New York / Rochester General Hospital

CMS certification 330125 · Rochester, NY · 1 entry in CMS's price-transparency list

Rochester General Hospital: charges and Medicare payments

Rochester General Hospital reported 2,545 Medicare inpatient stays across 89 DRGs in 2024. Across them it charged 2.45 times what it was paid — mid-range in New York, number 79 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: 205 stays at an average charge of $56,755, 37% below the national average. It also billed 2,125 outpatient services, charging 4.24 times what Medicare paid.

1Medicare inpatient stays 2,545
2Charge ÷ paid, inpatient 2.45×
3Rank in NY (highest ratio = 1) 79 of 123
4CMS price-transparency actions 1

Average charge per stay at Rochester General Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 89 DRGs that can be compared with the national average, Rochester General Hospital 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	205	$56,755	-37%	$22,197
291 Heart Failure and Shock with MCC	140	$30,391	-46%	$13,619
177 Respiratory Infections and Inflammations with MCC	77	$48,567	-31%	$19,076
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	72	$19,468	-52%	$8,478
286 Circulatory Disorders except AMI, with Cardiac...	62	$69,121	-38%	$25,503
267 Endovascular Cardiac Valve Replacement and Supplement...	59	$150,953	-32%	$49,439
071 Other Cerebrovascular Disorders with CC	57	$27,459	-46%	$11,678
189 Pulmonary Edema and Respiratory Failure	51	$45,681	-21%	$15,733
853 Infectious and Parasitic Diseases with O.R. Procedures with...	51	$133,524	-42%	$52,699
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	50	$25,354	-48%	$11,439
193 Simple Pneumonia and Pleurisy with MCC	45	$29,959	-50%	$14,219
266 Endovascular Cardiac Valve Replacement and Supplement...	43	$170,092	-40%	$61,437
378 Gastrointestinal Hemorrhage with CC	41	$28,216	-42%	$11,592
280 Acute Myocardial Infarction, Discharged Alive with MCC	40	$36,289	-52%	$19,341
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	39	$22,956	-38%	$8,966
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	38	$60,328	-40%	$21,129
698 Other Kidney and Urinary Tract Diagnoses with MCC	38	$43,187	-41%	$17,918
274 Percutaneous and Other Intracardiac Procedures without MCC	37	$100,972	-36%	$33,024
312 Syncope and Collapse	37	$19,240	-58%	$9,495
683 Renal Failure with CC	37	$22,400	-45%	$10,936
101 Seizures without MCC	35	$22,834	-53%	$9,761
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	34	$33,625	-40%	$13,142
603 Cellulitis without MCC	34	$17,693	-53%	$10,488
690 Kidney and Urinary Tract Infections without MCC	34	$17,022	-55%	$9,245
287 Circulatory Disorders except AMI, with Cardiac...	33	$30,674	-52%	$12,321
377 Gastrointestinal Hemorrhage with MCC	32	$47,366	-45%	$18,689
178 Respiratory Infections and Inflammations with CC	31	$27,027	-40%	$11,781
322 Percutaneous Cardiovascular Procedures with Intraluminal...	31	$69,473	-39%	$21,257
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	31	$21,715	-64%	$12,969
314 Other Circulatory System Diagnoses with MCC	30	$43,037	-55%	$21,378
190 Chronic Obstructive Pulmonary Disease with MCC	29	$24,667	-51%	$11,915
552 Medical Back Problems without MCC	29	$28,036	-43%	$12,160
309 Cardiac Arrhythmia and Conduction Disorders with CC	27	$16,710	-54%	$8,303
270 Other Major Cardiovascular Procedures with MCC	26	$180,389	-30%	$68,070
637 Diabetes with MCC	26	$41,409	-38%	$15,798
039 Extracranial Procedures without CC/MCC	25	$17,416	-73%	$16,607
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	25	$150,612	-30%	$55,949
057 Degenerative Nervous System Disorders without MCC	23	$35,345	-38%	$14,335
470 Major Hip and Knee Joint Replacement or Reattachment of...	23	$45,903	-51%	$20,121
100 Seizures with MCC	22	$37,584	-60%	$19,541
394 Other Digestive System Diagnoses with CC	22	$20,571	-56%	$10,845
812 Red Blood Cell Disorders without MCC	22	$32,628	-26%	$10,889
070 Other Cerebrovascular Disorders with MCC	21	$36,584	-52%	$18,232
092 Other Disorders of Nervous System with CC	21	$29,729	-42%	$11,449
194 Simple Pneumonia and Pleurisy with CC	21	$19,473	-49%	$9,946
191 Chronic Obstructive Pulmonary Disease with CC	20	$17,635	-55%	$10,318
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	20	$22,224	-48%	$9,830
269 Aortic and Heart Assist Procedures except Pulsation Balloon...	19	$119,802	-38%	$40,873
321 Percutaneous Cardiovascular Procedures with Intraluminal...	19	$105,156	-36%	$32,488
673 Other Kidney and Urinary Tract Procedures with MCC	19	$91,399	-47%	$39,291
699 Other Kidney and Urinary Tract Diagnoses with CC	19	$17,448	-63%	$11,285
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	19	$27,982	-25%	$9,979
281 Acute Myocardial Infarction, Discharged Alive with CC	18	$26,260	-48%	$10,736
308 Cardiac Arrhythmia and Conduction Disorders with MCC	18	$27,747	-51%	$13,499
389 Gastrointestinal Obstruction with CC	17	$19,482	-50%	$9,417
682 Renal Failure with MCC	17	$31,685	-52%	$16,093
870 Septicemia or Severe Sepsis with MV >96 Hours	17	$222,124	-31%	$86,091
315 Other Circulatory System Diagnoses with CC	16	$21,469	-55%	$10,660
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	16	$47,618	-22%	$12,926
481 Hip and Femur Procedures except Major Joint with CC	16	$49,637	-51%	$21,569

Showing the 60 most frequent of 89 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	340	$10,420	$2,834
Level 1 Endovascular Procedures	221	$13,038	$3,415
Level 2 Excision/ Biopsy/ Incision and Drainage	127	$8,568	$1,602
Level 3 Electrophysiologic Procedures	115	$100,001	$24,907
Level 3 Vascular Procedures	107	$12,233	$3,354
Level 3 Endovascular Procedures	85	$49,397	$11,295
Level 4 Urology and Related Services	82	$11,447	$3,591
Level 5 Urology and Related Services	82	$12,506	$5,382
Level 5 Musculoskeletal Procedures	65	$30,970	$13,437
Level 2 Endovascular Procedures	65	$23,901	$5,986
Level 1 Laparoscopy and Related Services	58	$16,903	$5,866
Level 4 Vascular Procedures	57	$25,518	$5,745
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	56	$11,356	$3,482
Level 3 Urology and Related Services	56	$12,593	$2,129
Level 3 Pacemaker and Similar Procedures	49	$33,954	$11,111
Level 2 Pacemaker and Similar Procedures	45	$21,357	$9,003
Level 2 Upper GI Procedures	45	$6,433	$2,017
Level 4 ENT Procedures	42	$5,625	$1,870
Level 4 Endovascular Procedures	42	$78,316	$18,151
Level 2 Breast/Lymphatic Surgery and Related Procedures	40	$22,741	$6,501
Level 1 Breast/Lymphatic Surgery and Related Procedures	38	$13,301	$4,041
Level 3 Excision/ Biopsy/ Incision and Drainage	31	$14,853	$2,858
Level 2 Laparoscopy and Related Services	31	$31,548	$10,603
Level 2 Vascular Procedures	28	$3,959	$1,553
Level 2 ICD and Similar Procedures	25	$107,945	$33,446

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Rochester General Hospital charged $56,755 on average, 51% less than the New York average of $116,930, and was paid $22,197 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Rochester General Hospital charged $30,391 on average, 63% less than the New York average of $81,161, and was paid $13,619 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), Rochester General Hospital charged $48,567 on average, 49% less than the New York average of $94,371, and was paid $19,076 against a state average of $19,472. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Rochester General Hospital charged $19,468 on average, 61% less than the New York average of $50,017, and was paid $8,478 against a state average of $9,945. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $10,420 was 61% below the state average of $26,675. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $13,038 was 49% below the state average of $25,359. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,568 was 33% below the state average of $12,815. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $100,001 was 41% below the state average of $168,194.

Price-transparency record

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

Met Requirements — 2025-04-11 (CMS case 3782)

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.