New Jersey / Overlook Medical Center

CMS certification 310051 · Summit, NJ · 4 entries in CMS's price-transparency list

Overlook Medical Center: charges and Medicare payments

Overlook Medical Center reported 4,844 Medicare inpatient stays across 124 DRGs in 2024. Across them it charged 5.96 times what it was paid — mid-range in New Jersey, number 37 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: 360 stays at an average charge of $127,698, 41% above the national average. It also billed 4,285 outpatient services, charging 7.24 times what Medicare paid.

1Medicare inpatient stays 4,844
2Charge ÷ paid, inpatient 5.96×
3Rank in NJ (highest ratio = 1) 37 of 60
4CMS price-transparency actions 4

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

Inpatient stays

For the 124 DRGs that can be compared with the national average, Overlook Medical Center charged more than the national average in 106 (85%). 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	360	$127,698	+41%	$20,090
291 Heart Failure and Shock with MCC	275	$81,221	+44%	$13,446
177 Respiratory Infections and Inflammations with MCC	201	$95,522	+35%	$16,806
193 Simple Pneumonia and Pleurisy with MCC	170	$83,373	+40%	$14,141
689 Kidney and Urinary Tract Infections with MCC	105	$72,563	+41%	$12,180
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	91	$129,592	+30%	$20,665
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	90	$59,406	+48%	$8,637
690 Kidney and Urinary Tract Infections without MCC	90	$57,154	+51%	$8,909
189 Pulmonary Edema and Respiratory Failure	86	$88,161	+53%	$12,956
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	84	$82,147	+47%	$10,438
378 Gastrointestinal Hemorrhage with CC	84	$77,058	+59%	$10,077
603 Cellulitis without MCC	82	$48,057	+29%	$9,498
683 Renal Failure with CC	77	$63,643	+56%	$9,687
853 Infectious and Parasitic Diseases with O.R. Procedures with...	73	$254,833	+11%	$47,337
682 Renal Failure with MCC	69	$100,409	+52%	$15,863
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	68	$73,649	+50%	$11,410
194 Simple Pneumonia and Pleurisy with CC	67	$52,714	+37%	$8,669
470 Major Hip and Knee Joint Replacement or Reattachment of...	66	$90,220	-3%	$18,222
190 Chronic Obstructive Pulmonary Disease with MCC	65	$75,199	+49%	$10,905
698 Other Kidney and Urinary Tract Diagnoses with MCC	64	$112,961	+54%	$17,698
481 Hip and Femur Procedures except Major Joint with CC	61	$98,135	-3%	$20,887
377 Gastrointestinal Hemorrhage with MCC	56	$129,576	+52%	$19,819
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	56	$81,816	+36%	$13,858
552 Medical Back Problems without MCC	53	$54,645	+12%	$10,306
101 Seizures without MCC	51	$88,346	+81%	$9,995
329 Major Small and Large Bowel Procedures with MCC	50	$196,388	-9%	$43,896
312 Syncope and Collapse	46	$58,149	+28%	$8,945
330 Major Small and Large Bowel Procedures with CC	44	$119,436	0%	$26,944
308 Cardiac Arrhythmia and Conduction Disorders with MCC	43	$100,198	+77%	$14,388
309 Cardiac Arrhythmia and Conduction Disorders with CC	43	$53,084	+47%	$7,932
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	43	$53,011	+43%	$8,289
322 Percutaneous Cardiovascular Procedures with Intraluminal...	41	$143,615	+25%	$21,304
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	41	$104,580	+2%	$20,573
280 Acute Myocardial Infarction, Discharged Alive with MCC	40	$102,135	+35%	$15,034
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	39	$82,249	+35%	$15,697
178 Respiratory Infections and Inflammations with CC	38	$67,776	+50%	$9,895
699 Other Kidney and Urinary Tract Diagnoses with CC	38	$68,001	+43%	$12,055
812 Red Blood Cell Disorders without MCC	38	$55,931	+26%	$9,706
057 Degenerative Nervous System Disorders without MCC	36	$88,161	+56%	$15,120
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	36	$94,641	+45%	$15,067
100 Seizures with MCC	33	$160,208	+70%	$23,891
025 Craniotomy and Endovascular Intracranial Procedures with MCC	32	$218,920	-5%	$48,144
092 Other Disorders of Nervous System with CC	32	$70,177	+36%	$10,578
331 Major Small and Large Bowel Procedures without CC/MCC	32	$79,700	-7%	$19,158
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	32	$264,561	+22%	$50,069
066 Intracranial Hemorrhage or Cerebral Infarction without...	30	$66,669	+57%	$8,473
069 Transient Ischemia without Thrombolytic	30	$65,717	+30%	$8,224
393 Other Digestive System Diagnoses with MCC	30	$101,466	+32%	$16,789
811 Red Blood Cell Disorders with MCC	30	$72,996	+7%	$15,729
372 Major Gastrointestinal Disorders and Peritoneal Infections...	29	$58,584	+23%	$11,099
444 Disorders of The Biliary Tract with MCC	29	$106,391	+28%	$17,439
208 Respiratory System Diagnosis with Ventilator Support <=96...	28	$189,292	+39%	$28,079
287 Circulatory Disorders except AMI, with Cardiac...	28	$78,393	+23%	$14,622
071 Other Cerebrovascular Disorders with CC	27	$80,272	+59%	$11,412
180 Respiratory Neoplasms with MCC	27	$104,239	+19%	$23,773
196 Interstitial Lung Disease with MCC	27	$158,961	+84%	$19,567
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	27	$40,929	+42%	$6,224
870 Septicemia or Severe Sepsis with MV >96 Hours	27	$466,847	+44%	$63,583
286 Circulatory Disorders except AMI, with Cardiac...	26	$164,606	+47%	$21,082
390 Gastrointestinal Obstruction without CC/MCC	26	$35,366	+27%	$6,838

Showing the 60 most frequent of 124 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	843	$31,224	$3,045
Level 5 Musculoskeletal Procedures	386	$67,050	$14,716
Level 2 Upper GI Procedures	381	$15,969	$2,114
Level 2 Excision/ Biopsy/ Incision and Drainage	299	$13,693	$1,788
Level 4 Musculoskeletal Procedures	174	$40,978	$7,755
Level 1 Laparoscopy and Related Services	163	$30,052	$6,430
Level 5 Urology and Related Services	132	$26,352	$5,753
Level 4 Urology and Related Services	126	$22,905	$3,900
Level 3 Vascular Procedures	125	$21,410	$3,564
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	120	$19,601	$3,868
Level 3 Lower GI Procedures	115	$18,612	$3,159
Level 4 Vascular Procedures	99	$64,807	$4,635
Level 1 Nerve Procedures	97	$10,683	$2,155
Level 6 Musculoskeletal Procedures	92	$104,754	$20,710
Level 1 Endovascular Procedures	92	$38,739	$3,673
Complex GI Procedures	88	$26,655	$6,414
Level 3 Excision/ Biopsy/ Incision and Drainage	81	$19,192	$3,166
Level 3 Urology and Related Services	81	$20,868	$2,247
Level 3 Endovascular Procedures	61	$103,915	$12,192
Level 2 Breast/Lymphatic Surgery and Related Procedures	55	$38,464	$7,232
Level 1 Breast/Lymphatic Surgery and Related Procedures	53	$25,672	$4,290
Level 2 Musculoskeletal Procedures	51	$11,833	$1,809
Level 3 Musculoskeletal Procedures	47	$21,868	$3,503
Level 4 Gynecologic Procedures	47	$18,240	$3,402
Level 4 Airway Endoscopy	43	$23,770	$4,058

Against the New Jersey average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Overlook Medical Center charged $127,698 on average, 3% less than the New Jersey average of $131,698, and was paid $20,090 against a state average of $19,296. For Heart Failure and Shock with MCC (DRG 291), Overlook Medical Center charged $81,221 on average, 17% less than the New Jersey average of $97,469, and was paid $13,446 against a state average of $12,811. For Respiratory Infections and Inflammations with MCC (DRG 177), Overlook Medical Center charged $95,522 on average, 18% less than the New Jersey average of $117,022, and was paid $16,806 against a state average of $16,115. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Overlook Medical Center charged $83,373 on average, 17% less than the New Jersey average of $100,241, and was paid $14,141 against a state average of $13,150. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $31,224 was 9% below the state average of $34,388. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $67,050 was 5% above the state average of $63,772. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $15,969 was 6% below the state average of $16,923. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $13,693 was 7% above the state average of $12,828.

Price-transparency record

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

Warning Notice — 2021-07-20 (CMS case 391)
CAP Request — 2022-01-12 (CMS case 391)
Closure Notice — 2023-05-08 (CMS case 391)
Met Requirements — 2025-04-16 (CMS case 3870)

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.