New York / Elmhurst Hospital Center
CMS certification 330128 · Elmhurst, NY · 4 entries in CMS's price-transparency list
Elmhurst Hospital Center: charges and Medicare payments
Elmhurst Hospital Center reported 1,022 Medicare inpatient stays across 40 DRGs in 2024. Across them it charged 1.76 times what it was paid — among the lower ratios in New York, number 105 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: 184 stays at an average charge of $96,237, 7% above the national average. It also billed 135 outpatient services, charging 4.89 times what Medicare paid.
- 1Medicare inpatient stays 1,022
- 2Charge ÷ paid, inpatient 1.76×
- 3Rank in NY (highest ratio = 1) 105 of 123
- 4CMS price-transparency actions 4
Inpatient stays
For the 40 DRGs that can be compared with the national average, Elmhurst Hospital Center charged more than the national average in 8 (20%). 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 | 184 | $96,237 | +7% | $41,835 |
| 291 Heart Failure and Shock with MCC | 58 | $57,947 | +3% | $33,023 |
| 682 Renal Failure with MCC | 44 | $48,666 | -26% | $35,452 |
| 312 Syncope and Collapse | 42 | $29,134 | -36% | $28,802 |
| 689 Kidney and Urinary Tract Infections with MCC | 38 | $48,151 | -6% | $31,537 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 36 | $52,423 | -31% | $38,063 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 34 | $49,073 | -19% | $33,913 |
| 690 Kidney and Urinary Tract Infections without MCC | 29 | $33,632 | -11% | $27,434 |
| 177 Respiratory Infections and Inflammations with MCC | 28 | $108,719 | +54% | $45,148 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 28 | $50,470 | 0% | $31,548 |
| 193 Simple Pneumonia and Pleurisy with MCC | 27 | $51,112 | -14% | $34,795 |
| 481 Hip and Femur Procedures except Major Joint with CC | 25 | $103,602 | +3% | $41,399 |
| 884 Organic Disturbances and Intellectual Disability | 24 | $53,974 | -14% | $36,569 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 22 | $44,867 | -11% | $29,138 |
| 552 Medical Back Problems without MCC | 21 | $40,472 | -17% | $29,097 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 20 | $50,617 | -9% | $31,405 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 19 | $38,313 | -10% | $29,250 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 19 | $43,002 | -12% | $30,444 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 18 | $25,672 | -36% | $27,662 |
| 603 Cellulitis without MCC | 18 | $37,213 | 0% | $31,254 |
| 605 Trauma To The Skin, Subcutaneous Tissue and Breast without... | 18 | $36,292 | -22% | $28,034 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 18 | $28,775 | -22% | $24,871 |
| 683 Renal Failure with CC | 18 | $31,274 | -23% | $26,282 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 18 | $36,568 | -1% | $25,890 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 17 | $102,281 | +2% | $42,633 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 17 | $39,716 | +10% | $27,309 |
| 637 Diabetes with MCC | 16 | $44,894 | -32% | $34,011 |
| 101 Seizures without MCC | 15 | $31,568 | -35% | $27,789 |
| 194 Simple Pneumonia and Pleurisy with CC | 15 | $32,287 | -16% | $28,070 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 14 | $220,891 | -32% | $100,530 |
| 896 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 14 | $51,502 | -34% | $41,099 |
| 082 Traumatic Stupor and Coma >1 Hour with MCC | 13 | $79,550 | -31% | $44,598 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 13 | $65,513 | -11% | $33,190 |
| 638 Diabetes with CC | 13 | $29,408 | -29% | $24,788 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 13 | $176,257 | -23% | $75,944 |
| 305 Hypertension without MCC | 12 | $22,073 | -45% | $27,176 |
| 377 Gastrointestinal Hemorrhage with MCC | 11 | $94,000 | +10% | $38,244 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $48,111 | -21% | $34,578 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 11 | $105,777 | +3% | $41,728 |
| 604 Trauma To The Skin, Subcutaneous Tissue and Breast with MCC | 11 | $70,598 | -3% | $41,104 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 77 | $12,098 | $3,115 |
| Level 1 Intraocular Procedures | 28 | $8,526 | $2,515 |
| Level 2 Musculoskeletal Procedures | 18 | $9,176 | $1,829 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 12 | $6,295 | $1,845 |
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Elmhurst Hospital Center charged $96,237 on average, 18% less than the New York average of $116,930, and was paid $41,835 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Elmhurst Hospital Center charged $57,947 on average, 29% less than the New York average of $81,161, and was paid $33,023 against a state average of $16,034. For Renal Failure with MCC (DRG 682), Elmhurst Hospital Center charged $48,666 on average, 49% less than the New York average of $95,149, and was paid $35,452 against a state average of $19,249. For Syncope and Collapse (DRG 312), Elmhurst Hospital Center charged $29,134 on average, 50% less than the New York average of $58,334, and was paid $28,802 against a state average of $11,568. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,098 was 55% below the state average of $26,675. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $8,526 was 47% below the state average of $16,178. For Level 2 Musculoskeletal Procedures (outpatient APC 5112), its average charge of $9,176 was 30% below the state average of $13,038. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,295 was 51% below the state average of $12,815.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Elmhurst Hospital Center in Elmhurst, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-08-19 (CMS case 142)
- CAP Request — 2021-09-30 (CMS case 142)
- Closure Notice — 2022-01-05 (CMS case 142)
- Met Requirements — 2025-03-28 (CMS case 3483)
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.