New York / Mount St Mary's Hospital and Health Center
CMS certification 330188 · Lewiston, NY
Mount St Mary's Hospital and Health Center: charges and Medicare payments
Mount St Mary's Hospital and Health Center reported 364 Medicare inpatient stays across 16 DRGs in 2024. Across them it charged 2.25 times what it was paid — among the lower ratios in New York, number 86 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: 78 stays at an average charge of $42,204, 53% below the national average. It also billed 303 outpatient services, charging 4.48 times what Medicare paid.
- 1Medicare inpatient stays 364
- 2Charge ÷ paid, inpatient 2.25×
- 3Rank in NY (highest ratio = 1) 86 of 123
- 4CMS price-transparency actions 0
Inpatient stays
For the 16 DRGs that can be compared with the national average, Mount St Mary's Hospital and Health Center charged more than the national average in 1 (6%). 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 | 78 | $42,204 | -53% | $18,612 |
| 291 Heart Failure and Shock with MCC | 44 | $23,341 | -59% | $13,280 |
| 895 Alcohol, Drug Abuse or Dependence with Rehabilitation... | 27 | $57,937 | +69% | $14,193 |
| 189 Pulmonary Edema and Respiratory Failure | 25 | $27,552 | -52% | $11,136 |
| 194 Simple Pneumonia and Pleurisy with CC | 24 | $14,024 | -63% | $9,420 |
| 193 Simple Pneumonia and Pleurisy with MCC | 22 | $27,827 | -53% | $13,289 |
| 177 Respiratory Infections and Inflammations with MCC | 19 | $35,607 | -50% | $14,353 |
| 683 Renal Failure with CC | 17 | $15,683 | -61% | $8,099 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $16,198 | -57% | $7,589 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $13,566 | -72% | $9,817 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 14 | $13,308 | -74% | $9,905 |
| 638 Diabetes with CC | 14 | $12,953 | -69% | $7,798 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 13 | $18,465 | -67% | $8,878 |
| 894 Alcohol, Drug Abuse or Dependence, Left Ama | 13 | $27,175 | -4% | $5,599 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $16,584 | -55% | $6,969 |
| 682 Renal Failure with MCC | 12 | $19,291 | -71% | $13,471 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 190 | $8,597 | $2,890 |
| Level 1 Intraocular Procedures | 60 | $7,042 | $988 |
| Level 3 Urology and Related Services | 18 | $4,934 | $1,728 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 13 | $4,032 | $1,243 |
| Level 2 Upper GI Procedures | 11 | $3,826 | $807 |
| Level 2 Intraocular Procedures | 11 | $18,061 | $1,724 |
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mount St Mary's Hospital and Health Center charged $42,204 on average, 64% less than the New York average of $116,930, and was paid $18,612 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Mount St Mary's Hospital and Health Center charged $23,341 on average, 71% less than the New York average of $81,161, and was paid $13,280 against a state average of $16,034. For Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy (DRG 895), Mount St Mary's Hospital and Health Center charged $57,937 on average, 30% less than the New York average of $82,693, and was paid $14,193 against a state average of $17,436. For Pulmonary Edema and Respiratory Failure (DRG 189), Mount St Mary's Hospital and Health Center charged $27,552 on average, 63% less than the New York average of $74,150, and was paid $11,136 against a state average of $15,119. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $8,597 was 68% below the state average of $26,675. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $7,042 was 56% below the state average of $16,178. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $4,934 was 62% below the state average of $13,044. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $4,032 was 69% below the state average of $12,815.
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.