New York / New York-Presbyterian/Queens

CMS certification 330055 · Flushing, NY · 1 entry in CMS's price-transparency list

New York-Presbyterian/Queens: charges and Medicare payments

New York-Presbyterian/Queens reported 4,779 Medicare inpatient stays across 117 DRGs in 2024. Across them it charged 5.37 times what it was paid — among the higher ratios in New York, number 27 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: 896 stays at an average charge of $143,945, 59% above the national average. It also billed 1,384 outpatient services, charging 4.62 times what Medicare paid.

1Medicare inpatient stays 4,779
2Charge ÷ paid, inpatient 5.37×
3Rank in NY (highest ratio = 1) 27 of 123
4CMS price-transparency actions 1

Average charge per stay at New York-Presbyterian/Queens, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 117 DRGs that can be compared with the national average, New York-Presbyterian/Queens charged more than the national average in 96 (82%). 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	896	$143,945	+59%	$25,092
291 Heart Failure and Shock with MCC	217	$109,164	+94%	$16,278
177 Respiratory Infections and Inflammations with MCC	129	$122,882	+74%	$19,575
470 Major Hip and Knee Joint Replacement or Reattachment of...	124	$74,243	-20%	$23,332
689 Kidney and Urinary Tract Infections with MCC	118	$86,529	+69%	$14,281
870 Septicemia or Severe Sepsis with MV >96 Hours	118	$376,766	+17%	$79,085
193 Simple Pneumonia and Pleurisy with MCC	114	$113,189	+89%	$16,187
312 Syncope and Collapse	102	$63,467	+39%	$10,317
853 Infectious and Parasitic Diseases with O.R. Procedures with...	100	$323,469	+41%	$62,892
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	95	$71,084	+45%	$13,052
690 Kidney and Urinary Tract Infections without MCC	82	$62,996	+67%	$10,318
698 Other Kidney and Urinary Tract Diagnoses with MCC	75	$139,557	+90%	$22,036
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	72	$155,583	+56%	$26,163
683 Renal Failure with CC	70	$64,513	+58%	$11,855
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	66	$82,289	+36%	$15,371
378 Gastrointestinal Hemorrhage with CC	63	$77,210	+59%	$14,452
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	62	$57,645	+44%	$9,647
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	61	$94,238	+69%	$12,394
377 Gastrointestinal Hemorrhage with MCC	59	$116,092	+36%	$19,869
682 Renal Failure with MCC	55	$139,843	+112%	$21,921
309 Cardiac Arrhythmia and Conduction Disorders with CC	53	$47,396	+31%	$9,682
481 Hip and Femur Procedures except Major Joint with CC	52	$101,187	0%	$22,241
190 Chronic Obstructive Pulmonary Disease with MCC	51	$72,425	+43%	$13,363
393 Other Digestive System Diagnoses with MCC	49	$125,663	+64%	$20,088
394 Other Digestive System Diagnoses with CC	49	$66,545	+41%	$11,682
552 Medical Back Problems without MCC	49	$65,183	+33%	$12,648
101 Seizures without MCC	45	$54,921	+13%	$10,727
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	45	$56,508	+52%	$9,673
286 Circulatory Disorders except AMI, with Cardiac...	44	$184,546	+64%	$30,620
280 Acute Myocardial Infarction, Discharged Alive with MCC	43	$117,569	+55%	$18,494
057 Degenerative Nervous System Disorders without MCC	42	$69,833	+23%	$15,286
603 Cellulitis without MCC	36	$79,968	+114%	$11,450
313 Chest Pain	35	$56,959	+43%	$10,174
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	34	$96,764	-5%	$23,292
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	33	$51,249	+20%	$10,633
638 Diabetes with CC	33	$51,464	+23%	$10,105
314 Other Circulatory System Diagnoses with MCC	31	$123,544	+30%	$22,880
056 Degenerative Nervous System Disorders with MCC	30	$144,731	+51%	$27,009
100 Seizures with MCC	30	$104,102	+10%	$29,547
149 Dysequilibrium	30	$65,101	+47%	$9,435
189 Pulmonary Edema and Respiratory Failure	28	$81,715	+42%	$15,521
699 Other Kidney and Urinary Tract Diagnoses with CC	28	$74,807	+58%	$12,387
274 Percutaneous and Other Intracardiac Procedures without MCC	27	$112,787	-28%	$35,617
480 Hip and Femur Procedures except Major Joint with MCC	27	$138,612	0%	$32,997
948 Signs and Symptoms without MCC	27	$54,053	+42%	$10,780
299 Peripheral Vascular Disorders with MCC	26	$85,801	+14%	$18,037
305 Hypertension without MCC	25	$49,929	+25%	$9,246
308 Cardiac Arrhythmia and Conduction Disorders with MCC	25	$98,378	+74%	$15,101
321 Percutaneous Cardiovascular Procedures with Intraluminal...	24	$135,461	-17%	$31,619
551 Medical Back Problems with MCC	24	$99,599	+27%	$19,352
202 Bronchitis and Asthma with CC/MCC	23	$61,553	+33%	$12,554
637 Diabetes with MCC	23	$136,366	+105%	$23,420
811 Red Blood Cell Disorders with MCC	23	$82,423	+21%	$16,607
194 Simple Pneumonia and Pleurisy with CC	22	$67,011	+75%	$10,170
812 Red Blood Cell Disorders without MCC	22	$48,910	+10%	$11,255
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	21	$1,170,886	+11%	$248,666
322 Percutaneous Cardiovascular Procedures with Intraluminal...	21	$106,685	-7%	$23,167
086 Traumatic Stupor and Coma <1 Hour with CC	20	$67,787	-1%	$14,478
178 Respiratory Infections and Inflammations with CC	20	$70,247	+55%	$12,066
287 Circulatory Disorders except AMI, with Cardiac...	20	$73,006	+14%	$16,364

Showing the 60 most frequent of 117 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Excision/ Biopsy/ Incision and Drainage	122	$9,894	$1,813
Level 1 Endovascular Procedures	101	$16,920	$3,689
Level 4 Musculoskeletal Procedures	93	$29,162	$8,140
Level 4 Urology and Related Services	90	$18,948	$3,897
Level 2 Upper GI Procedures	78	$12,082	$2,143
Level 1 Intraocular Procedures	75	$18,183	$2,652
Level 3 Electrophysiologic Procedures	73	$71,499	$26,949
Level 2 Musculoskeletal Procedures	69	$14,542	$1,829
Level 5 Urology and Related Services	65	$22,667	$5,888
Level 1 Laparoscopy and Related Services	60	$28,799	$6,479
Level 3 Endovascular Procedures	56	$29,885	$12,500
Level 1 Breast/Lymphatic Surgery and Related Procedures	51	$22,021	$4,337
Level 3 Urology and Related Services	51	$17,773	$2,226
Level 3 Vascular Procedures	39	$25,353	$3,627
Level 3 Lower GI Procedures	34	$16,356	$3,194
Level 1 Nerve Procedures	34	$10,449	$2,197
Level 3 Musculoskeletal Procedures	33	$18,559	$3,683
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	33	$25,185	$3,937
Level 5 Musculoskeletal Procedures	29	$40,598	$14,030
Level 3 Pacemaker and Similar Procedures	25	$36,851	$12,111
Level 4 Vascular Procedures	23	$18,404	$5,981
Level 4 Gynecologic Procedures	23	$17,687	$3,434
Level 3 Upper GI Procedures	22	$11,930	$4,358
Level 2 Breast/Lymphatic Surgery and Related Procedures	21	$35,804	$7,420
Level 3 Excision/ Biopsy/ Incision and Drainage	20	$19,117	$3,105

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), New York-Presbyterian/Queens charged $143,945 on average, 23% more than the New York average of $116,930, and was paid $25,092 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), New York-Presbyterian/Queens charged $109,164 on average, 35% more than the New York average of $81,161, and was paid $16,278 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), New York-Presbyterian/Queens charged $122,882 on average, 30% more than the New York average of $94,371, and was paid $19,575 against a state average of $19,472. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), New York-Presbyterian/Queens charged $74,243 on average, 31% less than the New York average of $107,202, and was paid $23,332 against a state average of $23,235. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,894 was 23% below the state average of $12,815. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $16,920 was 33% below the state average of $25,359. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $29,162 was 28% below the state average of $40,421. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $18,948 was 7% below the state average of $20,339.

Price-transparency record

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

Met Requirements — 2023-05-23 (CMS case 1431)

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.