New York / Claxton-Hepburn Medical Center
CMS certification 330211 · Ogdensburg, NY · 3 entries in CMS's price-transparency list
Claxton-Hepburn Medical Center: charges and Medicare payments
Claxton-Hepburn Medical Center reported 143 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 1.6 times what it was paid — among the lower ratios in New York, number 111 of 123 hospitals with at least 100 stays (state median 2.74×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 37 stays at an average charge of $27,168, 70% below the national average. It also billed 342 outpatient services, charging 3.49 times what Medicare paid.
- 1Medicare inpatient stays 143
- 2Charge ÷ paid, inpatient 1.6×
- 3Rank in NY (highest ratio = 1) 111 of 123
- 4CMS price-transparency actions 3
Inpatient stays
For the 7 DRGs that can be compared with the national average, Claxton-Hepburn Medical Center charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 37 | $27,168 | -70% | $18,704 |
| 193 Simple Pneumonia and Pleurisy with MCC | 29 | $23,581 | -61% | $12,803 |
| 291 Heart Failure and Shock with MCC | 20 | $15,744 | -72% | $12,281 |
| 177 Respiratory Infections and Inflammations with MCC | 19 | $25,876 | -63% | $16,150 |
| 194 Simple Pneumonia and Pleurisy with CC | 14 | $18,630 | -51% | $8,090 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $14,789 | -61% | $7,994 |
| 603 Cellulitis without MCC | 11 | $11,742 | -69% | $8,723 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 127 | $8,046 | $2,646 |
| Comprehensive Observation Services | 60 | $11,270 | $3,108 |
| Level 4 Urology and Related Services | 33 | $10,336 | $3,959 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 26 | $3,716 | $1,700 |
| Level 5 Urology and Related Services | 26 | $12,991 | $5,343 |
| Level 3 Vascular Procedures | 25 | $9,258 | $3,619 |
| Level 3 Urology and Related Services | 23 | $7,701 | $2,313 |
| Level 5 Musculoskeletal Procedures | 22 | $38,583 | $14,917 |
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Claxton-Hepburn Medical Center charged $27,168 on average, 77% less than the New York average of $116,930, and was paid $18,704 against a state average of $24,426. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Claxton-Hepburn Medical Center charged $23,581 on average, 69% less than the New York average of $77,177, and was paid $12,803 against a state average of $15,976. For Heart Failure and Shock with MCC (DRG 291), Claxton-Hepburn Medical Center charged $15,744 on average, 81% less than the New York average of $81,161, and was paid $12,281 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), Claxton-Hepburn Medical Center charged $25,876 on average, 73% less than the New York average of $94,371, and was paid $16,150 against a state average of $19,472. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $8,046 was 50% below the state average of $16,178. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $11,270 was 58% below the state average of $26,675. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $10,336 was 49% below the state average of $20,339. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $3,716 was 71% below the state average of $12,815.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Claxton-Hepburn Medical Center in Ogdensburg, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- CAP Request — 2024-10-09 (CMS case 2800)
- CAP Request — 2024-11-21 (CMS case 2800)
- Closure Notice — 2025-02-26 (CMS case 2800)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.