New York / Stony Brook University Hospital
CMS certification 330393 · Stony Brook, NY · 7 entries in CMS's price-transparency list
Stony Brook University Hospital: charges and Medicare payments
Stony Brook University Hospital reported 13,318 Medicare inpatient stays across 255 DRGs in 2024. Across them it charged 5.28 times what it was paid — among the higher ratios in New York, number 28 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: 979 stays at an average charge of $151,020, 67% above the national average. It also billed 10,624 outpatient services, charging 7.78 times what Medicare paid.
- 1Medicare inpatient stays 13,318
- 2Charge ÷ paid, inpatient 5.28×
- 3Rank in NY (highest ratio = 1) 28 of 123
- 4CMS price-transparency actions 7
Inpatient stays
For the 255 DRGs that can be compared with the national average, Stony Brook University Hospital charged more than the national average in 244 (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 | 979 | $151,020 | +67% | $27,648 |
| 291 Heart Failure and Shock with MCC | 514 | $107,742 | +91% | $18,615 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 452 | $68,910 | -26% | $23,872 |
| 193 Simple Pneumonia and Pleurisy with MCC | 351 | $100,053 | +67% | $18,074 |
| 690 Kidney and Urinary Tract Infections without MCC | 330 | $74,649 | +97% | $11,555 |
| 177 Respiratory Infections and Inflammations with MCC | 290 | $124,628 | +77% | $22,877 |
| 689 Kidney and Urinary Tract Infections with MCC | 224 | $105,687 | +106% | $17,027 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 213 | $64,092 | +60% | $10,823 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 211 | $85,186 | +74% | $14,060 |
| 312 Syncope and Collapse | 205 | $71,245 | +56% | $11,863 |
| 378 Gastrointestinal Hemorrhage with CC | 185 | $88,160 | +82% | $13,473 |
| 603 Cellulitis without MCC | 172 | $63,074 | +69% | $12,236 |
| 481 Hip and Femur Procedures except Major Joint with CC | 167 | $162,985 | +62% | $26,404 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 160 | $54,407 | +51% | $10,218 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 153 | $154,278 | -30% | $58,268 |
| 552 Medical Back Problems without MCC | 149 | $83,629 | +71% | $12,972 |
| 189 Pulmonary Edema and Respiratory Failure | 147 | $95,103 | +65% | $17,452 |
| 683 Renal Failure with CC | 135 | $69,031 | +70% | $12,266 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 128 | $117,026 | +110% | $15,669 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 123 | $314,060 | +37% | $69,420 |
| 057 Degenerative Nervous System Disorders without MCC | 116 | $120,738 | +113% | $17,900 |
| 884 Organic Disturbances and Intellectual Disability | 114 | $177,918 | +185% | $30,519 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 112 | $63,639 | +72% | $10,885 |
| 194 Simple Pneumonia and Pleurisy with CC | 111 | $72,715 | +89% | $11,710 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 107 | $169,440 | +70% | $28,873 |
| 377 Gastrointestinal Hemorrhage with MCC | 102 | $150,306 | +76% | $24,996 |
| 682 Renal Failure with MCC | 102 | $150,220 | +128% | $25,301 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 101 | $38,195 | +33% | $7,467 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 99 | $75,055 | +76% | $11,864 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 98 | $100,418 | +98% | $16,792 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 98 | $124,780 | -20% | $38,078 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 98 | $141,217 | +23% | $23,234 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 96 | $120,301 | +100% | $19,988 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 94 | $137,128 | +87% | $24,434 |
| 178 Respiratory Infections and Inflammations with CC | 92 | $77,706 | +71% | $13,179 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 90 | $75,668 | +18% | $14,856 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 86 | $99,012 | +62% | $17,674 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 85 | $81,242 | +71% | $13,878 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 79 | $180,210 | +61% | $31,755 |
| 305 Hypertension without MCC | 79 | $62,241 | +55% | $10,244 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 72 | $91,778 | +62% | $19,722 |
| 313 Chest Pain | 72 | $45,655 | +14% | $9,518 |
| 314 Other Circulatory System Diagnoses with MCC | 72 | $191,435 | +102% | $33,791 |
| 394 Other Digestive System Diagnoses with CC | 71 | $79,807 | +70% | $13,521 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 70 | $157,169 | +54% | $26,961 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 70 | $69,599 | +88% | $12,295 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 69 | $304,584 | +32% | $63,228 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 69 | $134,339 | +106% | $22,758 |
| 092 Other Disorders of Nervous System with CC | 68 | $75,748 | +47% | $13,452 |
| 101 Seizures without MCC | 66 | $90,179 | +85% | $13,249 |
| 605 Trauma To The Skin, Subcutaneous Tissue and Breast without... | 66 | $79,115 | +71% | $12,373 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 64 | $230,222 | +70% | $41,149 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 63 | $107,214 | -15% | $30,403 |
| 536 Fractures of Hip and Pelvis without MCC | 62 | $82,575 | +119% | $10,814 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 61 | $346,092 | +23% | $87,221 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 61 | $100,011 | +111% | $14,544 |
| 948 Signs and Symptoms without MCC | 61 | $72,684 | +91% | $10,943 |
| 315 Other Circulatory System Diagnoses with CC | 58 | $81,802 | +71% | $13,140 |
| 069 Transient Ischemia without Thrombolytic | 56 | $84,117 | +67% | $11,008 |
| 812 Red Blood Cell Disorders without MCC | 56 | $72,696 | +64% | $12,022 |
Showing the 60 most frequent of 255 DRGs.
Outpatient services
Against the New York average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Stony Brook University Hospital charged $151,020 on average, 29% more than the New York average of $116,930, and was paid $27,648 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Stony Brook University Hospital charged $107,742 on average, 33% more than the New York average of $81,161, and was paid $18,615 against a state average of $16,034. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Stony Brook University Hospital charged $68,910 on average, 36% less than the New York average of $107,202, and was paid $23,872 against a state average of $23,235. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Stony Brook University Hospital charged $100,053 on average, 30% more than the New York average of $77,177, and was paid $18,074 against a state average of $15,976. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $44,619 was 67% above the state average of $26,675. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $16,036 was 1% below the state average of $16,178. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $15,715 was 20% above the state average of $13,044. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $16,211 was 27% above the state average of $12,815.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Stony Brook University Hospital in Stony Brook, NY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-04-19 (CMS case 72)
- CAP Request — 2021-09-30 (CMS case 72)
- Closure Notice — 2022-03-10 (CMS case 72)
- Warning Notice — 2023-06-12 (CMS case 1616)
- Closure Notice — 2023-09-25 (CMS case 1616)
- Met Requirements — 2025-01-17 (CMS case 3005)
- Met Requirements — 2025-03-19 (CMS case 3287)
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.