New Jersey / Saint Clare's Hospital
CMS certification 310050 · Denville, NJ
Saint Clare's Hospital: charges and Medicare payments
Saint Clare's Hospital reported 2,868 Medicare inpatient stays across 78 DRGs in 2024. Across them it charged 4.23 times what it was paid — among the lower ratios in New Jersey, number 56 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: 351 stays at an average charge of $82,035, 9% below the national average. It also billed 903 outpatient services, charging 9.75 times what Medicare paid.
- 1Medicare inpatient stays 2,868
- 2Charge ÷ paid, inpatient 4.23×
- 3Rank in NJ (highest ratio = 1) 56 of 60
- 4CMS price-transparency actions 0
Inpatient stays
For the 78 DRGs that can be compared with the national average, Saint Clare's Hospital charged more than the national average in 16 (21%). 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 | 351 | $82,035 | -9% | $18,662 |
| 291 Heart Failure and Shock with MCC | 198 | $46,113 | -18% | $12,500 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 100 | $48,503 | -20% | $13,801 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 97 | $27,192 | -27% | $7,857 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 94 | $27,351 | -32% | $7,914 |
| 189 Pulmonary Edema and Respiratory Failure | 76 | $55,996 | -3% | $11,951 |
| 177 Respiratory Infections and Inflammations with MCC | 71 | $59,260 | -16% | $16,044 |
| 193 Simple Pneumonia and Pleurisy with MCC | 67 | $60,127 | +1% | $12,916 |
| 069 Transient Ischemia without Thrombolytic | 66 | $30,093 | -40% | $8,005 |
| 689 Kidney and Urinary Tract Infections with MCC | 64 | $38,330 | -25% | $11,404 |
| 603 Cellulitis without MCC | 62 | $34,285 | -8% | $8,820 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 57 | $54,384 | -26% | $15,779 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 57 | $234,412 | +2% | $44,776 |
| 690 Kidney and Urinary Tract Infections without MCC | 50 | $34,501 | -9% | $8,192 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 50 | $62,470 | +27% | $11,295 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 49 | $23,441 | -35% | $7,641 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 47 | $60,361 | -20% | $14,912 |
| 312 Syncope and Collapse | 47 | $22,184 | -51% | $8,495 |
| 377 Gastrointestinal Hemorrhage with MCC | 47 | $83,567 | -2% | $17,126 |
| 074 Cranial and Peripheral Nerve Disorders without MCC | 42 | $27,938 | -48% | $10,176 |
| 313 Chest Pain | 41 | $20,756 | -48% | $7,038 |
| 305 Hypertension without MCC | 40 | $23,016 | -43% | $7,541 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 39 | $155,729 | +67% | $17,719 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 39 | $28,149 | -34% | $9,021 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 37 | $45,206 | -26% | $12,605 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 36 | $45,012 | -19% | $10,049 |
| 378 Gastrointestinal Hemorrhage with CC | 36 | $46,562 | -4% | $9,721 |
| 682 Renal Failure with MCC | 36 | $66,851 | +1% | $14,752 |
| 552 Medical Back Problems without MCC | 32 | $33,412 | -32% | $9,588 |
| 895 Alcohol, Drug Abuse or Dependence with Rehabilitation... | 29 | $23,296 | -32% | $15,013 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 28 | $169,907 | +4% | $27,612 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 25 | $46,124 | -9% | $11,109 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 24 | $77,273 | -23% | $19,460 |
| 149 Dysequilibrium | 24 | $25,467 | -43% | $7,721 |
| 481 Hip and Femur Procedures except Major Joint with CC | 24 | $115,764 | +15% | $18,677 |
| 683 Renal Failure with CC | 24 | $47,387 | +16% | $8,947 |
| 178 Respiratory Infections and Inflammations with CC | 23 | $30,230 | -33% | $9,757 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 23 | $60,366 | +7% | $12,036 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 22 | $74,263 | -45% | $24,046 |
| 100 Seizures with MCC | 21 | $52,373 | -45% | $18,474 |
| 101 Seizures without MCC | 21 | $31,250 | -36% | $9,122 |
| 637 Diabetes with MCC | 21 | $44,152 | -34% | $14,393 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 20 | $34,701 | -27% | $9,466 |
| 194 Simple Pneumonia and Pleurisy with CC | 19 | $24,378 | -36% | $8,639 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 19 | $32,573 | -35% | $9,099 |
| 394 Other Digestive System Diagnoses with CC | 19 | $30,711 | -35% | $9,564 |
| 536 Fractures of Hip and Pelvis without MCC | 19 | $26,220 | -30% | $7,750 |
| 811 Red Blood Cell Disorders with MCC | 19 | $76,103 | +12% | $14,032 |
| 202 Bronchitis and Asthma with CC/MCC | 18 | $45,937 | 0% | $9,593 |
| 300 Peripheral Vascular Disorders with CC | 18 | $32,623 | -34% | $10,172 |
| 564 Other Musculoskeletal System and Connective Tissue Diagnoses... | 17 | $40,312 | -45% | $15,189 |
| 070 Other Cerebrovascular Disorders with MCC | 16 | $57,658 | -24% | $17,004 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 16 | $132,714 | +30% | $19,830 |
| 813 Coagulation Disorders | 16 | $71,927 | -10% | $15,861 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 16 | $266,427 | -18% | $62,428 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 16 | $37,342 | -50% | $15,141 |
| 304 Hypertension with MCC | 15 | $29,644 | -48% | $11,276 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 15 | $140,633 | +1% | $26,085 |
| 602 Cellulitis with MCC | 15 | $43,064 | -28% | $14,310 |
| 812 Red Blood Cell Disorders without MCC | 15 | $28,310 | -36% | $8,930 |
Showing the 60 most frequent of 78 DRGs.
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 3 Urology and Related Services | 173 | $23,260 | $2,263 |
| Level 4 Urology and Related Services | 145 | $24,204 | $3,904 |
| Level 5 Urology and Related Services | 95 | $40,312 | $5,774 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 72 | $12,982 | $1,825 |
| Level 5 Musculoskeletal Procedures | 53 | $136,178 | $14,784 |
| Level 1 Laparoscopy and Related Services | 50 | $63,405 | $6,286 |
| Comprehensive Observation Services | 50 | $11,311 | $3,080 |
| Level 1 Intraocular Procedures | 40 | $36,379 | $2,623 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 36 | $41,620 | $3,807 |
| Level 3 Musculoskeletal Procedures | 35 | $30,805 | $3,560 |
| Level 4 Musculoskeletal Procedures | 35 | $72,164 | $7,868 |
| Level 1 Endovascular Procedures | 27 | $20,914 | $3,576 |
| Level 6 Urology and Related Services | 21 | $69,338 | $10,358 |
| Level 6 Musculoskeletal Procedures | 18 | $145,925 | $20,920 |
| Level 3 Pacemaker and Similar Procedures | 15 | $65,481 | $12,001 |
| Level 2 Upper GI Procedures | 15 | $11,772 | $2,141 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $29,159 | $3,001 |
| Level 4 Gynecologic Procedures | 11 | $21,424 | $3,263 |
Against the New Jersey average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Saint Clare's Hospital charged $82,035 on average, 38% less than the New Jersey average of $131,698, and was paid $18,662 against a state average of $19,296. For Heart Failure and Shock with MCC (DRG 291), Saint Clare's Hospital charged $46,113 on average, 53% less than the New Jersey average of $97,469, and was paid $12,500 against a state average of $12,811. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC (DRG 640), Saint Clare's Hospital charged $48,503 on average, 50% less than the New Jersey average of $97,749, and was paid $13,801 against a state average of $13,386. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC (DRG 641), Saint Clare's Hospital charged $27,192 on average, 56% less than the New Jersey average of $62,001, and was paid $7,857 against a state average of $7,913. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $23,260 was 37% above the state average of $16,966. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $24,204 was 14% above the state average of $21,241. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $40,312 was 37% above the state average of $29,528. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,982 was 1% above the state average of $12,828.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.