Kaleida Health: charges and Medicare payments

Kaleida Health reported 4,764 Medicare inpatient stays across 133 DRGs in 2024. Across them it charged 2.71 times what it was paid — mid-range in New York, number 66 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: 449 stays at an average charge of $54,285, 40% below the national average. It also billed 4,901 outpatient services, charging 3.23 times what Medicare paid.

1Medicare inpatient stays 4,764
2Charge ÷ paid, inpatient 2.71×
3Rank in NY (highest ratio = 1) 66 of 123
4CMS price-transparency actions 0

Average charge per stay at Kaleida Health, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 133 DRGs that can be compared with the national average, Kaleida Health charged more than the national average in 2 (2%). 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	449	$54,285	-40%	$21,970
291 Heart Failure and Shock with MCC	210	$34,221	-39%	$14,448
274 Percutaneous and Other Intracardiac Procedures without MCC	182	$71,328	-54%	$32,943
267 Endovascular Cardiac Valve Replacement and Supplement...	164	$124,433	-44%	$51,907
189 Pulmonary Edema and Respiratory Failure	153	$40,286	-30%	$14,509
177 Respiratory Infections and Inflammations with MCC	102	$41,145	-42%	$17,936
193 Simple Pneumonia and Pleurisy with MCC	95	$30,886	-48%	$14,666
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	94	$73,867	-26%	$24,503
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	94	$39,220	-30%	$12,345
698 Other Kidney and Urinary Tract Diagnoses with MCC	78	$49,167	-33%	$17,909
853 Infectious and Parasitic Diseases with O.R. Procedures with...	76	$156,694	-32%	$57,887
683 Renal Failure with CC	75	$23,519	-42%	$10,392
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	73	$21,362	-42%	$8,981
682 Renal Failure with MCC	72	$49,497	-25%	$18,178
280 Acute Myocardial Infarction, Discharged Alive with MCC	70	$42,972	-43%	$16,829
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	64	$24,715	-38%	$9,092
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	64	$26,029	-47%	$11,661
377 Gastrointestinal Hemorrhage with MCC	63	$46,790	-45%	$19,382
378 Gastrointestinal Hemorrhage with CC	58	$30,643	-37%	$11,240
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	57	$41,874	-31%	$14,570
603 Cellulitis without MCC	45	$21,905	-41%	$9,872
951 Other Factors Influencing Health Status	44	$14,743	-42%	$6,673
330 Major Small and Large Bowel Procedures with CC	43	$91,713	-23%	$28,611
481 Hip and Femur Procedures except Major Joint with CC	43	$58,203	-42%	$21,940
308 Cardiac Arrhythmia and Conduction Disorders with MCC	42	$43,497	-23%	$15,431
322 Percutaneous Cardiovascular Procedures with Intraluminal...	42	$31,405	-73%	$20,498
190 Chronic Obstructive Pulmonary Disease with MCC	40	$34,125	-33%	$12,547
057 Degenerative Nervous System Disorders without MCC	39	$38,429	-32%	$14,418
266 Endovascular Cardiac Valve Replacement and Supplement...	39	$187,453	-34%	$67,687
690 Kidney and Urinary Tract Infections without MCC	39	$21,315	-44%	$9,426
208 Respiratory System Diagnosis with Ventilator Support <=96...	37	$97,301	-28%	$33,642
309 Cardiac Arrhythmia and Conduction Disorders with CC	36	$18,915	-48%	$8,980
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	35	$14,768	-49%	$7,522
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	34	$66,545	-35%	$24,393
101 Seizures without MCC	33	$21,429	-56%	$10,531
286 Circulatory Disorders except AMI, with Cardiac...	33	$44,477	-60%	$21,710
321 Percutaneous Cardiovascular Procedures with Intraluminal...	33	$61,932	-62%	$30,014
026 Craniotomy and Endovascular Intracranial Procedures with CC	32	$110,059	-33%	$31,010
281 Acute Myocardial Infarction, Discharged Alive with CC	32	$24,522	-51%	$10,890
314 Other Circulatory System Diagnoses with MCC	31	$79,037	-17%	$25,056
811 Red Blood Cell Disorders with MCC	31	$49,152	-28%	$17,957
870 Septicemia or Severe Sepsis with MV >96 Hours	31	$191,991	-41%	$70,324
023 Craniotomy with Major Device Implant or Acute Complex Cns...	30	$181,255	-35%	$61,635
312 Syncope and Collapse	30	$32,983	-28%	$10,007
638 Diabetes with CC	30	$31,608	-24%	$10,713
100 Seizures with MCC	29	$61,252	-35%	$22,533
178 Respiratory Infections and Inflammations with CC	29	$28,053	-38%	$10,340
329 Major Small and Large Bowel Procedures with MCC	29	$195,947	-9%	$63,724
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	29	$42,598	-30%	$14,428
552 Medical Back Problems without MCC	29	$29,696	-39%	$10,950
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	29	$163,157	-25%	$53,228
027 Craniotomy and Endovascular Intracranial Procedures without...	28	$66,954	-52%	$27,003
194 Simple Pneumonia and Pleurisy with CC	28	$21,644	-44%	$9,470
236 Coronary Bypass without Cardiac Catheterization without MCC	28	$149,586	-29%	$40,939
252 Other Vascular Procedures with MCC	27	$109,785	-36%	$37,769
689 Kidney and Urinary Tract Infections with MCC	27	$45,094	-12%	$14,965
025 Craniotomy and Endovascular Intracranial Procedures with MCC	26	$190,532	-18%	$48,457
066 Intracranial Hemorrhage or Cerebral Infarction without...	26	$27,219	-36%	$10,016
071 Other Cerebrovascular Disorders with CC	26	$32,234	-36%	$11,783
234 Coronary Bypass with Cardiac Catheterization or Open...	25	$176,596	-34%	$49,625

Showing the 60 most frequent of 133 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	1,053	$14,441	$2,861
Level 1 Endovascular Procedures	485	$6,352	$3,425
Level 5 Musculoskeletal Procedures	355	$41,463	$13,688
Level 3 Urology and Related Services	271	$6,637	$2,111
Level 5 Urology and Related Services	243	$16,600	$5,396
Level 4 Urology and Related Services	240	$10,042	$3,641
Level 2 Urology and Related Services	232	$2,861	$710
Level 3 Electrophysiologic Procedures	162	$38,591	$24,595
Level 2 Upper GI Procedures	142	$4,523	$2,006
Level 3 Vascular Procedures	140	$10,787	$3,248
Level 4 Vascular Procedures	126	$15,585	$5,753
Level 3 Endovascular Procedures	123	$17,354	$11,649
Level 2 Excision/ Biopsy/ Incision and Drainage	119	$6,698	$1,678
Level 1 Laparoscopy and Related Services	115	$24,099	$6,075
Level 2 Laparoscopy and Related Services	100	$47,686	$10,453
Level 3 Pacemaker and Similar Procedures	92	$19,970	$11,308
Level 6 Urology and Related Services	73	$18,721	$9,760
Level 2 ICD and Similar Procedures	65	$62,586	$33,242
Level 2 Vascular Procedures	58	$3,963	$1,660
Level 4 Endovascular Procedures	58	$30,197	$18,548
Level 2 Pacemaker and Similar Procedures	54	$14,943	$8,730
Level 4 Gynecologic Procedures	52	$11,273	$3,264
Level 2 Endovascular Procedures	51	$12,092	$6,060
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	50	$18,546	$3,668
Level 3 Excision/ Biopsy/ Incision and Drainage	47	$10,902	$2,915

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Kaleida Health charged $54,285 on average, 54% less than the New York average of $116,930, and was paid $21,970 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Kaleida Health charged $34,221 on average, 58% less than the New York average of $81,161, and was paid $14,448 against a state average of $16,034. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Kaleida Health charged $71,328 on average, 58% less than the New York average of $167,911, and was paid $32,943 against a state average of $36,556. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Kaleida Health charged $124,433 on average, 45% less than the New York average of $225,176, and was paid $51,907 against a state average of $54,006. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,441 was 46% below the state average of $26,675. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $6,352 was 75% below the state average of $25,359. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $41,463 was 39% below the state average of $67,926. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $6,637 was 49% below the state average of $13,044.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

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.