Montefiore Medical Center: charges and Medicare payments

Montefiore Medical Center reported 9,060 Medicare inpatient stays across 188 DRGs in 2024. Across them it charged 6.14 times what it was paid — among the higher ratios in New York, number 14 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: 995 stays at an average charge of $212,310, 135% above the national average. It also billed 3,863 outpatient services, charging 7.49 times what Medicare paid.

1Medicare inpatient stays 9,060
2Charge ÷ paid, inpatient 6.14×
3Rank in NY (highest ratio = 1) 14 of 123
4CMS price-transparency actions 0

Average charge per stay at Montefiore Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 188 DRGs that can be compared with the national average, Montefiore Medical Center charged more than the national average in 186 (99%). 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	995	$212,310	+135%	$31,878
291 Heart Failure and Shock with MCC	390	$169,882	+201%	$24,163
312 Syncope and Collapse	198	$81,317	+79%	$13,478
853 Infectious and Parasitic Diseases with O.R. Procedures with...	190	$519,773	+127%	$79,572
470 Major Hip and Knee Joint Replacement or Reattachment of...	186	$121,570	+30%	$31,015
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	182	$159,998	+165%	$23,332
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	160	$81,121	+102%	$13,616
870 Septicemia or Severe Sepsis with MV >96 Hours	155	$541,663	+68%	$97,578
698 Other Kidney and Urinary Tract Diagnoses with MCC	152	$197,267	+169%	$28,638
193 Simple Pneumonia and Pleurisy with MCC	142	$130,765	+119%	$21,718
177 Respiratory Infections and Inflammations with MCC	136	$152,658	+116%	$25,504
189 Pulmonary Edema and Respiratory Failure	125	$147,948	+157%	$20,254
699 Other Kidney and Urinary Tract Diagnoses with CC	124	$105,351	+122%	$16,076
682 Renal Failure with MCC	123	$144,962	+120%	$22,641
683 Renal Failure with CC	119	$100,000	+146%	$15,745
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	113	$238,819	+139%	$38,347
266 Endovascular Cardiac Valve Replacement and Supplement...	108	$396,289	+39%	$84,998
690 Kidney and Urinary Tract Infections without MCC	96	$87,179	+131%	$13,182
314 Other Circulatory System Diagnoses with MCC	92	$192,585	+103%	$31,210
689 Kidney and Urinary Tract Infections with MCC	90	$122,425	+139%	$19,027
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	89	$106,707	+118%	$18,074
300 Peripheral Vascular Disorders with CC	88	$110,124	+123%	$17,899
377 Gastrointestinal Hemorrhage with MCC	88	$191,586	+124%	$28,617
378 Gastrointestinal Hemorrhage with CC	88	$105,536	+117%	$16,531
313 Chest Pain	86	$69,431	+74%	$11,764
811 Red Blood Cell Disorders with MCC	80	$174,293	+156%	$24,376
280 Acute Myocardial Infarction, Discharged Alive with MCC	79	$194,233	+156%	$26,136
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	78	$127,010	+128%	$15,819
101 Seizures without MCC	76	$87,847	+80%	$15,061
100 Seizures with MCC	75	$183,154	+94%	$33,520
194 Simple Pneumonia and Pleurisy with CC	75	$87,266	+127%	$14,669
393 Other Digestive System Diagnoses with MCC	74	$134,555	+75%	$23,499
202 Bronchitis and Asthma with CC/MCC	72	$89,393	+94%	$17,078
603 Cellulitis without MCC	72	$84,740	+127%	$15,596
637 Diabetes with MCC	71	$158,480	+138%	$22,674
552 Medical Back Problems without MCC	70	$92,784	+90%	$15,601
057 Degenerative Nervous System Disorders without MCC	67	$108,965	+92%	$21,172
309 Cardiac Arrhythmia and Conduction Disorders with CC	64	$93,248	+158%	$12,894
884 Organic Disturbances and Intellectual Disability	64	$150,088	+141%	$26,129
394 Other Digestive System Diagnoses with CC	63	$91,860	+95%	$15,932
638 Diabetes with CC	63	$101,139	+143%	$19,779
299 Peripheral Vascular Disorders with MCC	60	$169,127	+125%	$24,097
308 Cardiac Arrhythmia and Conduction Disorders with MCC	60	$160,609	+184%	$19,908
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	58	$1,863,362	+77%	$334,930
252 Other Vascular Procedures with MCC	58	$322,038	+88%	$59,516
190 Chronic Obstructive Pulmonary Disease with MCC	57	$106,480	+110%	$22,331
286 Circulatory Disorders except AMI, with Cardiac...	51	$314,721	+180%	$39,255
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	51	$95,434	+158%	$14,335
812 Red Blood Cell Disorders without MCC	51	$102,952	+132%	$16,269
322 Percutaneous Cardiovascular Procedures with Intraluminal...	49	$157,380	+37%	$25,873
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	49	$130,720	+114%	$19,622
074 Cranial and Peripheral Nerve Disorders without MCC	47	$94,546	+76%	$16,232
149 Dysequilibrium	47	$65,422	+47%	$11,966
315 Other Circulatory System Diagnoses with CC	47	$116,296	+143%	$15,833
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	47	$82,106	+93%	$15,950
208 Respiratory System Diagnosis with Ventilator Support <=96...	46	$332,489	+145%	$48,043
554 Bone Diseases and Arthropathies without MCC	46	$79,707	+110%	$13,775
321 Percutaneous Cardiovascular Procedures with Intraluminal...	44	$267,687	+64%	$43,038
178 Respiratory Infections and Inflammations with CC	43	$114,249	+152%	$18,322
274 Percutaneous and Other Intracardiac Procedures without MCC	43	$150,482	-4%	$50,559

Showing the 60 most frequent of 188 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	511	$1,852	$767
Level 1 Intraocular Procedures	387	$25,441	$2,614
Level 1 Endovascular Procedures	246	$43,554	$3,631
Level 3 Urology and Related Services	246	$10,369	$2,287
Level 3 Electrophysiologic Procedures	159	$124,110	$26,282
Level 2 Excision/ Biopsy/ Incision and Drainage	143	$19,019	$1,813
Level 2 Upper GI Procedures	128	$16,274	$2,142
Level 1 Laparoscopy and Related Services	108	$47,984	$6,493
Level 3 Excision/ Biopsy/ Incision and Drainage	105	$33,709	$3,179
Level 2 Intraocular Procedures	102	$33,367	$4,580
Level 3 Vascular Procedures	99	$33,544	$3,506
Level 5 Urology and Related Services	98	$39,368	$5,825
Level 5 Airway Endoscopy	93	$38,371	$7,701
Level 4 Urology and Related Services	92	$30,541	$3,925
Level 2 Musculoskeletal Procedures	87	$20,678	$1,760
Level 1 Nerve Procedures	76	$20,132	$2,175
Level 3 Airway Endoscopy	74	$10,228	$1,890
Level 4 Airway Endoscopy	74	$28,760	$4,170
Level 4 Musculoskeletal Procedures	71	$49,889	$7,962
Level 3 Endovascular Procedures	71	$68,465	$12,356
Comprehensive Observation Services	68	$33,238	$3,083
Level 4 Vascular Procedures	67	$39,243	$5,996
Level 3 Musculoskeletal Procedures	65	$32,927	$3,602
Level 2 Endovascular Procedures	62	$53,600	$6,350
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	61	$31,377	$3,843

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Montefiore Medical Center charged $212,310 on average, 82% more than the New York average of $116,930, and was paid $31,878 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Montefiore Medical Center charged $169,882 on average, 109% more than the New York average of $81,161, and was paid $24,163 against a state average of $16,034. For Syncope and Collapse (DRG 312), Montefiore Medical Center charged $81,317 on average, 39% more than the New York average of $58,334, and was paid $13,478 against a state average of $11,568. For Infectious and Parasitic Diseases with O.R. Procedures with MCC (DRG 853), Montefiore Medical Center charged $519,773 on average, 80% more than the New York average of $288,832, and was paid $79,572 against a state average of $63,023. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,852 was 46% below the state average of $3,429. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $25,441 was 57% above the state average of $16,178. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $43,554 was 72% above the state average of $25,359. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $10,369 was 21% 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.