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Shoulder replacement in New York: what insurers pay

Posted commercial rates at 10 New York hospitals, each next to its own Medicare base rate.

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CPT 23472

HospitalMedian across insurers× MedicareInsurersFile date
Stony Brook University Hospital Stony Brook$19,9590.9×22026-06-10
Maimonides Medical Center Brooklyn$21,7921.0×32026-04-01
Montefiore Medical Center Bronx$22,8601.0×62026-04-01
LINCOLN MEDICAL & MENTAL HEALTH CENTER Bronx$32,8311.5×12026-09-05
Elmhurst Hospital Center Elmhurst$32,8311.5×12026-09-05
Jacobi Medical Center Bronx$33,1691.5×22026-09-05
South Brooklyn Health Brooklyn$33,1691.5×22026-09-05
NYU Langone Hospitals (Orthopedic Hospital + Tisch files) New York$39,1091.8×72026-01-01
Hospital for Special Surgery New York$47,9302.2×62026-04-01

MS-DRG 483

HospitalMedian across insurers× MedicareInsurersFile date
Montefiore Medical Center Bronx$25,0511.0×12026-04-01
Jamaica Hospital Medical Center Jamaica$45,1401.8×32026-03-25
Stony Brook University Hospital Stony Brook$51,3922.0×12026-06-10
LINCOLN MEDICAL & MENTAL HEALTH CENTER Bronx$51,9462.1×72026-09-05
South Brooklyn Health Brooklyn$51,9462.1×72026-09-05
Elmhurst Hospital Center Elmhurst$52,6882.1×72026-09-05
Hospital for Special Surgery New York$53,7802.1×52026-04-01
Jacobi Medical Center Bronx$54,7792.2×72026-09-05
Maimonides Medical Center Brooklyn$80,2893.2×62026-04-01
NYU Langone Hospitals (Orthopedic Hospital + Tisch files) New York$88,9593.5×72026-01-01

Questions

How much do insurers pay for shoulder replacement in New York?

10 New York hospitals post usable commercial rates for shoulder replacement in their federal price-transparency files. For CPT 23472, hospital outpatient, the median across 9 hospitals is $32,831, 1.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.