× · Q50 1.16× · Q75 1.23×

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

2.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

3.0× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.2× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.9× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.7× MedicareFair

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

2.3× MedicareFair

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

15% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 59/100Elevated

Procedure Prices at Montefiore Mount Vernon Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$12,065	$13,413	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,786	$6,109	1.3×
Bunion correction surgery CPT Code: `28296`	—	$7,498	$3,446	2.2×
Inguinal hernia repair CPT Code: `49505`	—	$7,498	$3,629	2.1×
C-section delivery (full package) CPT Code: `59510`	—	$7,276	$2,975	2.4×
Breast lump removal CPT Code: `19120`	—	$7,276	$3,875	1.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$7,276	$3,372	unverified
Cataract surgery with lens implant CPT Code: `66984`	—	$7,118	$2,540	2.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,829	$8,223	0.8×
Colonoscopy with biopsy CPT Code: `45380`	—	$6,699	$1,256	5.3×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$6,297	$30,775	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$8,366	$5,316	$981	5.4×
Upper endoscopy with biopsy CPT Code: `43239`	—	$5,316	$987	5.4×
Blood transfusion CPT Code: `36430`	$916	$5,003	$498	10.0×
Injection procedure for pain management HCPCS Code: `G0260`	—	$5,003	$855	5.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$3,549	$2,680	1.3×
Trauma team activation HCPCS Code: `G0390`	—	$1,664	$1,453	1.1×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$1,067	$1,021	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,109	$914	$583	1.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,898	$505	$511	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$2,908	$441	$338	1.3×
MRI, brain (no contrast) CPT Code: `70551`	$3,093	$441	$343	1.3×
MRI, knee or other leg joint CPT Code: `73721`	$759	$441	$369	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,465	$435	$448	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$336	$19,432	0.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$187	$309	$123	2.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$335	$306	$185	1.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,006	$298	$272	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,191	$298	$303	1.0×
Rabies immune globulin HCPCS Code: `90375`	—	$305	$322	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$244	$305	$110	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$285	$261	$166	1.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$301	$247	$181	1.4×
Neurobehavioral status check CPT Code: `96116`	—	$270	$231	1.2×
Psychological testing by technician CPT Code: `96138`	—	$286	$395	0.7×
Behavioral health assessment HCPCS Code: `H0001`	—	$204	$157	1.3×
Family therapy session CPT Code: `90847`	—	$222	$173	1.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,603	$219	$242	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,419	$219	$258	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$161	$243	$87	unverified
Physical therapy (gait training) CPT Code: `97116`	$163	$161	$33	4.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$170	$168	$35	4.8×
Physical therapy (manual therapy) CPT Code: `97140`	$158	$156	$34	4.6×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$146	$146	$38	3.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$148	$148	$40	3.7×
Psychological testing evaluation CPT Code: `96136`	—	$166	$128	1.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$508	$178	$148	1.2×
Group therapy session CPT Code: `90853`	—	$127	$100	1.3×
X-ray, pelvis CPT Code: `72170`	$359	$131	$110	1.2×
Screening mammogram (both breasts) CPT Code: `77067`	$542	$144	$123	1.2×
X-ray, lower back CPT Code: `72110`	$692	$131	$112	1.2×
Care planning with family CPT Code: `90887`	—	$123	$107	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$844	$131	$126	1.0×
Ultrasound, pelvis CPT Code: `76856`	$892	$131	$130	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$734	$131	$132	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$148	$151	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,056	$131	$134	1.0×
CT scan, pelvis CPT Code: `72192`	$657	$151	$163	0.9×
CT scan, sinuses CPT Code: `70486`	$1,576	$144	$166	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$1,289	$144	$167	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,412	$144	$168	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,327	$144	$169	0.9×
X-ray, chest (single view) CPT Code: `71045`	$267	$109	$92	1.2×
X-ray, shoulder CPT Code: `73030`	$267	$109	$92	1.2×
X-ray, foot CPT Code: `73630`	$267	$109	$92	1.2×
X-ray, chest (two views) CPT Code: `71046`	$263	$109	$93	1.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$438	$109	$93	1.2×
X-ray, hand CPT Code: `73130`	$267	$109	$93	1.2×
X-ray, hip CPT Code: `73502`	$267	$109	$93	1.2×
X-ray, ankle CPT Code: `73610`	$267	$109	$93	1.2×
CT scan, head (no contrast) CPT Code: `70450`	$1,360	$131	$160	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	—	$83	$86	1.0×
Typhoid vaccine HCPCS Code: `90675`	—	$371	$347	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$161	$158	$11	14.4×
Hepatitis C antibody test CPT Code: `86803`	$174	$172	$15	11.5×
Blood test, thyroid (TSH) CPT Code: `84443`	$148	$148	$18	8.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$150	$150	$19	7.9×
Blood test, vitamin D CPT Code: `82306`	$172	$172	$31	5.5×
Blood antibody screen CPT Code: `86850`	$163	$161	$46	3.5×
Blood test, basic metabolic panel CPT Code: `80048`	$114	$113	$9	12.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$118	$118	$14	8.4×
Pneumococcal vaccine HCPCS Code: `90732`	—	$141	$140	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$113	$113	$16	7.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$101	$100	$10	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$65	$64	$3	21.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$81	$79	$5	15.8×
Blood test, amylase CPT Code: `82150`	$81	$79	$7	11.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$96	$96	$14	6.9×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$77	$38	2.0×
Prosthetic fitting and training CPT Code: `97761`	—	$77	$45	1.7×
Orthotic fitting and training CPT Code: `97760`	—	$77	$51	1.5×
Culture, blood CPT Code: `87040`	$84	$84	$11	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$48	$47	$4	11.8×
Blood test, potassium CPT Code: `84132`	$59	$58	$5	11.6×
Blood test, sodium CPT Code: `84295`	$55	$54	$5	10.8×
Blood test, lipase CPT Code: `83690`	$75	$74	$7	unverified
Blood test, calcium CPT Code: `82310`	$45	$45	$5	9.0×
Blood test, liver function panel CPT Code: `80076`	$68	$67	$9	7.4×
Speech therapy (group session) CPT Code: `92508`	—	$77	$27	2.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$39	$20	1.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$53	$35	1.5×
Flu vaccine injection HCPCS Code: `G0008`	—	$58	$48	1.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$58	$49	1.2×
Colorectal cancer screening HCPCS Code: `G0010`	—	$58	$49	1.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$276	$74	$64	1.2×
Blood test, magnesium CPT Code: `83735`	$59	$59	$7	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$31	$31	$4	7.8×
Blood test, hemoglobin CPT Code: `85018`	$21	$21	$3	7.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$23	$23	$8	2.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$17	$17	$6	2.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$11	$11	$5	2.2×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$14	$14	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$33	$33	1.0×
Occupational therapy (self-care training) CPT Code: `97535`	—	$36	$38	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	—	$33	$37	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$22	$25	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$41	$56	0.7×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$53	$27	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$16	$25	0.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$513	$26	$201	0.1×
Culture, bacterial CPT Code: `87070`	$25	$25	$9	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$161	$36	$86	unverified
Drug screening test HCPCS Code: `G0480`	—	$16	$116	unverified

Showing top 25 high-impact procedures of 123 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 13.1%

Audit a Bill or Quote at Montefiore Mount Vernon Hospital (Zero PHI Required)

CMS CCN: 330086

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $12,065

1. Amount on Your Bill or Quote ($) Pre-filled with Montefiore Mount Vernon Hospital’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: $3,796 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,796

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (13.1% of gross = $3,796).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Montefiore Mount Vernon Hospital'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 +$15,543 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($28,956) is $15,543 above the denoised Fair BaseRate ($13,413) and 2.2× the $13,117 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 (13.1% 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 Overall2/5 Stars (2/5)

Safety Composite59/100

Would Recommend61%

Rated 9 or 10 (HCAHPS)63%

Median ER Wait194 min

Left ER Before Seen1%

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)

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 Montefiore Mount Vernon Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-26·administrative_or_closure
Closure Notice
Recorded
2025-02-12·cap_corrective_action
CAP Request
Recorded
2024-11-08·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (175 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 Montefiore Mount Vernon Hospital.

Price Index: 0.94× regional baseline

Quality: 48/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

SelectHealth

-41.2%

Blue Cross Blue Shield

+88.9%

Cigna

+99.2%

Centivo

+122.6%

Median Household Income$118,411U.S. Census ACS

Local Uninsured Share5.0%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 80/100 · Corroborated CMS CCN 330086

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 330086) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows7,035 (CMS v3.0.0)

File Integrity DigestVerified · CCN 330086

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