New York / Hospital for Special Surgery
CMS certification 330270 · New York, NY · 2 entries in CMS's price-transparency list
Hospital for Special Surgery: charges and Medicare payments
Hospital for Special Surgery reported 3,230 Medicare inpatient stays across 36 DRGs in 2024. Across them it charged 4.21 times what it was paid — mid-range in New York, number 43 of 123 hospitals with at least 100 stays (state median 2.74×, national 4.15×). Its most frequent stay was DRG 470, Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC: 1332 stays at an average charge of $120,505, 29% above the national average. It also billed 4,599 outpatient services, charging 6.92 times what Medicare paid.
- 1Medicare inpatient stays 3,230
- 2Charge ÷ paid, inpatient 4.21×
- 3Rank in NY (highest ratio = 1) 43 of 123
- 4CMS price-transparency actions 2
Inpatient stays
For the 36 DRGs that can be compared with the national average, Hospital for Special Surgery charged more than the national average in 30 (83%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 1332 | $120,505 | +29% | $25,507 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 244 | $139,455 | +13% | $34,565 |
| 467 Revision of Hip or Knee Replacement with CC | 223 | $182,224 | +16% | $43,090 |
| 460 Spinal Fusion except Cervical without MCC | 162 | $205,478 | +21% | $54,809 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 119 | $317,902 | +14% | $89,029 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 117 | $125,160 | -1% | $30,712 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 93 | $95,551 | -9% | $22,828 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 88 | $240,163 | +18% | $58,766 |
| 472 Cervical Spinal Fusion with CC | 80 | $150,533 | +5% | $36,408 |
| 469 Major Hip and Knee Joint Replacement or Reattachment of... | 63 | $160,665 | +7% | $40,227 |
| 520 Back and Neck Procedures except Spinal Fusion without CC/MCC | 63 | $78,482 | 0% | $18,702 |
| 457 Spinal Fusion except Cervical with Spinal Curvature,... | 54 | $316,135 | +9% | $87,869 |
| 462 Bilateral or Multiple Major Joint Procedures of Lower... | 46 | $189,583 | +37% | $45,773 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 43 | $131,443 | +10% | $28,494 |
| 427 Multiple Level Combined Anterior and Posterior Spinal Fusion... | 33 | $358,039 | +5% | $99,774 |
| 857 Postoperative or Post-Traumatic Infections with O.R.... | 32 | $137,055 | +37% | $32,166 |
| 458 Spinal Fusion except Cervical with Spinal Curvature,... | 31 | $217,615 | +14% | $59,820 |
| 488 Knee Procedures without Principal Diagnosis of Infection... | 30 | $94,001 | -2% | $24,037 |
| 494 Lower Extremity and Humerus Procedures except Hip, Foot and... | 29 | $133,446 | +40% | $27,739 |
| 481 Hip and Femur Procedures except Major Joint with CC | 27 | $181,868 | +81% | $38,865 |
| 451 Single Level Spinal Fusion except Cervical without MCC | 26 | $162,473 | +8% | $46,658 |
| 502 Soft Tissue Procedures without CC/MCC | 26 | $95,485 | +35% | $16,529 |
| 402 Single Level Combined Anterior and Posterior Spinal Fusion... | 25 | $209,774 | +12% | $50,294 |
| 464 Wound Debridement and Skin Graft except Hand for... | 25 | $334,954 | +130% | $68,269 |
| 473 Cervical Spinal Fusion without CC/MCC | 25 | $128,370 | +12% | $29,402 |
| 489 Knee Procedures without Principal Diagnosis of Infection... | 25 | $75,294 | +23% | $16,278 |
| 486 Knee Procedures with Principal Diagnosis of Infection with... | 23 | $154,840 | +56% | $31,456 |
| 517 Other Musculoskeletal System and Connective Tissue O.R.... | 22 | $73,294 | -6% | $19,582 |
| 448 Multiple Level Spinal Fusion except Cervical without MCC | 21 | $248,998 | +24% | $53,192 |
| 497 Local Excision and Removal of Internal Fixation Devices... | 21 | $83,342 | +17% | $17,592 |
| 466 Revision of Hip or Knee Replacement with MCC | 17 | $253,101 | +5% | $73,897 |
| 496 Local Excision and Removal of Internal Fixation Devices... | 15 | $110,887 | +19% | $24,343 |
| 501 Soft Tissue Procedures with CC | 14 | $95,702 | +7% | $24,886 |
| 482 Hip and Femur Procedures except Major Joint without CC/MCC | 13 | $110,608 | +42% | $25,117 |
| 516 Other Musculoskeletal System and Connective Tissue O.R.... | 12 | $92,883 | -9% | $23,344 |
| 487 Knee Procedures with Principal Diagnosis of Infection... | 11 | $102,438 | +36% | $18,357 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 2,670 | $88,594 | $14,605 |
| Level 4 Musculoskeletal Procedures | 642 | $47,547 | $7,916 |
| Level 1 Nerve Procedures | 616 | $13,401 | $2,157 |
| Level 3 Musculoskeletal Procedures | 342 | $29,976 | $3,518 |
| Level 6 Musculoskeletal Procedures | 156 | $99,093 | $20,691 |
| Level 2 Musculoskeletal Procedures | 95 | $12,738 | $1,795 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 50 | $30,865 | $3,150 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 28 | $20,760 | $1,673 |
Against the New York average
For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Hospital for Special Surgery charged $120,505 on average, 12% more than the New York average of $107,202, and was paid $25,507 against a state average of $23,235. For Revision of Hip or Knee Replacement without CC/MCC (DRG 468), Hospital for Special Surgery charged $139,455 on average, 20% more than the New York average of $116,033, and was paid $34,565 against a state average of $31,318. For Revision of Hip or Knee Replacement with CC (DRG 467), Hospital for Special Surgery charged $182,224 on average, 13% more than the New York average of $161,045, and was paid $43,090 against a state average of $38,202. For Spinal Fusion except Cervical without MCC (DRG 460), Hospital for Special Surgery charged $205,478 on average, 15% more than the New York average of $179,163, and was paid $54,809 against a state average of $45,982. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $88,594 was 30% above the state average of $67,926. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $47,547 was 18% above the state average of $40,421. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $13,401 was 1% above the state average of $13,330. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $29,976 was 44% above the state average of $20,797.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Hospital for Special Surgery in New York, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-03-11 (CMS case 3050)
- Closure Notice — 2025-05-22 (CMS case 3050)
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.