Pompton Plains, NJ 07444 · CMS Certification Number 310017. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | — | — | — | $14,766 |
| Shoulder replacement | — | — | — | — |
| Hip replacement after a fracture (DRG 522) | $17,079 | $106,306 | 6.2× | — |
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $38,570 | — | $12,000–$45,680 | 22 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Centivo | $45,680 | — | 1 |
| Cigna | $44,988 | — | 1 |
| EmblemHealth | $43,965 | — | 1 |
| Humana | $43,965 | — | 1 |
| Ila Local 1478-2 Welfare Fund | $43,965 | — | 1 |
| Oscar | $43,965 | — | 1 |
| Qualcare | $43,965 | — | 1 |
| Elevance/Anthem/Empire | $42,442 | — | 1 |
| Horizon BCBS NJ | $42,442 | — | 1 |
| BCBS (other) | $40,744 | — | 1 |
| 1199SEIU | $38,570 | — | 1 |
| Aetna | $38,570 | — | 1 |
| Bundled Cases/Episodic Payment | $37,971 | — | 1 |
| Claimdoc | $34,969 | — | 1 |
| Fairos | $30,222 | — | 1 |
| Claim Watcher/Homestead | $30,064 | — | 1 |
| UnitedHealthcare | $29,412 | — | 1 |
| Highmark BCBS | $17,405 | — | 1 |
| Kindred Giralda Hospital | $17,405 | — | 1 |
| UPMC | $17,405 | — | 1 |
| Karen Ann Quinlan | $12,659 | — | 1 |
| Kessler Foundation | $12,000 | — | 1 |
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-04-01); commercial plans, dollar-amount contracts only.
Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 260 beds
New Jersey has a certificate-of-need program that does not cover surgery centers.
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The Medicare allowed amount averaged $14,766 per outpatient hip or knee replacement case (APC 5115, 81 cases) in 2024. Inpatient stays were too few to report.
Yes for Medicare facility payments. Wayne Surgical Center LLC, an orthopedic surgery center 3.6 mi away, is paid about $10,735 by Medicare for a knee replacement (CPT 27447). Not every patient is a surgery-center candidate.
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $38,570 across 22 insurers, ranging from $12,000 to $45,680.