Hospital · CCN 330106
North Shore University Hospital
300 Community Drive, Manhasset, NY 11030 · Nassau County
Part of Northwell Health · 782 beds · 1
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
245 admission types 64 outpatient services 2 Medicare-file findings
Billed per dollar paid, all admissions
6.65×
$2,098.2M billed against $315.7M paid across 12,259 Medicare discharges; the national figure is 5.03×.
—
of adults in Nassau County have medical debt in collections — state bars medical debt from credit reports; the credit-bureau panel cannot see it
4.4%
uninsured in the county · state 5.7%
$140K
median household income
6.2×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (9 in the inpatient or outpatient file)ⓘ
28.4%
obesity in the countyⓘ
10.1%
diagnosed diabetes (PLACES)
5.4%
coronary heart disease (PLACES)
—
median age · — below poverty (ACS)
01 · Admissions
What it billed Medicare, by admission type
Average charge submitted and average total payment per discharge, 2024. Rows under 11 discharges are suppressed by CMS. The last column is the hospital's ratio against its state's for the same admission.
DRG
Admission
Discharges
Charge
Paid
Billed ÷ paid
871
Septicemia or severe sepsis without mv >96 hours with mcc
1,177
$179,219
$25,215
7.1× st 4.8×
291
Heart failure and shock with mcc
455
$144,582
$17,928
8.1× st 5.1×
177
Respiratory infections and inflammations with mcc
286
$154,010
$20,740
7.4× st 4.9×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
242
$94,640
$26,043
3.6× st 4.7×
872
Septicemia or severe sepsis without mv >96 hours without mcc
237
$92,271
$13,496
6.8× st 4.9×
690
Kidney and urinary tract infections without mcc
212
$81,954
$10,705
7.7× st 5.2×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
202
$69,362
$9,726
7.1× st 5.2×
689
Kidney and urinary tract infections with mcc
194
$113,073
$14,476
7.8× st 5.3×
312
Syncope and collapse
190
$87,147
$11,193
7.8× st 5.2×
698
Other kidney and urinary tract diagnoses with mcc
174
$152,840
$20,891
7.3× st 4.9×
481
Hip and femur procedures except major joint with cc
162
$131,967
$23,170
5.7× st 4.8×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
153
$249,893
$53,304
4.7× st 4.2×
853
Infectious and parasitic diseases with o.r. procedures with mcc
153
$404,800
$67,872
6.0× st 4.7×
552
Medical back problems without mcc
149
$84,974
$12,222
7.0× st 5.3×
378
Gastrointestinal hemorrhage with cc
145
$87,413
$12,219
7.2× st 5.5×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
141
$132,579
$26,797
4.9× st 4.6×
193
Simple pneumonia and pleurisy with mcc
137
$112,788
$16,655
6.8× st 4.9×
603
Cellulitis without mcc
136
$75,725
$11,550
6.6× st 4.7×
064
Intracranial hemorrhage or cerebral infarction with mcc
122
$198,683
$26,133
7.6× st 5.4×
682
Renal failure with mcc
121
$167,706
$20,481
8.2× st 5.1×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
113
$90,858
$14,844
6.1× st 5.6×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
113
$136,988
$17,437
7.9× st 4.8×
314
Other circulatory system diagnoses with mcc
112
$191,879
$26,528
7.2× st 5.1×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
109
$230,794
$31,186
7.4× st 5.7×
189
Pulmonary edema and respiratory failure
108
$158,699
$17,357
9.1× st 5.0×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
105
$68,483
$9,766
7.0× st 4.6×
699
Other kidney and urinary tract diagnoses with cc
103
$104,585
$13,052
8.0× st 5.4×
309
Cardiac arrhythmia and conduction disorders with cc
101
$76,149
$9,970
7.6× st 5.1×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
101
$123,371
$16,139
7.6× st 5.4×
274
Percutaneous and other intracardiac procedures without mcc
95
$206,335
$35,297
5.8× st 4.6×
330
Major small and large bowel procedures with cc
94
$131,763
$27,345
4.8× st 4.9×
377
Gastrointestinal hemorrhage with mcc
89
$148,246
$21,537
6.9× st 5.3×
057
Degenerative nervous system disorders without mcc
87
$114,887
$16,144
7.1× st 4.7×
175
Pulmonary embolism with mcc or acute cor pulmonale
85
$171,935
$19,752
8.7× st 6.1×
313
Chest pain
85
$64,492
$9,373
6.9× st 4.9×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
83
$227,039
$37,349
6.1× st 4.9×
308
Cardiac arrhythmia and conduction disorders with mcc
82
$113,346
$15,166
7.5× st 5.4×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
82
$72,066
$10,808
6.7× st 5.2×
683
Renal failure with cc
81
$102,963
$12,242
8.4× st 5.0×
884
Organic disturbances and intellectual disability
80
$114,559
$20,351
5.6× st 4.3×
329
Major small and large bowel procedures with mcc
80
$316,010
$59,751
5.3× st 5.0×
101
Seizures without mcc
80
$145,203
$13,312
10.9× st 5.3×
194
Simple pneumonia and pleurisy with cc
74
$80,488
$10,101
8.0× st 4.9×
025
Craniotomy and endovascular intracranial procedures with mcc
71
$387,966
$58,436
6.6× st 4.9×
394
Other digestive system diagnoses with cc
69
$83,027
$12,307
6.7× st 5.4×
522
Hip replacement with principal diagnosis of hip fracture without mcc
69
$138,280
$26,809
5.2× st 4.8×
190
Chronic obstructive pulmonary disease with mcc
66
$145,131
$14,898
9.7× st 4.7×
056
Degenerative nervous system disorders with mcc
66
$169,764
$29,894
5.7× st 5.3×
178
Respiratory infections and inflammations with cc
64
$92,820
$12,755
7.3× st 5.6×
092
Other disorders of nervous system with cc
61
$95,128
$12,349
7.7× st 5.8×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
60
$108,477
$13,325
8.1× st 5.7×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
60
$475,214
$81,251
5.8× st 4.6×
393
Other digestive system diagnoses with mcc
59
$143,644
$20,449
7.0× st 5.4×
202
Bronchitis and asthma with cc/mcc
59
$99,882
$11,364
8.8× st 5.4×
981
Extensive o.r. procedures unrelated to principal diagnosis with mcc
57
$356,689
$57,260
6.2× st 5.0×
551
Medical back problems with mcc
54
$133,212
$20,868
6.4× st 5.6×
811
Red blood cell disorders with mcc
53
$137,570
$19,320
7.1× st 5.4×
951
Other factors influencing health status
52
$91,894
$8,066
11.4× st 5.0×
149
Dysequilibrium
52
$67,180
$9,983
6.7× st 6.4×
300
Peripheral vascular disorders with cc
51
$77,051
$13,635
5.7× st 5.3×
280
Acute myocardial infarction, discharged alive with mcc
51
$167,556
$21,297
7.9× st 4.9×
812
Red blood cell disorders without mcc
51
$81,324
$11,348
7.2× st 5.2×
638
Diabetes with cc
51
$117,814
$13,168
8.9× st 4.9×
536
Fractures of hip and pelvis without mcc
50
$76,193
$10,901
7.0× st 6.0×
870
Septicemia or severe sepsis with mv >96 hours
48
$673,222
$90,973
7.4× st 4.3×
299
Peripheral vascular disorders with mcc
47
$164,712
$20,988
7.8× st 5.6×
270
Other major cardiovascular procedures with mcc
46
$408,759
$59,262
6.9× st 5.0×
602
Cellulitis with mcc
45
$121,029
$18,733
6.5× st 5.6×
482
Hip and femur procedures except major joint without cc/mcc
42
$92,090
$18,221
5.1× st 5.1×
374
Digestive malignancy with mcc
42
$178,179
$26,829
6.6× st 6.4×
184
Major chest trauma with cc
41
$80,660
$13,113
6.2× st 5.8×
252
Other vascular procedures with mcc
41
$241,537
$42,913
5.6× st 4.8×
243
Permanent cardiac pacemaker implant with cc
41
$142,458
$25,491
5.6× st 5.0×
605
Trauma to the skin, subcutaneous tissue and breast without mcc
40
$75,406
$11,439
6.6× st 4.9×
435
Malignancy of hepatobiliary system or pancreas with mcc
40
$190,141
$25,822
7.4× st 6.1×
556
Signs and symptoms of musculoskeletal system and connective tissue without mcc
39
$66,630
$10,111
6.6× st 5.8×
948
Signs and symptoms without mcc
39
$73,505
$10,067
7.3× st 5.7×
389
Gastrointestinal obstruction with cc
39
$74,396
$10,006
7.4× st 5.7×
554
Bone diseases and arthropathies without mcc
39
$69,541
$10,509
6.6× st 6.0×
480
Hip and femur procedures except major joint with mcc
38
$206,711
$35,300
5.9× st 5.3×
445
Disorders of the biliary tract with cc
38
$96,629
$14,059
6.9× st 5.8×
100
Seizures with mcc
37
$245,181
$30,799
8.0× st 4.8×
637
Diabetes with mcc
37
$136,725
$17,476
7.8× st 4.8×
315
Other circulatory system diagnoses with cc
37
$97,430
$12,244
8.0× st 6.1×
432
Cirrhosis and alcoholic hepatitis with mcc
37
$391,729
$49,557
7.9× st 6.6×
281
Acute myocardial infarction, discharged alive with cc
36
$83,700
$11,327
7.4× st 5.1×
813
Coagulation disorders
35
$138,801
$18,924
7.3× st 5.4×
660
Kidney and ureter procedures for non-neoplasm with cc
35
$108,585
$15,469
7.0× st 5.5×
652
Kidney transplant
35
$377,951
$47,093
8.0× st 7.6×
219
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
35
$611,888
$91,805
6.7× st 4.2×
235
Coronary bypass without cardiac catheterization with mcc
35
$429,465
$68,790
6.2× st 4.3×
919
Complications of treatment with mcc
34
$212,934
$38,955
5.5× st 5.2×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
33
$59,063
$7,932
7.4× st 5.4×
444
Disorders of the biliary tract with mcc
33
$123,171
$19,846
6.2× st 5.9×
208
Respiratory system diagnosis with ventilator support <=96 hours
33
$260,325
$34,966
7.4× st 4.8×
441
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with mcc
33
$223,237
$28,277
7.9× st 6.2×
331
Major small and large bowel procedures without cc/mcc
33
$83,528
$19,987
4.2× st 4.1×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
33
$2,340,880
$306,044
7.6× st 5.2×
253
Other vascular procedures with cc
33
$155,924
$31,842
4.9× st 4.8×
180
Respiratory neoplasms with mcc
33
$189,758
$23,930
7.9× st 5.9×
372
Major gastrointestinal disorders and peritoneal infections with cc
32
$96,231
$13,347
7.2× st 5.7×
840
Lymphoma and non-acute leukemia with mcc
32
$320,315
$40,011
8.0× st 6.0×
086
Traumatic stupor and coma <1 hour with cc
32
$91,261
$15,699
5.8× st 5.7×
454
Combined anterior and posterior spinal fusion with cc
31
$320,948
$72,670
4.4× st 4.0×
229
Other cardiothoracic procedures without mcc
31
$170,694
$35,265
4.8× st 5.1×
388
Gastrointestinal obstruction with mcc
31
$147,210
$19,459
7.6× st 6.0×
091
Other disorders of nervous system with mcc
31
$246,602
$33,649
7.3× st 5.5×
643
Endocrine disorders with mcc
31
$117,693
$19,633
6.0× st 5.8×
521
Hip replacement with principal diagnosis of hip fracture with mcc
30
$185,462
$31,994
5.8× st 5.9×
176
Pulmonary embolism without mcc
30
$87,911
$10,830
8.1× st 6.0×
027
Craniotomy and endovascular intracranial procedures without cc/mcc
30
$175,789
$29,975
5.9× st 4.4×
460
Spinal fusion except cervical without mcc
29
$208,571
$43,707
4.8× st 4.1×
244
Permanent cardiac pacemaker implant without cc/mcc
29
$111,095
$21,854
5.1× st 4.9×
082
Traumatic stupor and coma >1 hour with mcc
29
$217,096
$30,619
7.1× st 5.5×
069
Transient ischemia without thrombolytic
29
$68,598
$10,193
6.7× st 6.2×
273
Percutaneous and other intracardiac procedures with mcc
28
$290,004
$44,860
6.5× st 5.2×
264
Other circulatory system o.r. procedures
28
$339,542
$48,765
7.0× st 5.7×
196
Interstitial lung disease with mcc
28
$216,072
$26,569
8.1× st 5.9×
834
Acute leukemia with mcc
27
$520,256
$92,585
5.6× st 5.0×
543
Pathological fractures and musculoskeletal and connective tissue malignancy with cc
27
$82,574
$13,231
6.2× st 5.4×
236
Coronary bypass without cardiac catheterization without mcc
27
$269,851
$56,051
4.8× st 4.5×
183
Major chest trauma with mcc
27
$87,220
$19,715
4.4× st 5.6×
085
Traumatic stupor and coma <1 hour with mcc
26
$199,816
$26,562
7.5× st 5.6×
234
Coronary bypass with cardiac catheterization or open ablation without mcc
26
$345,868
$67,937
5.1× st 4.4×
216
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit
26
$571,736
$107,291
5.3× st 4.2×
228
Other cardiothoracic procedures with mcc
26
$399,824
$69,653
5.7× st 4.9×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
25
$136,689
$29,226
4.7× st 5.2×
472
Cervical spinal fusion with cc
25
$153,478
$37,773
4.1× st 4.4×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
25
$365,695
$58,175
6.3× st 4.7×
854
Infectious and parasitic diseases with o.r. procedures with cc
24
$168,498
$31,264
5.4× st 5.0×
205
Other respiratory system diagnoses with mcc
24
$135,522
$22,341
6.1× st 6.0×
239
Amputation for circulatory system disorders except upper limb and toe with mcc
24
$362,760
$64,200
5.7× st 5.0×
847
Chemotherapy without acute leukemia as secondary diagnosis with cc
24
$88,962
$15,114
5.9× st 4.8×
071
Other cerebrovascular disorders with cc
24
$117,077
$13,714
8.5× st 5.4×
468
Revision of hip or knee replacement without cc/mcc
23
$140,170
$33,168
4.2× st 3.9×
542
Pathological fractures and musculoskeletal and connective tissue malignancy with mcc
23
$165,168
$22,070
7.5× st 6.7×
375
Digestive malignancy with cc
23
$108,955
$14,767
7.4× st 6.2×
371
Major gastrointestinal disorders and peritoneal infections with mcc
23
$165,617
$20,387
8.1× st 6.2×
659
Kidney and ureter procedures for non-neoplasm with mcc
23
$264,776
$34,992
7.6× st 5.5×
206
Other respiratory system diagnoses without mcc
23
$88,120
$11,542
7.6× st 7.2×
494
Lower extremity and humerus procedures except hip, foot and femur without cc/mcc
23
$116,896
$20,402
5.7× st 4.2×
390
Gastrointestinal obstruction without cc/mcc
23
$47,953
$8,669
5.5× st 5.5×
862
Postoperative and post-traumatic infections with mcc
22
$153,805
$21,274
7.2× st 5.5×
863
Postoperative and post-traumatic infections without mcc
22
$88,637
$12,363
7.2× st 6.6×
920
Complications of treatment with cc
22
$80,876
$12,659
6.4× st 5.5×
562
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc
22
$148,062
$19,907
7.4× st 5.7×
644
Endocrine disorders with cc
22
$115,993
$13,562
8.6× st 6.1×
483
Major joint or limb reattachment procedures of upper extremities
21
$136,689
$25,839
5.3× st 4.5×
673
Other kidney and urinary tract procedures with mcc
21
$372,329
$50,433
7.4× st 5.4×
866
Viral illness without mcc
21
$97,672
$13,568
7.2× st 6.9×
565
Other musculoskeletal system and connective tissue diagnoses with cc
21
$80,720
$12,038
6.7× st 5.7×
070
Other cerebrovascular disorders with mcc
20
$134,357
$19,831
6.8× st 5.3×
535
Fractures of hip and pelvis with mcc
20
$88,471
$15,801
5.6× st 6.3×
433
Cirrhosis and alcoholic hepatitis with cc
20
$115,754
$14,490
8.0× st 7.8×
650
Kidney transplant with hemodialysis with mcc
20
$477,887
$52,495
9.1× st 6.7×
204
Respiratory signs and symptoms
20
$82,373
$10,087
8.2× st 6.0×
269
Aortic and heart assist procedures except pulsation balloon without mcc
20
$182,609
$43,379
4.2× st 4.2×
233
Coronary bypass with cardiac catheterization or open ablation with mcc
20
$495,822
$89,230
5.6× st 4.2×
277
Cardiac defibrillator implant without mcc
20
$282,951
$60,883
4.6× st 5.2×
442
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with cc
19
$101,839
$11,640
8.7× st 6.9×
864
Fever and inflammatory conditions
19
$67,270
$11,835
5.7× st 6.6×
103
Headaches without mcc
19
$82,883
$10,420
8.0× st 6.8×
026
Craniotomy and endovascular intracranial procedures with cc
19
$199,752
$34,412
5.8× st 4.7×
054
Nervous system neoplasms with mcc
19
$165,029
$18,437
9.0× st 6.5×
305
Hypertension without mcc
19
$81,961
$9,504
8.6× st 5.3×
242
Permanent cardiac pacemaker implant with mcc
19
$184,400
$37,565
4.9× st 5.0×
439
Disorders of pancreas except malignancy with cc
19
$65,967
$10,569
6.2× st 5.4×
987
Non-extensive o.r. procedures unrelated to principal diagnosis with mcc
19
$398,804
$57,836
6.9× st 6.0×
956
Limb reattachment, hip and femur procedures for multiple significant trauma
19
$243,284
$43,086
5.6× st 5.2×
306
Cardiac congenital and valvular disorders with mcc
19
$159,002
$19,977
8.0× st 6.4×
379
Gastrointestinal hemorrhage without cc/mcc
19
$52,466
$7,610
6.9× st 6.2×
040
Peripheral, cranial nerve and other nervous system procedures with mcc
19
$273,872
$41,589
6.6× st 5.3×
467
Revision of hip or knee replacement with cc
18
$196,935
$35,758
5.5× st 4.3×
191
Chronic obstructive pulmonary disease with cc
18
$80,238
$10,538
7.6× st 4.8×
592
Skin ulcers with mcc
18
$158,724
$33,243
4.8× st 5.2×
917
Poisoning and toxic effects of drugs with mcc
18
$175,737
$21,040
8.4× st 4.9×
066
Intracranial hemorrhage or cerebral infarction without cc/mcc
18
$68,700
$8,470
8.1× st 6.2×
166
Other respiratory system o.r. procedures with mcc
18
$382,111
$54,784
7.0× st 5.3×
186
Pleural effusion with mcc
18
$121,771
$18,515
6.6× st 6.5×
841
Lymphoma and non-acute leukemia with cc
17
$135,816
$18,093
7.5× st 6.1×
418
Laparoscopic cholecystectomy without c.d.e. with cc
17
$130,241
$21,696
6.0× st 5.7×
074
Cranial and peripheral nerve disorders without mcc
17
$110,935
$12,925
8.6× st 6.0×
856
Postoperative or post-traumatic infections with o.r. procedures with mcc
17
$292,191
$48,737
6.0× st 5.3×
041
Peripheral, cranial nerve and other nervous system procedures with cc or peripheral neur
17
$157,324
$25,738
6.1× st 5.3×
125
Other disorders of the eye without mcc
17
$67,628
$10,088
6.7× st 6.3×
271
Other major cardiovascular procedures with cc
16
$219,170
$36,281
6.0× st 4.1×
809
Major hematological and immunological diagnoses except sickle cell crisis and coagulatio
16
$203,521
$23,933
8.5× st 5.6×
545
Connective tissue disorders with mcc
16
$182,887
$26,210
7.0× st 6.1×
240
Amputation for circulatory system disorders except upper limb and toe with cc
16
$223,193
$41,780
5.3× st 5.0×
896
Alcohol, drug abuse or dependence without rehabilitation therapy with mcc
16
$168,228
$20,268
8.3× st 5.0×
083
Traumatic stupor and coma >1 hour with cc
16
$102,843
$15,209
6.8× st 5.2×
303
Atherosclerosis without mcc
15
$65,462
$7,839
8.4× st 6.3×
004
Tracheostomy with mv >96 hours or principal diagnosis except face, mouth and neck withou
15
$1,700,384
$195,307
8.7× st 4.6×
373
Major gastrointestinal disorders and peritoneal infections without cc/mcc
15
$62,146
$11,194
5.6× st 6.4×
982
Extensive o.r. procedures unrelated to principal diagnosis with cc
15
$207,380
$33,137
6.3× st 5.6×
694
Urinary stones without mcc
15
$62,306
$11,595
5.4× st 6.4×
661
Kidney and ureter procedures for non-neoplasm without cc/mcc
15
$79,988
$12,141
6.6× st 5.2×
897
Alcohol, drug abuse or dependence without rehabilitation therapy without mcc
15
$82,387
$11,172
7.4× st 3.7×
292
Heart failure and shock with cc
15
$76,387
$10,728
7.1× st 6.4×
607
Minor skin disorders without mcc
15
$73,813
$11,017
6.7× st 5.8×
885
Psychoses
14
$134,827
$18,204
7.4× st 4.5×
307
Cardiac congenital and valvular disorders without mcc
14
$84,567
$12,784
6.6× st 6.8×
918
Poisoning and toxic effects of drugs without mcc
14
$60,194
$10,468
5.8× st 4.6×
386
Inflammatory bowel disease with cc
14
$60,475
$12,803
4.7× st 6.8×
438
Disorders of pancreas except malignancy with mcc
14
$123,599
$19,469
6.3× st 5.9×
546
Connective tissue disorders with cc
14
$144,297
$15,241
9.5× st 7.6×
033
Ventricular shunt procedures without cc/mcc
13
$94,530
$17,720
5.3× st 6.0×
865
Viral illness with mcc
13
$107,675
$22,339
4.8× st 6.4×
564
Other musculoskeletal system and connective tissue diagnoses with mcc
13
$107,684
$18,833
5.7× st 6.8×
457
Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive
13
$396,274
$62,473
6.3× st 4.6×
207
Respiratory system diagnosis with ventilator support >96 hours
13
$615,654
$76,194
8.1× st 4.4×
419
Laparoscopic cholecystectomy without c.d.e. without cc/mcc
13
$94,584
$16,776
5.6× st 5.1×
038
Extracranial procedures with cc
13
$132,800
$17,627
7.5× st 5.1×
195
Simple pneumonia and pleurisy without cc/mcc
13
$52,908
$8,861
6.0× st 6.0×
539
Osteomyelitis with mcc
13
$149,784
$22,500
6.7× st 6.0×
212
Concomitant aortic and mitral valve procedures
13
$723,863
$122,114
5.9× st 6.0×
988
Non-extensive o.r. procedures unrelated to principal diagnosis with cc
13
$134,278
$23,355
5.8× st 5.8×
907
Other o.r. procedures for injuries with mcc
12
$425,684
$56,429
7.5× st 5.8×
179
Respiratory infections and inflammations without cc/mcc
12
$69,929
$9,373
7.5× st 5.3×
553
Bone diseases and arthropathies with mcc
12
$84,149
$18,577
4.5× st 5.9×
185
Major chest trauma without cc/mcc
12
$48,821
$10,278
4.8× st 5.1×
964
Other multiple significant trauma with cc
12
$116,393
$17,614
6.6× st 6.1×
455
Combined anterior and posterior spinal fusion without cc/mcc
12
$221,555
$49,259
4.5× st 3.9×
947
Signs and symptoms with mcc
12
$136,507
$16,800
8.1× st 6.5×
005
Liver transplant with mcc or intestinal transplant
12
$953,330
$114,782
8.3× st 6.1×
823
Lymphoma and non-acute leukemia with other procedures with mcc
12
$308,099
$52,554
5.9× st 6.1×
880
Acute adjustment reaction and psychosocial dysfunction
12
$94,129
$12,345
7.6× st 6.9×
617
Amputation of lower limb for endocrine, nutritional and metabolic disorders with cc
12
$153,940
$24,674
6.2× st 5.3×
001
Heart transplant or implant of heart assist system with mcc
12
$2,735,305
$375,586
7.3× st 5.5×
039
Extracranial procedures without cc/mcc
12
$70,208
$14,961
4.7× st 4.5×
557
Tendonitis, myositis and bursitis with mcc
12
$154,659
$19,404
8.0× st 6.7×
326
Stomach, esophageal and duodenal procedures with mcc
11
$389,187
$59,587
6.5× st 4.9×
336
Peritoneal adhesiolysis with cc
11
$119,951
$28,338
4.2× st 4.8×
014
Allogeneic bone marrow transplant
11
$856,443
$144,629
5.9× st 4.5×
260
Cardiac pacemaker revision except device replacement with mcc
11
$206,025
$34,775
5.9× st 5.7×
696
Kidney and urinary tract signs and symptoms without mcc
11
$66,172
$9,097
7.3× st 6.2×
558
Tendonitis, myositis and bursitis without mcc
11
$84,252
$10,967
7.7× st 6.4×
857
Postoperative or post-traumatic infections with o.r. procedures with cc
11
$169,367
$25,769
6.6× st 5.6×
282
Acute myocardial infarction, discharged alive without cc/mcc
11
$51,602
$9,415
5.5× st 4.9×
579
Other skin, subcutaneous tissue and breast procedures with mcc
11
$322,286
$48,393
6.7× st 5.5×
908
Other o.r. procedures for injuries with cc
11
$100,651
$26,791
3.8× st 5.8×
436
Malignancy of hepatobiliary system or pancreas with cc
11
$111,046
$13,914
8.0× st 7.0×
093
Other disorders of nervous system without cc/mcc
11
$72,011
$9,044
8.0× st 6.6×
560
Aftercare, musculoskeletal system and connective tissue with cc
11
$77,340
$12,589
6.1× st 6.3×
020
Intracranial vascular procedures with principal diagnosis hemorrhage with mcc
11
$376,801
$91,446
4.1× st 3.7×
02 · Outpatient
Outpatient services
Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.
APC
Service
Services
Charge
Allowed
Billed ÷ allowed
5372
Level 2 Urology and Related Services
1,623
$4,078
$750
5.4×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
1,154
$10,266
$1,769
5.8×
5191
Level 1 Endovascular Procedures
669
$17,737
$3,571
5.0×
5373
Level 3 Urology and Related Services
651
$8,981
$2,252
4.0×
5193
Level 3 Endovascular Procedures
388
$58,780
$11,810
5.0×
5492
Level 2 Intraocular Procedures
374
$19,615
$4,379
4.5×
5115
Level 5 Musculoskeletal Procedures
320
$57,623
$14,004
4.1×
8011
Comprehensive Observation Services
304
$30,671
$3,008
10.2×
5302
Level 2 Upper GI Procedures
273
$14,082
$2,091
6.7×
5374
Level 4 Urology and Related Services
222
$22,223
$3,884
5.7×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
192
$21,334
$3,715
5.7×
5431
Level 1 Nerve Procedures
174
$16,579
$2,097
7.9×
5375
Level 5 Urology and Related Services
173
$31,754
$5,753
5.5×
5114
Level 4 Musculoskeletal Procedures
172
$36,660
$7,700
4.8×
5183
Level 3 Vascular Procedures
171
$19,324
$3,530
5.5×
5213
Level 3 Electrophysiologic Procedures
170
$200,246
$25,798
7.8×
5112
Level 2 Musculoskeletal Procedures
160
$16,851
$1,762
9.6×
5414
Level 4 Gynecologic Procedures
158
$21,429
$3,342
6.4×
5113
Level 3 Musculoskeletal Procedures
126
$23,807
$3,587
6.6×
5361
Level 1 Laparoscopy and Related Services
124
$32,069
$6,235
5.1×
5184
Level 4 Vascular Procedures
111
$41,099
$5,661
7.3×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
110
$19,019
$3,142
6.1×
5491
Level 1 Intraocular Procedures
100
$17,499
$2,593
6.7×
5313
Level 3 Lower GI Procedures
85
$19,333
$3,124
6.2×
5223
Level 3 Pacemaker and Similar Procedures
75
$63,134
$11,724
5.4×
5222
Level 2 Pacemaker and Similar Procedures
70
$55,630
$9,147
6.1×
5303
Level 3 Upper GI Procedures
60
$20,490
$4,287
4.8×
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
58
$19,300
$2,623
7.4×
5192
Level 2 Endovascular Procedures
50
$38,063
$6,168
6.2×
5182
Level 2 Vascular Procedures
45
$7,869
$1,726
4.6×
5465
Level 5 Neurostimulator and Related Procedures
44
$121,930
$33,176
3.7×
5331
Complex GI Procedures
43
$28,541
$6,295
4.5×
5464
Level 4 Neurostimulator and Related Procedures
42
$106,691
$23,241
4.6×
5415
Level 5 Gynecologic Procedures
41
$33,862
$5,467
6.2×
5362
Level 2 Laparoscopy and Related Services
39
$60,367
$10,710
5.6×
5154
Level 4 Airway Endoscopy
34
$25,446
$4,195
6.1×
5194
Level 4 Endovascular Procedures
34
$92,597
$18,836
4.9×
5462
Level 2 Neurostimulator and Related Procedures
31
$23,317
$7,459
3.1×
5232
Level 2 ICD and Similar Procedures
28
$176,496
$35,142
5.0×
5463
Level 3 Neurostimulator and Related Procedures
25
$42,199
$13,879
3.0×
5493
Level 3 Intraocular Procedures
22
$27,357
$5,882
4.7×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
22
$38,818
$7,232
5.4×
5116
Level 6 Musculoskeletal Procedures
21
$80,017
$19,083
4.2×
5200
Implantation Wireless PA Pressure Monitor
17
$111,405
$32,608
3.4×
5376
Level 6 Urology and Related Services
16
$37,947
$9,821
3.9×
5378
Level 8 Urology and Related Services
15
$88,059
$19,840
4.4×
5155
Level 5 Airway Endoscopy
14
$32,054
$6,826
4.7×
5164
Level 4 ENT Procedures
13
$22,108
$3,623
6.1×
5504
Level 4 Extraocular, Repair, and Plastic Eye Procedures
11
$21,056
$4,351
4.8×
5165
Level 5 ENT Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5093
Level 3 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5211
Level 1 Electrophysiologic Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5432
Level 2 Nerve Procedures
—
—
—
—
5212
Level 2 Electrophysiologic Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5094
Level 4 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5377
Level 7 Urology and Related Services
—
—
—
—
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
03 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 101
info
inp_charge_10x_payment
average charge $145,203 is 10.9× the total payment
MS-DRG 951
info
inp_charge_10x_payment
average charge $91,894 is 11.4× the total payment
Sources for this hospital
the files read, as fetched — not our copy of them- MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
- MUP_OUT_RY26_P04_V10_DY24_Prov_Svc.csv · 28.1M bytes · fetched 2026-08-21 · sha256 f293918edbf6… · publisher's page · public domain (US federal)
- chsp-hospital-linkage-2023.csv · 1.5M bytes · fetched 2026-08-21 · sha256 a86146f10c8d… · publisher's page · public; cite AHRQ Compendium of U.S. Health Systems
- 2020 ZCTA to County relationship file · US Census Bureau · 2020tab20_zcta520_county20_natl.txt · 6.8M bytes · fetched 2026-08-21 · sha256 3ed41278d637… · publisher's page · public domain (US federal)
Every figure on this page is computed from these files by pipeline/prices/; the same rows are in the API.
Source rows for this hospital as JSON: inpatient · outpatient. CMS, Medicare Inpatient and Outpatient Hospitals by Provider and Service, 2024.