New Jersey / Community Medical Center
CMS certification 310041 · Toms River, NJ · 4 entries in CMS's price-transparency list
Community Medical Center: charges and Medicare payments
Community Medical Center reported 7,467 Medicare inpatient stays across 149 DRGs in 2024. Across them it charged 6.73 times what it was paid — mid-range in New Jersey, number 23 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: 887 stays at an average charge of $116,195, 29% above the national average. It also billed 4,231 outpatient services, charging 6.05 times what Medicare paid.
- 1Medicare inpatient stays 7,467
- 2Charge ÷ paid, inpatient 6.73×
- 3Rank in NJ (highest ratio = 1) 23 of 60
- 4CMS price-transparency actions 4
Inpatient stays
For the 149 DRGs that can be compared with the national average, Community Medical Center charged more than the national average in 122 (82%). 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 | 887 | $116,195 | +29% | $17,298 |
| 291 Heart Failure and Shock with MCC | 462 | $86,877 | +54% | $11,617 |
| 193 Simple Pneumonia and Pleurisy with MCC | 254 | $88,535 | +48% | $11,889 |
| 689 Kidney and Urinary Tract Infections with MCC | 174 | $82,453 | +61% | $10,326 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 174 | $80,245 | +64% | $9,859 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 160 | $101,233 | +38% | $14,118 |
| 177 Respiratory Infections and Inflammations with MCC | 155 | $111,981 | +59% | $15,089 |
| 690 Kidney and Urinary Tract Infections without MCC | 149 | $56,802 | +50% | $7,117 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 135 | $230,415 | +1% | $44,187 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 124 | $62,264 | +55% | $7,239 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 112 | $90,227 | +78% | $10,569 |
| 603 Cellulitis without MCC | 110 | $61,145 | +64% | $8,098 |
| 312 Syncope and Collapse | 107 | $66,809 | +47% | $7,694 |
| 378 Gastrointestinal Hemorrhage with CC | 105 | $77,929 | +61% | $8,795 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 100 | $111,262 | +11% | $17,965 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 99 | $107,310 | +42% | $13,876 |
| 682 Renal Failure with MCC | 98 | $89,866 | +36% | $13,214 |
| 481 Hip and Femur Procedures except Major Joint with CC | 96 | $91,947 | -9% | $17,930 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 91 | $60,244 | +63% | $6,760 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 90 | $77,826 | +40% | $9,564 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 87 | $59,280 | +64% | $6,603 |
| 194 Simple Pneumonia and Pleurisy with CC | 81 | $67,136 | +75% | $7,596 |
| 683 Renal Failure with CC | 81 | $61,309 | +51% | $8,094 |
| 189 Pulmonary Edema and Respiratory Failure | 77 | $78,814 | +37% | $11,321 |
| 377 Gastrointestinal Hemorrhage with MCC | 77 | $124,841 | +46% | $16,504 |
| 552 Medical Back Problems without MCC | 75 | $60,755 | +24% | $8,453 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 69 | $56,891 | -39% | $17,119 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 69 | $56,343 | +19% | $9,148 |
| 813 Coagulation Disorders | 65 | $92,508 | +16% | $13,818 |
| 069 Transient Ischemia without Thrombolytic | 64 | $76,549 | +52% | $8,200 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 61 | $99,401 | +65% | $12,338 |
| 057 Degenerative Nervous System Disorders without MCC | 60 | $66,726 | +18% | $11,252 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 56 | $95,751 | +69% | $10,917 |
| 638 Diabetes with CC | 56 | $67,804 | +63% | $8,798 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 55 | $114,842 | 0% | $16,745 |
| 637 Diabetes with MCC | 55 | $104,501 | +57% | $14,624 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 54 | $61,442 | +55% | $7,632 |
| 884 Organic Disturbances and Intellectual Disability | 54 | $81,735 | +31% | $15,180 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 52 | $49,571 | +16% | $7,866 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 51 | $139,046 | +2% | $23,673 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 51 | $139,092 | +24% | $19,612 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 51 | $48,155 | +68% | $5,011 |
| 948 Signs and Symptoms without MCC | 49 | $57,355 | +51% | $6,918 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 46 | $179,090 | +9% | $24,064 |
| 330 Major Small and Large Bowel Procedures with CC | 46 | $120,248 | +1% | $21,801 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 46 | $129,248 | +32% | $17,513 |
| 314 Other Circulatory System Diagnoses with MCC | 43 | $120,687 | +27% | $17,616 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 42 | $88,991 | -13% | $18,374 |
| 101 Seizures without MCC | 40 | $53,300 | +9% | $8,133 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 40 | $68,229 | +7% | $9,890 |
| 812 Red Blood Cell Disorders without MCC | 40 | $79,723 | +80% | $8,050 |
| 056 Degenerative Nervous System Disorders with MCC | 39 | $98,345 | +2% | $18,035 |
| 389 Gastrointestinal Obstruction with CC | 39 | $68,288 | +75% | $7,403 |
| 202 Bronchitis and Asthma with CC/MCC | 38 | $72,288 | +57% | $9,053 |
| 394 Other Digestive System Diagnoses with CC | 37 | $63,528 | +35% | $9,075 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 36 | $77,868 | +54% | $8,003 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 36 | $89,852 | +47% | $11,673 |
| 092 Other Disorders of Nervous System with CC | 35 | $61,978 | +20% | $9,075 |
| 811 Red Blood Cell Disorders with MCC | 34 | $100,584 | +48% | $12,845 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 33 | $282,273 | -13% | $63,189 |
Showing the 60 most frequent of 149 DRGs.
Outpatient services
Against the New Jersey average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Community Medical Center charged $116,195 on average, 12% less than the New Jersey average of $131,698, and was paid $17,298 against a state average of $19,296. For Heart Failure and Shock with MCC (DRG 291), Community Medical Center charged $86,877 on average, 11% less than the New Jersey average of $97,469, and was paid $11,617 against a state average of $12,811. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Community Medical Center charged $88,535 on average, 12% less than the New Jersey average of $100,241, and was paid $11,889 against a state average of $13,150. For Kidney and Urinary Tract Infections with MCC (DRG 689), Community Medical Center charged $82,453 on average, 6% less than the New Jersey average of $87,977, and was paid $10,326 against a state average of $11,697. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $21,709 was 37% below the state average of $34,388. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $22,641 was 24% below the state average of $29,645. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,265 was 43% below the state average of $12,828. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $10,071 was 41% below the state average of $16,966.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Community Medical Center in Toms River, NJ, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-04-19 (CMS case 82)
- CAP Request — 2021-09-30 (CMS case 82)
- Closure Notice — 2022-02-11 (CMS case 82)
- Met Requirements — 2025-03-28 (CMS case 3481)
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.