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Hospital Profile Acute Care Hospital Voluntary non-profit - Private 19 Beds · urban Updated: 1/1/2026

Wellspan Surgery and Rehabilitation Hospital

55 Monument Road, York, PA 17403 · 80 Priced Procedures · 87% Patient Recommendation

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.High Markup · Shop Alternatives
2.45×vs. Fair Market Price
Position vs. 1.00× Fair Price+145% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are +145% above the fair benchmark (2.45×) even after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).76/100 · Corroborated
76/100Self-Pay Cash Beats Insurance 76% of the Time
File Completeness95Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic52Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment83Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing55Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.High-Markup · Check Safety
CMS Star Rating4/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score75/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

4-Star CMS clinical quality rating paired with 2.45× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 5,215), Wellspan Surgery and Rehabilitation Hospital commands a 2.45× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#127 of 134 in PA · 94th State Percentile#3,243 of 3,385 in U.S. · 95th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 2.30× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 76% of shoppable procedures (99/100 Cash Honesty)
  • 4-Star CMS clinical rating with 87% 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 (59.1% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 1.9× markup over Medicare rates
  • Commercial insurance median sits at 2.45× Fair BaseRate (2.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Specialty infusion drugs (J-codes) average 1.6× Medicare — verify per-unit billing on itemized statements
  • Consolidated metro market (HHI 5,215) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
2.9× Medicare

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

Back-Door Captive & ER0.79× Divergence
2.3× Medicare

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

Quantile Tail Spread+3% Upper Tail
Q25 2.30× · Q50 2.45× · Q75 2.52×

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
2.9× MedicareFair
Outpatient Surgery & ORBack-Door Captive
1.9× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.6× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
2.9× MedicareFair
Inpatient Lab & PathologyBack-Door Captive
1.5× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.6× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
76% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 75/100Fair

Procedure Prices at Wellspan Surgery and Rehabilitation Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 80 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Hip or knee replacement (inpatient stay)
MS-DRG Code: 470
 $50,656 2.6×
Total hip replacement
CPT Code: 27130
 $21,947 1.6×
Total knee replacement
CPT Code: 27447
 $21,747 1.6×
Knee arthroscopy with meniscus repair
CPT Code: 29881
 $6,420 1.9×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $2,077 unverified
MRI, brain (with and without contrast)
CPT Code: 70553
 $1,253 2.5×
Blood transfusion
CPT Code: 36430
 $1,152 2.3×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $1,124 2.5×
MRI, brain (no contrast)
CPT Code: 70551
 $916 2.7×
MRI, lower back (no contrast)
CPT Code: 72148
 $893 2.6×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $744 2.5×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $707 2.6×
Hospital observation (per hour)
HCPCS Code: G0378
 $487 unverified
CT scan, head (no contrast)
CPT Code: 70450
 $400 2.5×
CT scan, sinuses
CPT Code: 70486
 $403 2.4×
CT scan, chest (no contrast)
CPT Code: 71250
 $403 2.4×
CT scan, pelvis
CPT Code: 72192
 $393 2.4×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $403 2.4×
CT scan, neck (cervical spine)
CPT Code: 72125
 $403 2.4×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $363 2.7×
Screening mammogram (both breasts)
CPT Code: 77067
 $325 2.6×
Ultrasound, abdomen (limited)
CPT Code: 76705
 $308 2.4×
X-ray, pelvis
CPT Code: 72170
 $280 2.5×
X-ray, lower back
CPT Code: 72110
 $280 2.5×
X-ray, chest (single view)
CPT Code: 71045
 $232 2.5×
Showing top 25 high-impact procedures of 80 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 59.1%

Audit a Bill or Quote at Wellspan Surgery and Rehabilitation Hospital (Zero PHI Required)

CMS CCN: 390327
CPT 470
Fair BaseRate™ $19,432
Medicare Rate $14,044
Self-Pay Cash Request Quote
Insurer Median $50,656
Pre-filled with Wellspan Surgery and Rehabilitation Hospital’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $71,802 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $71,802

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (59.1% of gross = $71,802).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Wellspan Surgery and Rehabilitation 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 +$102,142 Above Fair BaseRate

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

Your bill ($121,574) is $102,142 above the denoised Fair BaseRate ($19,432) and 8.7× 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: 232899911
Filing Period: 199707
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 (59.1% 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 Overall4/5 Stars (4/5)
Safety Composite75/100
Would Recommend87%
Rated 9 or 10 (HCAHPS)91%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

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

  • 2025-03-27·administrative_or_closure

    Met Requirements

    Recorded

Source: CMS Hospital Care Compare (108 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 Pareto Frontier (Price + Quality)

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

Price Index: 1.16× regional baseline
Quality: 71/100 CMS composite
Median Household Income$82,238U.S. Census ACS
Local Uninsured Share4.7%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 76/100 · Corroborated CMS CCN 390327 EIN 232899911

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 390327) ↗ Verify IRS Form 990 (EIN 232899911) ↗ CMS HCRIS Cost Reports ↗
Published MRF File232899911_wellspan-surgery-and-rehabilitation-hospital_standardcharges.csv
Publication / Vintage1/1/2026 · 26.87 MB
Validated Rate Rows1,913 (CMS v3.0.0)
File Integrity Digestf43d0c48bdac40bdf18b…

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