New Jersey / Robert Wood Johnson University Hospital Somerset
CMS certification 310048 · Somerville, NJ · 4 entries in CMS's price-transparency list
Robert Wood Johnson University Hospital Somerset: charges and Medicare payments
Robert Wood Johnson University Hospital Somerset reported 3,390 Medicare inpatient stays across 93 DRGs in 2024. Across them it charged 8.35 times what it was paid — among the higher ratios in New Jersey, number 15 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: 493 stays at an average charge of $137,851, 53% above the national average. It also billed 1,830 outpatient services, charging 7.38 times what Medicare paid.
- 1Medicare inpatient stays 3,390
- 2Charge ÷ paid, inpatient 8.35×
- 3Rank in NJ (highest ratio = 1) 15 of 60
- 4CMS price-transparency actions 4
Inpatient stays
For the 93 DRGs that can be compared with the national average, Robert Wood Johnson University Hospital Somerset charged more than the national average in 88 (95%). 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 | 493 | $137,851 | +53% | $17,599 |
| 291 Heart Failure and Shock with MCC | 214 | $108,894 | +93% | $11,269 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 91 | $123,546 | +63% | $13,930 |
| 177 Respiratory Infections and Inflammations with MCC | 81 | $114,037 | +62% | $14,946 |
| 193 Simple Pneumonia and Pleurisy with MCC | 80 | $113,925 | +91% | $11,884 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 78 | $75,583 | +88% | $7,827 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 76 | $82,930 | +69% | $10,114 |
| 689 Kidney and Urinary Tract Infections with MCC | 72 | $93,687 | +83% | $10,032 |
| 885 Psychoses | 68 | $121,530 | +176% | $13,531 |
| 312 Syncope and Collapse | 66 | $74,732 | +64% | $8,498 |
| 189 Pulmonary Edema and Respiratory Failure | 63 | $123,720 | +115% | $10,449 |
| 552 Medical Back Problems without MCC | 63 | $72,292 | +48% | $9,280 |
| 683 Renal Failure with CC | 56 | $81,828 | +101% | $8,195 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 56 | $255,907 | +12% | $43,732 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 55 | $65,799 | +82% | $6,543 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 49 | $131,713 | +118% | $12,543 |
| 378 Gastrointestinal Hemorrhage with CC | 46 | $95,591 | +97% | $9,647 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 46 | $72,679 | +96% | $8,294 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 43 | $146,161 | +99% | $13,654 |
| 682 Renal Failure with MCC | 40 | $123,616 | +87% | $14,018 |
| 481 Hip and Femur Procedures except Major Joint with CC | 39 | $115,398 | +15% | $16,483 |
| 690 Kidney and Urinary Tract Infections without MCC | 38 | $70,614 | +87% | $6,937 |
| 069 Transient Ischemia without Thrombolytic | 37 | $72,749 | +44% | $7,377 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 37 | $101,492 | +59% | $10,686 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 35 | $118,173 | +18% | $18,489 |
| 313 Chest Pain | 35 | $57,413 | +44% | $7,750 |
| 884 Organic Disturbances and Intellectual Disability | 35 | $94,761 | +52% | $14,843 |
| 194 Simple Pneumonia and Pleurisy with CC | 34 | $68,585 | +79% | $8,168 |
| 305 Hypertension without MCC | 33 | $68,265 | +70% | $7,911 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 32 | $95,926 | +90% | $8,671 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 32 | $136,506 | +19% | $13,767 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 32 | $95,196 | +56% | $12,089 |
| 178 Respiratory Infections and Inflammations with CC | 31 | $80,175 | +77% | $8,649 |
| 394 Other Digestive System Diagnoses with CC | 30 | $72,534 | +54% | $8,062 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 29 | $118,161 | +134% | $9,229 |
| 389 Gastrointestinal Obstruction with CC | 29 | $79,519 | +104% | $7,063 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 29 | $113,076 | +11% | $18,965 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 29 | $70,619 | +66% | $7,975 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 28 | $155,179 | +38% | $19,890 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 28 | $103,360 | +83% | $11,899 |
| 603 Cellulitis without MCC | 28 | $73,439 | +97% | $7,690 |
| 811 Red Blood Cell Disorders with MCC | 28 | $114,557 | +68% | $11,762 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 27 | $81,237 | +46% | $8,671 |
| 638 Diabetes with CC | 26 | $71,876 | +72% | $8,666 |
| 101 Seizures without MCC | 25 | $84,599 | +74% | $7,822 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 25 | $82,858 | -11% | $15,618 |
| 554 Bone Diseases and Arthropathies without MCC | 24 | $70,807 | +86% | $7,256 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 24 | $56,224 | +52% | $8,304 |
| 556 Signs and Symptoms of Musculoskeletal System and Connective... | 23 | $61,728 | +53% | $7,198 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 23 | $67,279 | +42% | $8,722 |
| 813 Coagulation Disorders | 23 | $115,138 | +44% | $13,346 |
| 092 Other Disorders of Nervous System with CC | 22 | $81,003 | +57% | $8,735 |
| 057 Degenerative Nervous System Disorders without MCC | 21 | $98,621 | +74% | $11,858 |
| 377 Gastrointestinal Hemorrhage with MCC | 21 | $144,886 | +70% | $16,302 |
| 812 Red Blood Cell Disorders without MCC | 21 | $94,129 | +112% | $8,600 |
| 300 Peripheral Vascular Disorders with CC | 20 | $75,468 | +53% | $11,317 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 20 | $62,070 | +116% | $6,957 |
| 948 Signs and Symptoms without MCC | 20 | $69,193 | +82% | $6,622 |
| 056 Degenerative Nervous System Disorders with MCC | 19 | $92,024 | -4% | $17,649 |
| 202 Bronchitis and Asthma with CC/MCC | 19 | $96,752 | +110% | $7,911 |
Showing the 60 most frequent of 93 DRGs.
Outpatient services
Against the New Jersey average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Robert Wood Johnson University Hospital Somerset charged $137,851 on average, 5% more than the New Jersey average of $131,698, and was paid $17,599 against a state average of $19,296. For Heart Failure and Shock with MCC (DRG 291), Robert Wood Johnson University Hospital Somerset charged $108,894 on average, 12% more than the New Jersey average of $97,469, and was paid $11,269 against a state average of $12,811. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Robert Wood Johnson University Hospital Somerset charged $123,546 on average, 11% more than the New Jersey average of $111,703, and was paid $13,930 against a state average of $15,382. For Respiratory Infections and Inflammations with MCC (DRG 177), Robert Wood Johnson University Hospital Somerset charged $114,037 on average, 3% less than the New Jersey average of $117,022, and was paid $14,946 against a state average of $16,115. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $32,478 was 6% below the state average of $34,388. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,091 was 29% below the state average of $12,828. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $51,946 was 19% below the state average of $63,772. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $33,986 was 15% above the state average of $29,645.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Robert Wood Johnson University Hospital Somerset in Somerville, NJ, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-17 (CMS case 295)
- Closure Notice — 2023-06-29 (CMS case 295)
- Warning Notice — 2025-02-24 (CMS case 3141)
- Closure Notice — 2025-03-14 (CMS case 3141)
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.