New York / Phelps Hospital
CMS certification 330261 · Sleepy Hollow, NY · 4 entries in CMS's price-transparency list
Phelps Hospital: charges and Medicare payments
Phelps Hospital reported 1,551 Medicare inpatient stays across 54 DRGs in 2024. Across them it charged 6.33 times what it was paid — among the higher ratios in New York, number 12 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: 332 stays at an average charge of $117,256, 30% above the national average. It also billed 1,694 outpatient services, charging 10.62 times what Medicare paid.
- 1Medicare inpatient stays 1,551
- 2Charge ÷ paid, inpatient 6.33×
- 3Rank in NY (highest ratio = 1) 12 of 123
- 4CMS price-transparency actions 4
Inpatient stays
For the 54 DRGs that can be compared with the national average, Phelps Hospital charged more than the national average in 52 (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 | 332 | $117,256 | +30% | $20,180 |
| 291 Heart Failure and Shock with MCC | 96 | $91,482 | +62% | $13,335 |
| 177 Respiratory Infections and Inflammations with MCC | 79 | $115,349 | +63% | $16,176 |
| 689 Kidney and Urinary Tract Infections with MCC | 70 | $80,255 | +56% | $11,554 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 47 | $74,474 | +52% | $10,381 |
| 193 Simple Pneumonia and Pleurisy with MCC | 43 | $81,816 | +37% | $12,995 |
| 690 Kidney and Urinary Tract Infections without MCC | 43 | $60,070 | +59% | $8,353 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 42 | $101,868 | +39% | $17,855 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 38 | $151,356 | +52% | $20,324 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 34 | $252,501 | +10% | $50,229 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 31 | $72,974 | +21% | $12,614 |
| 378 Gastrointestinal Hemorrhage with CC | 29 | $91,239 | +88% | $11,518 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 27 | $91,972 | +65% | $10,028 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 26 | $107,705 | +76% | $14,066 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 25 | $61,585 | +66% | $7,956 |
| 603 Cellulitis without MCC | 24 | $65,640 | +76% | $10,194 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $60,887 | +52% | $8,272 |
| 884 Organic Disturbances and Intellectual Disability | 22 | $79,486 | +27% | $16,350 |
| 552 Medical Back Problems without MCC | 21 | $66,155 | +35% | $9,575 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $108,070 | +7% | $20,423 |
| 057 Degenerative Nervous System Disorders without MCC | 19 | $80,224 | +42% | $13,514 |
| 189 Pulmonary Edema and Respiratory Failure | 18 | $84,470 | +47% | $12,780 |
| 682 Renal Failure with MCC | 18 | $85,889 | +30% | $14,298 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 18 | $58,253 | +23% | $10,406 |
| 713 Transurethral Prostatectomy with CC/MCC | 18 | $139,150 | +82% | $17,730 |
| 312 Syncope and Collapse | 17 | $65,512 | +44% | $8,908 |
| 895 Alcohol, Drug Abuse or Dependence with Rehabilitation... | 17 | $140,913 | +312% | $18,519 |
| 330 Major Small and Large Bowel Procedures with CC | 16 | $140,610 | +18% | $22,510 |
| 101 Seizures without MCC | 15 | $41,253 | -15% | $9,093 |
| 194 Simple Pneumonia and Pleurisy with CC | 15 | $60,569 | +58% | $8,485 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 15 | $54,023 | +50% | $7,487 |
| 393 Other Digestive System Diagnoses with MCC | 15 | $102,952 | +34% | $16,662 |
| 683 Renal Failure with CC | 15 | $68,865 | +69% | $8,980 |
| 811 Red Blood Cell Disorders with MCC | 15 | $103,948 | +52% | $15,228 |
| 252 Other Vascular Procedures with MCC | 14 | $209,080 | +22% | $34,960 |
| 377 Gastrointestinal Hemorrhage with MCC | 14 | $124,637 | +46% | $18,594 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 14 | $52,916 | +24% | $9,027 |
| 643 Endocrine Disorders with MCC | 14 | $105,006 | +42% | $17,114 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 14 | $74,580 | +11% | $12,877 |
| 149 Dysequilibrium | 13 | $69,611 | +57% | $7,811 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $75,801 | +50% | $10,960 |
| 329 Major Small and Large Bowel Procedures with MCC | 13 | $317,390 | +48% | $46,624 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 13 | $84,039 | +71% | $10,749 |
| 602 Cellulitis with MCC | 13 | $122,207 | +103% | $13,998 |
| 644 Endocrine Disorders with CC | 13 | $75,756 | +58% | $10,766 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 12 | $135,302 | +32% | $20,978 |
| 556 Signs and Symptoms of Musculoskeletal System and Connective... | 12 | $68,556 | +70% | $10,517 |
| 100 Seizures with MCC | 11 | $79,181 | -16% | $19,784 |
| 178 Respiratory Infections and Inflammations with CC | 11 | $60,572 | +34% | $9,441 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 11 | $80,399 | +6% | $13,245 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 11 | $71,189 | +26% | $12,400 |
| 389 Gastrointestinal Obstruction with CC | 11 | $40,382 | +4% | $7,416 |
| 394 Other Digestive System Diagnoses with CC | 11 | $52,163 | +11% | $9,708 |
| 542 Pathological Fractures and Musculoskeletal and Connective... | 11 | $92,599 | +16% | $15,896 |
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Phelps Hospital charged $117,256 on average, 0% less than the New York average of $116,930, and was paid $20,180 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Phelps Hospital charged $91,482 on average, 13% more than the New York average of $81,161, and was paid $13,335 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), Phelps Hospital charged $115,349 on average, 22% more than the New York average of $94,371, and was paid $16,176 against a state average of $19,472. For Kidney and Urinary Tract Infections with MCC (DRG 689), Phelps Hospital charged $80,255 on average, 6% more than the New York average of $75,577, and was paid $11,554 against a state average of $14,604. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $52,136 was 95% above the state average of $26,675. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $22,222 was 37% above the state average of $16,178. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,920 was 24% above the state average of $12,815. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $24,937 was 65% above the state average of $15,077.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Phelps Hospital in Sleepy Hollow, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-02-01 (CMS case 245)
- Closure Notice — 2024-05-08 (CMS case 245)
- Warning Notice — 2025-07-30 (CMS case 6031)
- Closure Notice — 2025-11-12 (CMS case 6031)
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.