New York / Oneida Health
CMS certification 330115 · Oneida, NY
Oneida Health: charges and Medicare payments
Oneida Health reported 287 Medicare inpatient stays across 11 DRGs in 2024. Across them it charged 1.6 times what it was paid — among the lower ratios in New York, number 112 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: 113 stays at an average charge of $26,943, 70% below the national average. It also billed 553 outpatient services, charging 4.8 times what Medicare paid.
- 1Medicare inpatient stays 287
- 2Charge ÷ paid, inpatient 1.6×
- 3Rank in NY (highest ratio = 1) 112 of 123
- 4CMS price-transparency actions 0
Inpatient stays
For the 11 DRGs that can be compared with the national average, Oneida Health charged more than the national average in 0 (0%). 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 | 113 | $26,943 | -70% | $18,090 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 34 | $18,012 | -63% | $9,985 |
| 189 Pulmonary Edema and Respiratory Failure | 28 | $27,128 | -53% | $11,950 |
| 291 Heart Failure and Shock with MCC | 22 | $18,871 | -67% | $11,706 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 15 | $59,330 | -74% | $43,828 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $12,206 | -67% | $7,554 |
| 683 Renal Failure with CC | 13 | $15,550 | -62% | $8,683 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 13 | $17,883 | -76% | $13,699 |
| 177 Respiratory Infections and Inflammations with MCC | 12 | $33,079 | -53% | $17,288 |
| 194 Simple Pneumonia and Pleurisy with CC | 12 | $19,078 | -50% | $7,874 |
| 193 Simple Pneumonia and Pleurisy with MCC | 11 | $17,403 | -71% | $12,311 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Upper GI Procedures | 101 | $7,986 | $2,017 |
| Comprehensive Observation Services | 88 | $12,597 | $2,836 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 82 | $6,755 | $1,656 |
| Level 3 Vascular Procedures | 44 | $14,439 | $3,320 |
| Level 5 Musculoskeletal Procedures | 38 | $50,707 | $13,930 |
| Level 1 Laparoscopy and Related Services | 33 | $25,311 | $6,118 |
| Level 4 Urology and Related Services | 31 | $12,627 | $3,696 |
| Level 3 Lower GI Procedures | 24 | $9,416 | $2,684 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 22 | $15,146 | $3,668 |
| Level 4 Airway Endoscopy | 17 | $15,123 | $3,970 |
| Level 2 Breast/Lymphatic Surgery and Related Procedures | 16 | $30,905 | $6,914 |
| Level 3 Urology and Related Services | 16 | $7,084 | $2,160 |
| Level 2 Musculoskeletal Procedures | 15 | $6,924 | $1,614 |
| Level 1 Breast/Lymphatic Surgery and Related Procedures | 14 | $12,737 | $4,041 |
| Level 5 Urology and Related Services | 12 | $18,147 | $5,486 |
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Oneida Health charged $26,943 on average, 77% less than the New York average of $116,930, and was paid $18,090 against a state average of $24,426. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Oneida Health charged $18,012 on average, 71% less than the New York average of $61,129, and was paid $9,985 against a state average of $12,692. For Pulmonary Edema and Respiratory Failure (DRG 189), Oneida Health charged $27,128 on average, 63% less than the New York average of $74,150, and was paid $11,950 against a state average of $15,119. For Heart Failure and Shock with MCC (DRG 291), Oneida Health charged $18,871 on average, 77% less than the New York average of $81,161, and was paid $11,706 against a state average of $16,034. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $7,986 was 47% below the state average of $15,077. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,597 was 53% below the state average of $26,675. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,755 was 47% below the state average of $12,815. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $14,439 was 22% below the state average of $18,520.
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.