New York / Mount Sinai South Nassau
CMS certification 330198 · Oceanside, NY · 3 entries in CMS's price-transparency list
Mount Sinai South Nassau: charges and Medicare payments
Mount Sinai South Nassau reported 5,144 Medicare inpatient stays across 112 DRGs in 2024. Across them it charged 7.13 times what it was paid — among the higher ratios in New York, number 7 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: 1110 stays at an average charge of $149,635, 66% above the national average. It also billed 4,003 outpatient services, charging 11.49 times what Medicare paid.
- 1Medicare inpatient stays 5,144
- 2Charge ÷ paid, inpatient 7.13×
- 3Rank in NY (highest ratio = 1) 7 of 123
- 4CMS price-transparency actions 3
Inpatient stays
For the 112 DRGs that can be compared with the national average, Mount Sinai South Nassau charged more than the national average in 108 (96%). 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 | 1110 | $149,635 | +66% | $20,621 |
| 291 Heart Failure and Shock with MCC | 253 | $107,526 | +91% | $12,873 |
| 177 Respiratory Infections and Inflammations with MCC | 177 | $122,690 | +74% | $16,806 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 167 | $89,346 | +82% | $11,230 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 141 | $335,959 | +47% | $51,934 |
| 193 Simple Pneumonia and Pleurisy with MCC | 136 | $111,030 | +86% | $14,927 |
| 689 Kidney and Urinary Tract Infections with MCC | 105 | $97,162 | +89% | $11,980 |
| 377 Gastrointestinal Hemorrhage with MCC | 101 | $144,124 | +69% | $18,093 |
| 682 Renal Failure with MCC | 95 | $128,774 | +95% | $15,305 |
| 683 Renal Failure with CC | 85 | $77,923 | +91% | $9,912 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 83 | $160,586 | +61% | $21,937 |
| 481 Hip and Femur Procedures except Major Joint with CC | 83 | $129,145 | +28% | $21,143 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 79 | $118,708 | +62% | $16,837 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 75 | $405,937 | +26% | $67,550 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 72 | $122,692 | +120% | $11,065 |
| 378 Gastrointestinal Hemorrhage with CC | 68 | $93,207 | +92% | $10,314 |
| 603 Cellulitis without MCC | 67 | $66,281 | +78% | $9,629 |
| 189 Pulmonary Edema and Respiratory Failure | 65 | $115,118 | +100% | $13,019 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 65 | $72,816 | +81% | $8,836 |
| 690 Kidney and Urinary Tract Infections without MCC | 63 | $86,327 | +128% | $9,021 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 59 | $83,424 | +38% | $13,105 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 51 | $173,142 | +51% | $19,461 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 49 | $116,047 | +53% | $16,157 |
| 330 Major Small and Large Bowel Procedures with CC | 46 | $130,290 | +9% | $25,531 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 43 | $59,873 | +66% | $8,037 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 42 | $74,750 | +48% | $11,012 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 42 | $163,998 | +46% | $22,092 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 41 | $90,171 | +59% | $12,885 |
| 393 Other Digestive System Diagnoses with MCC | 40 | $135,850 | +77% | $18,036 |
| 312 Syncope and Collapse | 39 | $90,682 | +99% | $9,437 |
| 552 Medical Back Problems without MCC | 38 | $87,137 | +78% | $10,571 |
| 184 Major Chest Trauma with CC | 37 | $82,806 | +49% | $12,197 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 36 | $83,489 | +31% | $10,756 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 36 | $118,073 | +15% | $21,342 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 35 | $182,306 | +31% | $28,679 |
| 811 Red Blood Cell Disorders with MCC | 35 | $109,890 | +61% | $14,470 |
| 813 Coagulation Disorders | 34 | $89,335 | +12% | $15,920 |
| 100 Seizures with MCC | 33 | $100,808 | +7% | $24,764 |
| 101 Seizures without MCC | 31 | $70,700 | +45% | $9,287 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 31 | $101,982 | +67% | $13,432 |
| 602 Cellulitis with MCC | 31 | $113,786 | +89% | $15,698 |
| 004 Tracheostomy with MV >96 Hours or Principal Diagnosis except... | 30 | $953,241 | +55% | $138,618 |
| 314 Other Circulatory System Diagnoses with MCC | 30 | $143,349 | +51% | $20,628 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 30 | $240,014 | +47% | $35,520 |
| 394 Other Digestive System Diagnoses with CC | 30 | $69,446 | +48% | $10,167 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 28 | $184,301 | +36% | $27,348 |
| 389 Gastrointestinal Obstruction with CC | 28 | $77,229 | +98% | $8,866 |
| 194 Simple Pneumonia and Pleurisy with CC | 26 | $73,748 | +92% | $8,722 |
| 329 Major Small and Large Bowel Procedures with MCC | 26 | $251,083 | +17% | $43,436 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 26 | $72,824 | +71% | $9,040 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 25 | $113,496 | +55% | $14,510 |
| 388 Gastrointestinal Obstruction with MCC | 25 | $116,536 | +70% | $15,358 |
| 178 Respiratory Infections and Inflammations with CC | 24 | $88,602 | +96% | $10,352 |
| 638 Diabetes with CC | 24 | $67,923 | +63% | $10,035 |
| 091 Other Disorders of Nervous System with MCC | 22 | $151,646 | +83% | $18,543 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 22 | $83,455 | +76% | $11,763 |
| 637 Diabetes with MCC | 22 | $90,896 | +37% | $14,627 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 22 | $144,090 | +47% | $22,084 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 21 | $307,675 | +33% | $44,466 |
| 551 Medical Back Problems with MCC | 21 | $196,713 | +150% | $18,693 |
Showing the 60 most frequent of 112 DRGs.
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mount Sinai South Nassau charged $149,635 on average, 28% more than the New York average of $116,930, and was paid $20,621 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Mount Sinai South Nassau charged $107,526 on average, 32% more than the New York average of $81,161, and was paid $12,873 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), Mount Sinai South Nassau charged $122,690 on average, 30% more than the New York average of $94,371, and was paid $16,806 against a state average of $19,472. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Mount Sinai South Nassau charged $89,346 on average, 46% more than the New York average of $61,129, and was paid $11,230 against a state average of $12,692. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $66,163 was 148% above the state average of $26,675. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $16,478 was 29% above the state average of $12,815. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $117,895 was 67% above the state average of $70,682. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $40,502 was 60% above the state average of $25,359.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Mount Sinai South Nassau in Oceanside, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-09-30 (CMS case 2655)
- CAP Request — 2025-01-10 (CMS case 2655)
- Closure Notice — 2025-03-10 (CMS case 2655)
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.