New York / St Anthony Community Hospital
CMS certification 330205 · Warwick, NY
St Anthony Community Hospital: charges and Medicare payments
St Anthony Community Hospital reported 280 Medicare inpatient stays across 13 DRGs in 2024. Across them it charged 8.63 times what it was paid — among the higher ratios in New York, number 4 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: 53 stays at an average charge of $125,962, 39% above the national average. It also billed 543 outpatient services, charging 10.82 times what Medicare paid.
- 1Medicare inpatient stays 280
- 2Charge ÷ paid, inpatient 8.63×
- 3Rank in NY (highest ratio = 1) 4 of 123
- 4CMS price-transparency actions 0
Inpatient stays
For the 13 DRGs that can be compared with the national average, St Anthony Community Hospital charged more than the national average in 13 (100%). 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 | 53 | $125,962 | +39% | $16,334 |
| 291 Heart Failure and Shock with MCC | 41 | $89,407 | +59% | $10,678 |
| 193 Simple Pneumonia and Pleurisy with MCC | 36 | $91,743 | +54% | $12,184 |
| 177 Respiratory Infections and Inflammations with MCC | 21 | $114,470 | +62% | $14,205 |
| 690 Kidney and Urinary Tract Infections without MCC | 17 | $81,537 | +116% | $6,787 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 16 | $77,111 | +92% | $11,762 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 16 | $107,948 | +120% | $8,347 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 15 | $64,482 | +27% | $11,455 |
| 689 Kidney and Urinary Tract Infections with MCC | 15 | $79,037 | +54% | $9,733 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $120,576 | +148% | $8,084 |
| 603 Cellulitis without MCC | 13 | $102,124 | +174% | $7,445 |
| 194 Simple Pneumonia and Pleurisy with CC | 12 | $76,077 | +98% | $6,934 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 12 | $156,930 | +68% | $15,844 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 119 | $53,889 | $3,060 |
| Level 5 Musculoskeletal Procedures | 112 | $109,395 | $14,339 |
| Level 6 Musculoskeletal Procedures | 60 | $140,517 | $20,920 |
| Level 1 Intraocular Procedures | 53 | $43,021 | $2,623 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 27 | $15,930 | $1,771 |
| Level 1 Nerve Procedures | 27 | $40,883 | $2,173 |
| Level 2 Upper GI Procedures | 26 | $35,108 | $2,141 |
| Level 4 Gynecologic Procedures | 26 | $47,905 | $3,518 |
| Level 4 Musculoskeletal Procedures | 21 | $79,873 | $8,051 |
| Level 3 Urology and Related Services | 18 | $46,617 | $2,292 |
| Level 2 Musculoskeletal Procedures | 16 | $38,645 | $1,809 |
| Level 3 Musculoskeletal Procedures | 13 | $43,353 | $3,419 |
| Level 5 Gynecologic Procedures | 13 | $51,650 | $5,598 |
| Level 3 Intraocular Procedures | 12 | $56,224 | $5,882 |
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Anthony Community Hospital charged $125,962 on average, 8% more than the New York average of $116,930, and was paid $16,334 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), St Anthony Community Hospital charged $89,407 on average, 10% more than the New York average of $81,161, and was paid $10,678 against a state average of $16,034. For Simple Pneumonia and Pleurisy with MCC (DRG 193), St Anthony Community Hospital charged $91,743 on average, 19% more than the New York average of $77,177, and was paid $12,184 against a state average of $15,976. For Respiratory Infections and Inflammations with MCC (DRG 177), St Anthony Community Hospital charged $114,470 on average, 21% more than the New York average of $94,371, and was paid $14,205 against a state average of $19,472. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $53,889 was 102% above the state average of $26,675. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $109,395 was 61% above the state average of $67,926. For Level 6 Musculoskeletal Procedures (outpatient APC 5116), its average charge of $140,517 was 70% above the state average of $82,540. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $43,021 was 166% above the state average of $16,178.
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.