Community Medical Center
Community Medical Center in Toms River, NJ charges 9.4x the Medicare reimbursement rate across 155 analyzed procedures, with 8% classified as pricing outliers.
Toms River, NJ 08755 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
F
Very high
Avg markup vs Medicare
9.38x
Charge / Medicare rate
Max markup
18.07x
Worst procedure
Procedures analyzed
155
With pricing data
Outlier procedures
8.4%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| DIABETES WITHOUT CC/MCC | 639 | $49,033 | $24,516 | — | 18.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $46,610 | $23,305 | — | 17.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | 195 | $55,413 | $27,706 | — | 15.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $61,908 | $30,954 | — | 15.8x |
| RENAL FAILURE WITHOUT CC/MCC | 684 | $50,761 | $25,380 | — | 15x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $62,990 | $31,495 | — | 15x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | 192 | $48,309 | $24,154 | — | 14.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $66,769 | $33,384 | — | 14.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $78,234 | $39,117 | — | 14.1x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $66,112 | $33,056 | — | 13.8x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 809 | $102,755 | $51,378 | — | 13.5x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | 093 | $58,013 | $29,007 | — | 13.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $83,186 | $41,593 | — | 12.9x |
| ATHEROSCLEROSIS WITHOUT MCC | 303 | $48,982 | $24,491 | — | 12.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $53,818 | $26,909 | — | 12.7x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $89,997 | $44,998 | — | 12.7x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $61,043 | $30,521 | — | 12.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $59,563 | $29,781 | — | 12.6x |
| CHEST PAIN | 313 | $49,585 | $24,793 | — | 12.5x |
| SYNCOPE AND COLLAPSE | 312 | $68,731 | $34,366 | — | 12.5x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | 565 | $79,908 | $39,954 | — | 12.4x |
| SEIZURES WITHOUT MCC | 101 | $73,330 | $36,665 | — | 12.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $56,905 | $28,452 | — | 12.1x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/M | 544 | $53,610 | $26,805 | — | 12.1x |
| DYSEQUILIBRIUM | 149 | $53,194 | $26,597 | — | 12x |
| CELLULITIS WITHOUT MCC | 603 | $62,025 | $31,013 | — | 12x |
| DIABETES WITH CC | 638 | $62,926 | $31,463 | — | 11.9x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $61,156 | $30,578 | — | 11.8x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $80,266 | $40,133 | — | 11.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $55,175 | $27,587 | — | 11.6x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $58,587 | $29,294 | — | 11.5x |
| ENDOCRINE DISORDERS WITH CC | 644 | $79,934 | $39,967 | — | 11.5x |
| HYPERTENSION WITHOUT MCC | 305 | $49,277 | $24,638 | — | 11.5x |
| CELLULITIS WITH MCC | 602 | $134,351 | $67,175 | — | 11.4x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $39,703 | $19,852 | — | 11.4x |
| KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | 696 | $44,359 | $22,179 | — | 11.2x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $59,719 | $29,860 | — | 11.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $72,658 | $36,329 | — | 11x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $86,770 | $43,385 | — | 11x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $97,601 | $48,801 | — | 10.9x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $63,937 | $31,969 | — | 10.9x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $64,442 | $32,221 | — | 10.9x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $132,376 | $66,188 | — | 10.8x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $61,144 | $30,572 | — | 10.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $76,562 | $38,281 | — | 10.8x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | 395 | $44,207 | $22,104 | — | 10.6x |
| TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | 605 | $62,255 | $31,127 | — | 10.6x |
| RENAL FAILURE WITH CC | 683 | $61,916 | $30,958 | — | 10.6x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $50,902 | $25,451 | — | 10.6x |
| BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | 554 | $55,055 | $27,528 | — | 10.6x |
Showing 50 of 155 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use