New York / St Charles Hospital
CMS certification 330246 · Port Jefferson, NY
St Charles Hospital: charges and Medicare payments
St Charles Hospital reported 1,409 Medicare inpatient stays across 45 DRGs in 2024. Across them it charged 5.02 times what it was paid — among the higher ratios in New York, number 34 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: 195 stays at an average charge of $84,142, 7% below the national average. It also billed 1,394 outpatient services, charging 6.09 times what Medicare paid.
- 1Medicare inpatient stays 1,409
- 2Charge ÷ paid, inpatient 5.02×
- 3Rank in NY (highest ratio = 1) 34 of 123
- 4CMS price-transparency actions 0
Inpatient stays
For the 45 DRGs that can be compared with the national average, St Charles Hospital charged more than the national average in 23 (51%). 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 | 195 | $84,142 | -7% | $19,584 |
| 895 Alcohol, Drug Abuse or Dependence with Rehabilitation... | 136 | $90,867 | +166% | $14,452 |
| 690 Kidney and Urinary Tract Infections without MCC | 76 | $40,195 | +6% | $7,854 |
| 291 Heart Failure and Shock with MCC | 58 | $65,124 | +16% | $11,993 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 51 | $79,881 | -14% | $17,430 |
| 689 Kidney and Urinary Tract Infections with MCC | 51 | $47,821 | -7% | $10,728 |
| 177 Respiratory Infections and Inflammations with MCC | 49 | $76,978 | +9% | $15,212 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 43 | $62,449 | -15% | $14,647 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 42 | $52,762 | +8% | $10,891 |
| 193 Simple Pneumonia and Pleurisy with MCC | 38 | $67,628 | +13% | $13,271 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 38 | $33,577 | -16% | $8,435 |
| 101 Seizures without MCC | 33 | $55,112 | +13% | $9,300 |
| 603 Cellulitis without MCC | 33 | $35,282 | -5% | $8,742 |
| 552 Medical Back Problems without MCC | 30 | $45,824 | -6% | $9,141 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 30 | $59,115 | -2% | $12,555 |
| 189 Pulmonary Edema and Respiratory Failure | 27 | $56,329 | -2% | $11,573 |
| 682 Renal Failure with MCC | 26 | $54,482 | -17% | $12,471 |
| 194 Simple Pneumonia and Pleurisy with CC | 24 | $38,239 | 0% | $8,081 |
| 683 Renal Failure with CC | 24 | $50,714 | +25% | $8,523 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 24 | $299,679 | +31% | $56,109 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 21 | $47,089 | -1% | $10,265 |
| 884 Organic Disturbances and Intellectual Disability | 20 | $37,237 | -40% | $14,366 |
| 894 Alcohol, Drug Abuse or Dependence, Left Ama | 20 | $51,280 | +82% | $7,688 |
| 305 Hypertension without MCC | 19 | $46,117 | +15% | $7,192 |
| 378 Gastrointestinal Hemorrhage with CC | 18 | $58,947 | +21% | $10,238 |
| 300 Peripheral Vascular Disorders with CC | 17 | $53,487 | +8% | $10,053 |
| 481 Hip and Femur Procedures except Major Joint with CC | 17 | $86,268 | -14% | $18,682 |
| 638 Diabetes with CC | 17 | $41,473 | 0% | $9,263 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 16 | $50,321 | -1% | $10,360 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 16 | $48,306 | +22% | $7,866 |
| 377 Gastrointestinal Hemorrhage with MCC | 16 | $90,099 | +6% | $15,004 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 16 | $61,097 | 0% | $13,253 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $39,022 | +5% | $7,354 |
| 312 Syncope and Collapse | 15 | $52,189 | +15% | $8,220 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 14 | $97,992 | -2% | $17,048 |
| 092 Other Disorders of Nervous System with CC | 14 | $43,749 | -15% | $9,783 |
| 057 Degenerative Nervous System Disorders without MCC | 13 | $51,669 | -9% | $12,209 |
| 100 Seizures with MCC | 13 | $123,151 | +30% | $18,088 |
| 178 Respiratory Infections and Inflammations with CC | 13 | $47,211 | +4% | $9,359 |
| 330 Major Small and Large Bowel Procedures with CC | 13 | $137,938 | +16% | $24,049 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 12 | $57,248 | +3% | $9,369 |
| 605 Trauma To The Skin, Subcutaneous Tissue and Breast without... | 12 | $39,391 | -15% | $8,670 |
| 467 Revision of Hip or Knee Replacement with CC | 11 | $161,579 | +2% | $29,627 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 11 | $38,809 | -9% | $8,293 |
| 811 Red Blood Cell Disorders with MCC | 11 | $95,307 | +40% | $13,194 |
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Charles Hospital charged $84,142 on average, 28% less than the New York average of $116,930, and was paid $19,584 against a state average of $24,426. For Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy (DRG 895), St Charles Hospital charged $90,867 on average, 10% more than the New York average of $82,693, and was paid $14,452 against a state average of $17,436. For Kidney and Urinary Tract Infections without MCC (DRG 690), St Charles Hospital charged $40,195 on average, 24% less than the New York average of $52,794, and was paid $7,854 against a state average of $10,297. For Heart Failure and Shock with MCC (DRG 291), St Charles Hospital charged $65,124 on average, 20% less than the New York average of $81,161, and was paid $11,993 against a state average of $16,034. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $65,199 was 4% below the state average of $67,926. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $25,641 was 4% below the state average of $26,675. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $13,389 was 0% below the state average of $13,330. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $41,911 was 19% above the state average of $35,085.
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.