New York / Mount Sinai West
CMS certification 330046 · New York, NY · 2 entries in CMS's price-transparency list
Mount Sinai West: charges and Medicare payments
Mount Sinai West reported 4,907 Medicare inpatient stays across 138 DRGs in 2024. Across them it charged 5.58 times what it was paid — among the higher ratios in New York, number 23 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: 559 stays at an average charge of $176,977, 96% above the national average. It also billed 3,231 outpatient services, charging 4.3 times what Medicare paid.
- 1Medicare inpatient stays 4,907
- 2Charge ÷ paid, inpatient 5.58×
- 3Rank in NY (highest ratio = 1) 23 of 123
- 4CMS price-transparency actions 2
Inpatient stays
For the 138 DRGs that can be compared with the national average, Mount Sinai West charged more than the national average in 123 (89%). 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 | 559 | $176,977 | +96% | $28,988 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 155 | $151,824 | +100% | $23,366 |
| 291 Heart Failure and Shock with MCC | 150 | $125,049 | +122% | $19,498 |
| 312 Syncope and Collapse | 123 | $66,724 | +47% | $12,362 |
| 177 Respiratory Infections and Inflammations with MCC | 110 | $128,209 | +82% | $23,104 |
| 689 Kidney and Urinary Tract Infections with MCC | 101 | $131,991 | +157% | $19,000 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 99 | $74,061 | -21% | $24,680 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 96 | $124,297 | +106% | $20,746 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 84 | $410,752 | +79% | $74,133 |
| 193 Simple Pneumonia and Pleurisy with MCC | 83 | $107,587 | +80% | $18,931 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 80 | $147,657 | +101% | $24,694 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 73 | $228,475 | +129% | $34,365 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 73 | $99,804 | +148% | $15,219 |
| 682 Renal Failure with MCC | 72 | $143,098 | +117% | $22,209 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 68 | $88,346 | +80% | $14,795 |
| 481 Hip and Femur Procedures except Major Joint with CC | 64 | $156,009 | +55% | $28,202 |
| 552 Medical Back Problems without MCC | 61 | $87,314 | +79% | $14,256 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 58 | $199,217 | +44% | $38,920 |
| 027 Craniotomy and Endovascular Intracranial Procedures without... | 53 | $86,395 | -38% | $32,034 |
| 690 Kidney and Urinary Tract Infections without MCC | 53 | $68,738 | +82% | $11,850 |
| 603 Cellulitis without MCC | 52 | $70,851 | +90% | $12,860 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 52 | $78,728 | +112% | $12,596 |
| 056 Degenerative Nervous System Disorders with MCC | 50 | $191,808 | +100% | $38,124 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 47 | $156,431 | 0% | $42,103 |
| 378 Gastrointestinal Hemorrhage with CC | 45 | $94,070 | +94% | $14,220 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 45 | $98,801 | +62% | $17,520 |
| 377 Gastrointestinal Hemorrhage with MCC | 43 | $178,476 | +109% | $26,884 |
| 551 Medical Back Problems with MCC | 42 | $138,751 | +76% | $24,268 |
| 100 Seizures with MCC | 41 | $221,862 | +135% | $33,710 |
| 811 Red Blood Cell Disorders with MCC | 40 | $126,444 | +85% | $20,008 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 39 | $333,584 | +44% | $59,662 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 39 | $63,325 | +75% | $10,513 |
| 683 Renal Failure with CC | 39 | $86,341 | +112% | $13,698 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 39 | $638,863 | +98% | $100,579 |
| 091 Other Disorders of Nervous System with MCC | 38 | $135,915 | +64% | $23,693 |
| 092 Other Disorders of Nervous System with CC | 38 | $78,535 | +52% | $14,539 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 38 | $146,827 | +125% | $22,228 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 38 | $123,693 | +118% | $16,860 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 36 | $97,491 | +93% | $14,880 |
| 884 Organic Disturbances and Intellectual Disability | 36 | $146,242 | +134% | $26,643 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 35 | $101,372 | +82% | $14,523 |
| 101 Seizures without MCC | 35 | $83,671 | +72% | $13,424 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 35 | $83,814 | +66% | $13,274 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 35 | $134,149 | +31% | $28,145 |
| 057 Degenerative Nervous System Disorders without MCC | 32 | $155,270 | +174% | $27,680 |
| 189 Pulmonary Edema and Respiratory Failure | 32 | $109,858 | +91% | $18,633 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 32 | $56,159 | +52% | $11,145 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 31 | $510,455 | +82% | $85,106 |
| 637 Diabetes with MCC | 31 | $148,010 | +123% | $22,873 |
| 253 Other Vascular Procedures with CC | 30 | $122,809 | -7% | $34,040 |
| 460 Spinal Fusion except Cervical without MCC | 30 | $182,091 | +7% | $47,377 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 29 | $67,536 | +59% | $12,145 |
| 149 Dysequilibrium | 28 | $65,870 | +48% | $10,492 |
| 393 Other Digestive System Diagnoses with MCC | 28 | $140,119 | +82% | $22,835 |
| 270 Other Major Cardiovascular Procedures with MCC | 27 | $515,702 | +99% | $92,415 |
| 974 HIV with Major Related Condition with MCC | 27 | $238,279 | +59% | $48,072 |
| 252 Other Vascular Procedures with MCC | 26 | $375,951 | +120% | $56,913 |
| 271 Other Major Cardiovascular Procedures with CC | 26 | $179,924 | +3% | $46,912 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 26 | $146,776 | -10% | $39,891 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 26 | $117,013 | -7% | $31,534 |
Showing the 60 most frequent of 138 DRGs.
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mount Sinai West charged $176,977 on average, 51% more than the New York average of $116,930, and was paid $28,988 against a state average of $24,426. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Mount Sinai West charged $151,824 on average, 48% more than the New York average of $102,833, and was paid $23,366 against a state average of $21,127. For Heart Failure and Shock with MCC (DRG 291), Mount Sinai West charged $125,049 on average, 54% more than the New York average of $81,161, and was paid $19,498 against a state average of $16,034. For Syncope and Collapse (DRG 312), Mount Sinai West charged $66,724 on average, 14% more than the New York average of $58,334, and was paid $12,362 against a state average of $11,568. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $44,491 was 37% below the state average of $70,682. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $16,776 was 34% below the state average of $25,359. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $96,439 was 43% below the state average of $168,194. For Level 6 Urology and Related Services (outpatient APC 5376), its average charge of $27,206 was 51% below the state average of $55,845.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Mount Sinai West 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 — 2025-04-16 (CMS case 3809)
- Closure Notice — 2025-06-27 (CMS case 3809)
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.