Toms River, NJ 08755 · CMS Certification Number 310041. 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 paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $17,119 | $56,891 | 3.3× | $13,667 |
| Shoulder replacement | — | — | — | $19,463 |
| Hip replacement after a fracture (DRG 522) | $18,374 | $88,991 | 4.8× | — |
Complications after hip or knee replacement: 3.7% (no different from the national rate). Readmissions: 6.1%. Overall Care Compare rating: 1 of 5 stars. Nonprofit · Acute · 592 beds
New Jersey has a certificate-of-need program that does not cover surgery centers.
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In 2024 Medicare paid Community Medical Center an average of $17,119 per inpatient hip or knee replacement stay (MS-DRG 470, 69 stays) and $13,667 per outpatient case (APC 5115, 138 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $56,891, 3.3× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Toms River West Ambulatory Surgery Center, LLC, an orthopedic surgery center same ZIP away, is paid about $9,582 by Medicare for a knee replacement (CPT 27447), $7,537 less than an inpatient stay at Community Medical Center. Not every patient is a surgery-center candidate.
Medicare paid Community Medical Center more than 54% of the 26 New Jersey hospitals that report inpatient hip or knee replacement.