Unity Hospital of Rochester: charges and Medicare payments

Unity Hospital of Rochester reported 1,598 Medicare inpatient stays across 57 DRGs in 2024. Across them it charged 2.07 times what it was paid — among the lower ratios in New York, number 94 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: 184 stays at an average charge of $38,620, 57% below the national average. It also billed 1,172 outpatient services, charging 3.13 times what Medicare paid.

1Medicare inpatient stays 1,598
2Charge ÷ paid, inpatient 2.07×
3Rank in NY (highest ratio = 1) 94 of 123
4CMS price-transparency actions 0

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

Inpatient stays

For the 57 DRGs that can be compared with the national average, Unity Hospital of Rochester charged more than the national average in 1 (2%). 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	184	$38,620	-57%	$18,349
291 Heart Failure and Shock with MCC	123	$25,793	-54%	$12,367
177 Respiratory Infections and Inflammations with MCC	83	$37,336	-47%	$16,029
690 Kidney and Urinary Tract Infections without MCC	65	$13,545	-64%	$8,357
470 Major Hip and Knee Joint Replacement or Reattachment of...	58	$36,464	-61%	$18,194
193 Simple Pneumonia and Pleurisy with MCC	57	$26,315	-56%	$13,678
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	51	$20,492	-58%	$10,224
189 Pulmonary Edema and Respiratory Failure	49	$24,015	-58%	$11,795
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	47	$13,600	-66%	$8,053
378 Gastrointestinal Hemorrhage with CC	39	$19,189	-60%	$10,010
603 Cellulitis without MCC	39	$14,211	-62%	$9,552
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	36	$13,226	-64%	$8,078
312 Syncope and Collapse	34	$17,541	-61%	$8,671
683 Renal Failure with CC	33	$16,818	-59%	$8,556
638 Diabetes with CC	29	$17,464	-58%	$8,887
698 Other Kidney and Urinary Tract Diagnoses with MCC	29	$42,631	-42%	$16,197
178 Respiratory Infections and Inflammations with CC	28	$26,187	-42%	$10,123
071 Other Cerebrovascular Disorders with CC	26	$16,006	-68%	$9,996
853 Infectious and Parasitic Diseases with O.R. Procedures with...	25	$150,934	-34%	$57,735
682 Renal Failure with MCC	24	$22,057	-67%	$13,733
481 Hip and Femur Procedures except Major Joint with CC	21	$43,177	-57%	$19,491
194 Simple Pneumonia and Pleurisy with CC	20	$14,236	-63%	$8,707
330 Major Small and Large Bowel Procedures with CC	20	$46,266	-61%	$22,375
699 Other Kidney and Urinary Tract Diagnoses with CC	20	$15,610	-67%	$10,076
309 Cardiac Arrhythmia and Conduction Disorders with CC	19	$11,848	-67%	$7,504
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	19	$31,728	-47%	$13,835
057 Degenerative Nervous System Disorders without MCC	18	$17,060	-70%	$13,070
092 Other Disorders of Nervous System with CC	18	$16,453	-68%	$10,074
190 Chronic Obstructive Pulmonary Disease with MCC	18	$34,144	-33%	$11,062
689 Kidney and Urinary Tract Infections with MCC	18	$16,367	-68%	$11,599
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	17	$37,713	-62%	$18,150
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	17	$17,869	-68%	$10,694
191 Chronic Obstructive Pulmonary Disease with CC	16	$16,396	-59%	$8,625
070 Other Cerebrovascular Disorders with MCC	14	$35,954	-53%	$15,812
286 Circulatory Disorders except AMI, with Cardiac...	14	$44,853	-60%	$20,930
314 Other Circulatory System Diagnoses with MCC	14	$38,200	-60%	$20,023
377 Gastrointestinal Hemorrhage with MCC	14	$43,047	-50%	$17,195
389 Gastrointestinal Obstruction with CC	14	$12,365	-68%	$7,912
552 Medical Back Problems without MCC	14	$15,617	-68%	$9,992
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	14	$16,886	-60%	$9,206
895 Alcohol, Drug Abuse or Dependence with Rehabilitation...	14	$57,594	+68%	$14,327
483 Major Joint or Limb Reattachment Procedures of Upper...	13	$43,711	-65%	$22,927
884 Organic Disturbances and Intellectual Disability	13	$13,720	-78%	$14,305
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	12	$27,620	-55%	$12,529
472 Cervical Spinal Fusion with CC	12	$45,040	-69%	$30,070
602 Cellulitis with MCC	12	$43,304	-28%	$12,188
637 Diabetes with MCC	12	$32,715	-51%	$14,018
894 Alcohol, Drug Abuse or Dependence, Left Ama	12	$23,448	-17%	$6,434
948 Signs and Symptoms without MCC	12	$14,954	-61%	$7,366
179 Respiratory Infections and Inflammations without CC/MCC	11	$18,766	-47%	$7,245
304 Hypertension with MCC	11	$20,434	-64%	$11,257
305 Hypertension without MCC	11	$14,097	-65%	$8,016
308 Cardiac Arrhythmia and Conduction Disorders with MCC	11	$22,605	-60%	$11,906
394 Other Digestive System Diagnoses with CC	11	$10,531	-78%	$9,541
467 Revision of Hip or Knee Replacement with CC	11	$69,158	-56%	$28,679
536 Fractures of Hip and Pelvis without MCC	11	$17,422	-54%	$8,196
556 Signs and Symptoms of Musculoskeletal System and Connective...	11	$14,025	-65%	$9,398

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	273	$7,766	$2,826
Level 5 Musculoskeletal Procedures	175	$29,003	$13,578
Level 2 Upper GI Procedures	88	$4,306	$1,998
Level 3 Vascular Procedures	78	$11,042	$3,241
Level 1 Nerve Procedures	58	$7,573	$1,935
Level 1 Endovascular Procedures	54	$12,012	$3,414
Level 2 Endovascular Procedures	47	$19,572	$6,060
Level 1 Laparoscopy and Related Services	46	$18,302	$5,696
Level 3 Musculoskeletal Procedures	40	$10,108	$3,295
Level 6 Musculoskeletal Procedures	34	$39,546	$19,711
Level 2 Excision/ Biopsy/ Incision and Drainage	33	$9,848	$1,719
Level 2 Vascular Procedures	29	$3,034	$1,698
Level 4 Musculoskeletal Procedures	25	$16,932	$7,585
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	22	$11,349	$3,535
Level 4 Gynecologic Procedures	22	$10,948	$3,016
Level 5 Urology and Related Services	20	$13,367	$5,486
Level 3 Endovascular Procedures	19	$40,756	$11,649
Level 3 Excision/ Biopsy/ Incision and Drainage	17	$10,030	$3,013
Level 2 Breast/Lymphatic Surgery and Related Procedures	16	$21,197	$6,914
Level 1 Breast/Lymphatic Surgery and Related Procedures	15	$13,507	$4,041
Level 3 Pacemaker and Similar Procedures	14	$27,358	$11,309
Level 4 Airway Endoscopy	13	$20,659	$3,970
Level 4 Vascular Procedures	12	$15,449	$5,826
Level 2 Musculoskeletal Procedures	11	$8,011	$1,704
Level 4 Urology and Related Services	11	$11,343	$3,696

Against the New York average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Unity Hospital of Rochester charged $38,620 on average, 67% less than the New York average of $116,930, and was paid $18,349 against a state average of $24,426. For Heart Failure and Shock with MCC (DRG 291), Unity Hospital of Rochester charged $25,793 on average, 68% less than the New York average of $81,161, and was paid $12,367 against a state average of $16,034. For Respiratory Infections and Inflammations with MCC (DRG 177), Unity Hospital of Rochester charged $37,336 on average, 60% less than the New York average of $94,371, and was paid $16,029 against a state average of $19,472. For Kidney and Urinary Tract Infections without MCC (DRG 690), Unity Hospital of Rochester charged $13,545 on average, 74% less than the New York average of $52,794, and was paid $8,357 against a state average of $10,297. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $7,766 was 71% below the state average of $26,675. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $29,003 was 57% below the state average of $67,926. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $4,306 was 71% below the state average of $15,077. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $11,042 was 40% below the state average of $18,520.

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.