New York / Garnet Health Medical Center
CMS certification 330126 · Middletown, NY · 1 entry in CMS's price-transparency list
Garnet Health Medical Center: charges and Medicare payments
Garnet Health Medical Center reported 5,742 Medicare inpatient stays across 126 DRGs in 2024. Across them it charged 4.62 times what it was paid — among the higher ratios in New York, number 39 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: 477 stays at an average charge of $88,357, 2% below the national average. It also billed 4,827 outpatient services, charging 5.72 times what Medicare paid.
- 1Medicare inpatient stays 5,742
- 2Charge ÷ paid, inpatient 4.62×
- 3Rank in NY (highest ratio = 1) 39 of 123
- 4CMS price-transparency actions 1
Inpatient stays
For the 126 DRGs that can be compared with the national average, Garnet Health Medical Center charged more than the national average in 77 (61%). 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 | 477 | $88,357 | -2% | $20,359 |
| 291 Heart Failure and Shock with MCC | 349 | $66,210 | +17% | $14,493 |
| 193 Simple Pneumonia and Pleurisy with MCC | 223 | $73,009 | +22% | $14,951 |
| 177 Respiratory Infections and Inflammations with MCC | 213 | $76,840 | +9% | $17,441 |
| 189 Pulmonary Edema and Respiratory Failure | 192 | $64,272 | +12% | $13,205 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 157 | $75,660 | 0% | $16,313 |
| 689 Kidney and Urinary Tract Infections with MCC | 143 | $66,472 | +30% | $12,183 |
| 690 Kidney and Urinary Tract Infections without MCC | 113 | $50,429 | +33% | $8,877 |
| 378 Gastrointestinal Hemorrhage with CC | 103 | $59,357 | +22% | $10,591 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 103 | $54,185 | +35% | $9,484 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 100 | $46,054 | +28% | $8,355 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 96 | $62,777 | +13% | $10,952 |
| 603 Cellulitis without MCC | 94 | $45,614 | +22% | $10,375 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 93 | $65,350 | +33% | $12,093 |
| 377 Gastrointestinal Hemorrhage with MCC | 88 | $82,862 | -3% | $19,009 |
| 194 Simple Pneumonia and Pleurisy with CC | 87 | $46,374 | +21% | $8,862 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 81 | $191,571 | -16% | $53,767 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 80 | $76,606 | +4% | $17,753 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 79 | $88,210 | -12% | $20,289 |
| 069 Transient Ischemia without Thrombolytic | 70 | $52,311 | +4% | $8,507 |
| 481 Hip and Femur Procedures except Major Joint with CC | 67 | $101,425 | +1% | $22,493 |
| 312 Syncope and Collapse | 66 | $51,793 | +14% | $9,817 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 65 | $51,679 | +39% | $8,496 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 63 | $66,718 | +11% | $13,774 |
| 389 Gastrointestinal Obstruction with CC | 62 | $49,422 | +27% | $9,318 |
| 682 Renal Failure with MCC | 61 | $89,529 | +36% | $16,122 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 60 | $95,001 | -15% | $23,841 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 58 | $52,629 | +4% | $11,147 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 58 | $57,820 | +15% | $9,767 |
| 071 Other Cerebrovascular Disorders with CC | 57 | $69,599 | +38% | $10,997 |
| 812 Red Blood Cell Disorders without MCC | 57 | $66,796 | +50% | $13,109 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 55 | $33,728 | +17% | $6,029 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 52 | $56,157 | -12% | $12,137 |
| 683 Renal Failure with CC | 50 | $57,398 | +41% | $10,370 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 48 | $74,137 | +31% | $14,042 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 46 | $101,095 | -12% | $19,203 |
| 101 Seizures without MCC | 45 | $67,442 | +38% | $10,372 |
| 178 Respiratory Infections and Inflammations with CC | 44 | $61,468 | +36% | $11,031 |
| 638 Diabetes with CC | 41 | $61,578 | +48% | $10,623 |
| 637 Diabetes with MCC | 40 | $65,499 | -2% | $14,593 |
| 070 Other Cerebrovascular Disorders with MCC | 38 | $81,431 | +7% | $17,341 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 38 | $85,749 | +41% | $14,136 |
| 552 Medical Back Problems without MCC | 37 | $50,806 | +4% | $10,536 |
| 100 Seizures with MCC | 36 | $85,892 | -9% | $20,201 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 35 | $65,987 | -29% | $20,409 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 34 | $46,676 | +10% | $9,317 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 34 | $228,239 | -29% | $69,651 |
| 314 Other Circulatory System Diagnoses with MCC | 32 | $116,300 | +23% | $24,329 |
| 330 Major Small and Large Bowel Procedures with CC | 32 | $113,652 | -5% | $25,195 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 32 | $97,469 | -5% | $22,975 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 31 | $58,063 | +47% | $10,090 |
| 305 Hypertension without MCC | 31 | $49,257 | +23% | $8,797 |
| 602 Cellulitis with MCC | 31 | $83,850 | +39% | $16,968 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 31 | $51,811 | +9% | $10,652 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 29 | $81,590 | +25% | $14,333 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 28 | $129,177 | +16% | $22,808 |
| 315 Other Circulatory System Diagnoses with CC | 26 | $48,300 | +1% | $9,819 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 26 | $108,609 | -22% | $28,566 |
| 811 Red Blood Cell Disorders with MCC | 26 | $93,997 | +38% | $15,859 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 26 | $195,179 | -10% | $43,935 |
Showing the 60 most frequent of 126 DRGs.
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Garnet Health Medical Center charged $88,357 on average, 24% less than the New York average of $116,930, and was paid $20,359 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Garnet Health Medical Center charged $66,210 on average, 18% less than the New York average of $81,161, and was paid $14,493 against a state average of $16,034. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Garnet Health Medical Center charged $73,009 on average, 5% less than the New York average of $77,177, and was paid $14,951 against a state average of $15,976. For Respiratory Infections and Inflammations with MCC (DRG 177), Garnet Health Medical Center charged $76,840 on average, 19% less than the New York average of $94,371, and was paid $17,441 against a state average of $19,472. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,981 was 6% below the state average of $26,675. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $13,136 was 19% below the state average of $16,178. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $14,671 was 42% below the state average of $25,359. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,932 was 38% below the state average of $12,815.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Garnet Health Medical Center in Middletown, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-24 (CMS case 3972)
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.