New Jersey / Bayshore Medical Center

CMS certification 310112 · Holmdel, NJ · 3 entries in CMS's price-transparency list

Bayshore Medical Center: charges and Medicare payments

Bayshore Medical Center reported 2,136 Medicare inpatient stays across 60 DRGs in 2024. Across them it charged 6.69 times what it was paid — mid-range in New Jersey, number 24 of 60 hospitals with at least 100 stays (state median 6.25×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 371 stays at an average charge of $108,436, 20% above the national average. It also billed 1,684 outpatient services, charging 6.82 times what Medicare paid.

1Medicare inpatient stays 2,136
2Charge ÷ paid, inpatient 6.69×
3Rank in NJ (highest ratio = 1) 24 of 60
4CMS price-transparency actions 3

Average charge per stay at Bayshore Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 60 DRGs that can be compared with the national average, Bayshore Medical Center charged more than the national average in 45 (75%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	371	$108,436	+20%	$15,525
193 Simple Pneumonia and Pleurisy with MCC	149	$83,286	+39%	$10,468
291 Heart Failure and Shock with MCC	114	$83,759	+49%	$10,288
177 Respiratory Infections and Inflammations with MCC	108	$98,128	+39%	$13,443
689 Kidney and Urinary Tract Infections with MCC	73	$72,010	+40%	$8,958
690 Kidney and Urinary Tract Infections without MCC	65	$52,690	+39%	$6,810
870 Septicemia or Severe Sepsis with MV >96 Hours	63	$234,177	-28%	$50,767
682 Renal Failure with MCC	56	$72,868	+11%	$11,740
853 Infectious and Parasitic Diseases with O.R. Procedures with...	56	$262,817	+15%	$46,879
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	52	$64,550	+32%	$8,132
603 Cellulitis without MCC	51	$51,013	+37%	$7,854
698 Other Kidney and Urinary Tract Diagnoses with MCC	51	$88,221	+20%	$12,866
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	42	$51,951	+29%	$6,807
377 Gastrointestinal Hemorrhage with MCC	41	$126,188	+48%	$14,262
683 Renal Failure with CC	39	$51,943	+28%	$6,719
190 Chronic Obstructive Pulmonary Disease with MCC	37	$74,761	+48%	$8,626
280 Acute Myocardial Infarction, Discharged Alive with MCC	37	$75,027	-1%	$12,400
378 Gastrointestinal Hemorrhage with CC	34	$66,451	+37%	$7,627
552 Medical Back Problems without MCC	30	$60,563	+24%	$8,255
189 Pulmonary Edema and Respiratory Failure	29	$79,075	+37%	$9,642
481 Hip and Femur Procedures except Major Joint with CC	29	$93,069	-8%	$15,987
322 Percutaneous Cardiovascular Procedures with Intraluminal...	26	$105,139	-8%	$16,213
309 Cardiac Arrhythmia and Conduction Disorders with CC	23	$52,846	+46%	$5,747
312 Syncope and Collapse	21	$54,743	+20%	$6,776
389 Gastrointestinal Obstruction with CC	21	$60,504	+55%	$6,249
602 Cellulitis with MCC	21	$88,294	+47%	$12,037
699 Other Kidney and Urinary Tract Diagnoses with CC	21	$73,049	+54%	$8,651
281 Acute Myocardial Infarction, Discharged Alive with CC	20	$56,512	+12%	$7,027
308 Cardiac Arrhythmia and Conduction Disorders with MCC	20	$104,387	+84%	$11,594
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	20	$105,146	+74%	$11,835
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	19	$91,647	-8%	$15,544
480 Hip and Femur Procedures except Major Joint with MCC	19	$140,255	+1%	$27,909
194 Simple Pneumonia and Pleurisy with CC	18	$53,993	+41%	$6,444
286 Circulatory Disorders except AMI, with Cardiac...	17	$113,013	+1%	$16,895
287 Circulatory Disorders except AMI, with Cardiac...	17	$68,190	+7%	$11,544
811 Red Blood Cell Disorders with MCC	17	$93,343	+37%	$11,969
207 Respiratory System Diagnosis with Ventilator Support >96...	16	$279,712	-4%	$48,298
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	16	$48,056	+13%	$7,013
638 Diabetes with CC	16	$55,054	+32%	$7,091
314 Other Circulatory System Diagnoses with MCC	15	$86,894	-8%	$16,889
305 Hypertension without MCC	14	$52,217	+30%	$5,896
321 Percutaneous Cardiovascular Procedures with Intraluminal...	14	$170,747	+4%	$25,438
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	14	$212,721	-2%	$39,670
180 Respiratory Neoplasms with MCC	13	$95,156	+8%	$13,207
196 Interstitial Lung Disease with MCC	13	$96,541	+12%	$16,382
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	13	$50,136	+35%	$6,900
673 Other Kidney and Urinary Tract Procedures with MCC	13	$226,510	+31%	$33,446
039 Extracranial Procedures without CC/MCC	12	$54,605	-14%	$8,925
178 Respiratory Infections and Inflammations with CC	12	$69,452	+53%	$7,728
191 Chronic Obstructive Pulmonary Disease with CC	12	$57,551	+45%	$6,669
208 Respiratory System Diagnosis with Ventilator Support <=96...	12	$111,774	-18%	$20,012
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	12	$77,501	+27%	$11,964
394 Other Digestive System Diagnoses with CC	12	$50,243	+7%	$7,343
659 Kidney and Ureter Procedures for Non-Neoplasm with MCC	12	$103,584	-13%	$19,954
813 Coagulation Disorders	12	$85,965	+7%	$11,721
854 Infectious and Parasitic Diseases with O.R. Procedures with...	12	$96,196	-2%	$17,918
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	11	$80,352	+44%	$7,546
252 Other Vascular Procedures with MCC	11	$94,450	-45%	$26,342
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	11	$97,135	-5%	$16,388
917 Poisoning and Toxic Effects of Drugs with MCC	11	$67,924	-9%	$12,510

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	466	$29,179	$2,886
Level 2 Excision/ Biopsy/ Incision and Drainage	250	$9,406	$1,667
Level 5 Musculoskeletal Procedures	107	$43,826	$13,700
Level 5 Urology and Related Services	93	$25,463	$5,485
Level 1 Endovascular Procedures	90	$23,126	$3,432
Level 4 Urology and Related Services	76	$16,792	$3,657
Level 3 Urology and Related Services	74	$12,325	$2,159
Level 3 Endovascular Procedures	67	$45,028	$11,361
Level 3 Vascular Procedures	65	$15,768	$3,337
Level 3 Excision/ Biopsy/ Incision and Drainage	54	$18,864	$3,012
Level 2 Endovascular Procedures	38	$30,629	$6,059
Level 1 Laparoscopy and Related Services	35	$33,182	$6,116
Level 2 Upper GI Procedures	31	$13,752	$2,017
Level 4 Musculoskeletal Procedures	28	$39,880	$7,583
Level 1 Breast/Lymphatic Surgery and Related Procedures	27	$17,396	$4,041
Level 4 Airway Endoscopy	25	$24,246	$3,970
Level 4 Vascular Procedures	23	$27,832	$5,825
Level 3 Extraocular, Repair, and Plastic Eye Procedures	21	$22,083	$2,477
Level 3 Musculoskeletal Procedures	20	$16,365	$3,431
Level 2 Musculoskeletal Procedures	19	$12,688	$1,704
Level 4 Endovascular Procedures	18	$60,096	$16,484
Level 2 Vascular Procedures	16	$10,155	$1,613
Level 5 Airway Endoscopy	15	$64,340	$6,870
Level 3 Pacemaker and Similar Procedures	13	$39,174	$11,306
Level 2 Laparoscopy and Related Services	13	$46,070	$10,900

Against the New Jersey average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Bayshore Medical Center charged $108,436 on average, 18% less than the New Jersey average of $131,698, and was paid $15,525 against a state average of $19,296. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Bayshore Medical Center charged $83,286 on average, 17% less than the New Jersey average of $100,241, and was paid $10,468 against a state average of $13,150. For Heart Failure and Shock with MCC (DRG 291), Bayshore Medical Center charged $83,759 on average, 14% less than the New Jersey average of $97,469, and was paid $10,288 against a state average of $12,811. For Respiratory Infections and Inflammations with MCC (DRG 177), Bayshore Medical Center charged $98,128 on average, 16% less than the New Jersey average of $117,022, and was paid $13,443 against a state average of $16,115. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $29,179 was 15% below the state average of $34,388. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,406 was 27% below the state average of $12,828. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $43,826 was 31% below the state average of $63,772. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $25,463 was 14% below the state average of $29,528.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Bayshore Medical Center in Holmdel, NJ, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2022-08-31 (CMS case 672)
Closure Notice — 2023-02-17 (CMS case 672)
Met Requirements — 2025-08-01 (CMS case 6052)

A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.

Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.

Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.