New York / Mount Sinai Hospital

CMS certification 330024 · New York, NY · 5 entries in CMS's price-transparency list

Mount Sinai Hospital: charges and Medicare payments

Mount Sinai Hospital reported 9,718 Medicare inpatient stays across 219 DRGs in 2024. Across them it charged 3.99 times what it was paid — mid-range in New York, number 46 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: 630 stays at an average charge of $163,338, 81% above the national average. It also billed 7,789 outpatient services, charging 4.21 times what Medicare paid.

1Medicare inpatient stays 9,718
2Charge ÷ paid, inpatient 3.99×
3Rank in NY (highest ratio = 1) 46 of 123
4CMS price-transparency actions 5

Average charge per stay at Mount Sinai Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 219 DRGs that can be compared with the national average, Mount Sinai Hospital charged more than the national average in 167 (76%). 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	630	$163,338	+81%	$34,560
322 Percutaneous Cardiovascular Procedures with Intraluminal...	366	$66,648	-42%	$26,321
267 Endovascular Cardiac Valve Replacement and Supplement...	326	$184,294	-17%	$65,750
291 Heart Failure and Shock with MCC	307	$133,647	+137%	$25,110
280 Acute Myocardial Infarction, Discharged Alive with MCC	177	$127,204	+68%	$25,966
274 Percutaneous and Other Intracardiac Procedures without MCC	176	$116,749	-26%	$44,001
470 Major Hip and Knee Joint Replacement or Reattachment of...	158	$70,474	-24%	$27,622
177 Respiratory Infections and Inflammations with MCC	157	$140,249	+99%	$28,462
193 Simple Pneumonia and Pleurisy with MCC	156	$105,644	+77%	$22,745
266 Endovascular Cardiac Valve Replacement and Supplement...	144	$256,904	-10%	$82,719
271 Other Major Cardiovascular Procedures with CC	143	$112,440	-35%	$48,354
286 Circulatory Disorders except AMI, with Cardiac...	124	$187,312	+67%	$37,319
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	121	$381,852	-4%	$114,361
698 Other Kidney and Urinary Tract Diagnoses with MCC	119	$120,788	+65%	$26,798
853 Infectious and Parasitic Diseases with O.R. Procedures with...	118	$378,080	+65%	$90,764
321 Percutaneous Cardiovascular Procedures with Intraluminal...	113	$103,687	-37%	$40,736
682 Renal Failure with MCC	109	$123,112	+87%	$26,433
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	103	$118,067	+96%	$24,686
377 Gastrointestinal Hemorrhage with MCC	93	$129,258	+51%	$28,496
329 Major Small and Large Bowel Procedures with MCC	91	$242,643	+13%	$66,377
689 Kidney and Urinary Tract Infections with MCC	89	$83,252	+62%	$18,859
189 Pulmonary Edema and Respiratory Failure	87	$88,515	+54%	$20,232
270 Other Major Cardiovascular Procedures with MCC	83	$288,532	+11%	$79,281
324 Coronary Intravascular Lithotripsy with Intraluminal Device...	82	$85,025	-51%	$42,136
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	81	$65,134	+62%	$13,506
699 Other Kidney and Urinary Tract Diagnoses with CC	81	$72,803	+53%	$17,136
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	81	$73,306	+49%	$17,164
287 Circulatory Disorders except AMI, with Cardiac...	80	$78,605	+23%	$16,963
330 Major Small and Large Bowel Procedures with CC	80	$117,343	-1%	$35,972
683 Renal Failure with CC	78	$71,584	+76%	$15,134
252 Other Vascular Procedures with MCC	73	$224,730	+32%	$48,760
393 Other Digestive System Diagnoses with MCC	73	$140,913	+84%	$28,840
690 Kidney and Urinary Tract Infections without MCC	73	$63,781	+69%	$13,358
314 Other Circulatory System Diagnoses with MCC	69	$185,667	+96%	$36,397
312 Syncope and Collapse	67	$65,151	+43%	$14,195
378 Gastrointestinal Hemorrhage with CC	67	$80,039	+65%	$16,436
025 Craniotomy and Endovascular Intracranial Procedures with MCC	66	$300,489	+30%	$69,312
460 Spinal Fusion except Cervical without MCC	66	$148,850	-13%	$61,445
811 Red Blood Cell Disorders with MCC	63	$113,200	+66%	$24,779
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	62	$219,024	+119%	$37,655
309 Cardiac Arrhythmia and Conduction Disorders with CC	61	$51,449	+42%	$12,584
164 Major Chest Procedures with CC	60	$102,964	-19%	$37,665
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	60	$130,444	+114%	$24,456
216 Cardiac Valve and Other Major Cardiothoracic Procedures with...	58	$458,104	-7%	$138,418
870 Septicemia or Severe Sepsis with MV >96 Hours	57	$535,143	+66%	$123,094
840 Lymphoma and Non-Acute Leukemia with MCC	56	$281,993	+81%	$50,000
308 Cardiac Arrhythmia and Conduction Disorders with MCC	51	$109,819	+94%	$21,169
281 Acute Myocardial Infarction, Discharged Alive with CC	50	$79,785	+58%	$15,259
652 Kidney Transplant	50	$308,196	-8%	$50,034
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	50	$97,813	+45%	$21,130
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	48	$1,560,076	+48%	$369,877
091 Other Disorders of Nervous System with MCC	48	$142,405	+72%	$29,009
194 Simple Pneumonia and Pleurisy with CC	48	$49,025	+28%	$13,019
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	47	$265,655	-4%	$78,177
253 Other Vascular Procedures with CC	47	$116,746	-11%	$36,966
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	47	$340,087	+57%	$79,899
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	46	$110,317	+98%	$18,501
884 Organic Disturbances and Intellectual Disability	46	$165,877	+166%	$36,006
190 Chronic Obstructive Pulmonary Disease with MCC	45	$89,355	+77%	$18,595
603 Cellulitis without MCC	45	$61,546	+65%	$14,877

Showing the 60 most frequent of 219 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 3 Excision/ Biopsy/ Incision and Drainage	754	$19,679	$3,181
Level 3 Electrophysiologic Procedures	621	$84,988	$26,746
Level 1 Endovascular Procedures	597	$15,750	$3,665
Level 3 Endovascular Procedures	542	$36,887	$12,438
Comprehensive Observation Services	527	$26,099	$3,104
Level 2 Excision/ Biopsy/ Incision and Drainage	364	$9,575	$1,810
Level 3 Vascular Procedures	281	$13,796	$3,596
Level 3 Urology and Related Services	271	$9,356	$2,301
Level 2 Upper GI Procedures	258	$11,774	$2,145
Level 1 Laparoscopy and Related Services	255	$27,548	$6,504
Level 5 Urology and Related Services	234	$26,661	$5,836
Level 5 Musculoskeletal Procedures	230	$38,070	$14,891
Level 2 Laparoscopy and Related Services	230	$41,464	$11,656
Level 4 Airway Endoscopy	188	$18,341	$4,114
Level 4 Urology and Related Services	182	$21,038	$3,915
Level 2 Pacemaker and Similar Procedures	167	$22,333	$9,613
Level 4 Endovascular Procedures	162	$50,599	$19,898
Level 4 Vascular Procedures	148	$34,843	$6,220
Level 2 Endovascular Procedures	138	$24,184	$6,392
Level 1 Intraocular Procedures	124	$12,969	$2,619
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	123	$21,220	$3,911
Level 1 Breast/Lymphatic Surgery and Related Procedures	122	$20,207	$4,282
Level 5 ENT Procedures	104	$27,969	$6,626
Level 5 Airway Endoscopy	96	$26,160	$7,788
Level 2 Urology and Related Services	89	$2,496	$770

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mount Sinai Hospital charged $163,338 on average, 40% more than the New York average of $116,930, and was paid $34,560 against a state average of $24,426. For Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC (DRG 322), Mount Sinai Hospital charged $66,648 on average, 35% less than the New York average of $102,482, and was paid $26,321 against a state average of $22,289. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Mount Sinai Hospital charged $184,294 on average, 18% less than the New York average of $225,176, and was paid $65,750 against a state average of $54,006. For Heart Failure and Shock with MCC (DRG 291), Mount Sinai Hospital charged $133,647 on average, 65% more than the New York average of $81,161, and was paid $25,110 against a state average of $16,034. For Level 3 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5073), its average charge of $19,679 was 12% below the state average of $22,362. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $84,988 was 49% below the state average of $168,194. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $15,750 was 38% below the state average of $25,359. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $36,887 was 48% below the state average of $70,682.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Mount Sinai Hospital in New York, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2021-04-19 (CMS case 3)
CAP Request — 2021-09-30 (CMS case 3)
Closure Notice — 2023-02-14 (CMS case 3)
Warning Notice — 2025-04-28 (CMS case 4115)
Closure Notice — 2025-05-16 (CMS case 4115)

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.