Cardiac congenital and valvular disorders with major complications in New York
What 7 hospitals in New York charged and were paid for a Medicare hospital stay for cardiac congenital and valvular disorders with major complications (DRG 306), from 2024 Medicare claims.
Average charge
$154,758
Hospital list price billed
Average payment
$24,275
Medicare + patient + other payers
Medicare paid
$18,656
Average per stay
State rank
#4 of 4
1 = lowest average payment
Hospitals in New York billed an average of $154,758 for cardiac congenital and valvular disorders with major complications, about 6.4 times the average total payment of $24,275. That payment is 27% above the U.S. average of $19,049.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $24,275Billed $154,758
About 16¢ was paid for every $1 hospitals in New York billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in New York:
New York hospitals: cardiac congenital and valvular disorders with major complications
Every New York hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Mount Sinai HospitalNew York | 42 | $116,124 | $25,079 | $19,620 |
| New York-Presbyterian HospitalNew York | 21 | $187,043 | $26,295 | $20,447 |
| NYU Hospitals CenterNew York | 20 | $127,985 | $22,918 | $19,114 |
| North Shore University HospitalManhasset | 19 | $159,002 | $19,977 | $13,928 |
| St Francis Hospital, RoslynRoslyn | 16 | $83,951 | $14,395 | $11,546 |
| Montefiore Medical CenterBronx | 15 | $303,064 | $37,388 | $25,420 |
| Lenox Hill HospitalNew York | 12 | $180,403 | $23,771 | $19,899 |
Lowest and highest payments in New York
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| St Francis Hospital, RoslynRoslyn, NY | $14,395 |
|---|---|
| North Shore University HospitalManhasset, NY | $19,977 |
| NYU Hospitals CenterNew York, NY | $22,918 |
| Lenox Hill HospitalNew York, NY | $23,771 |
| Mount Sinai HospitalNew York, NY | $25,079 |
Highest
| Montefiore Medical CenterBronx, NY | $37,388 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $26,295 |
| Mount Sinai HospitalNew York, NY | $25,079 |
| Lenox Hill HospitalNew York, NY | $23,771 |
| NYU Hospitals CenterNew York, NY | $22,918 |
Cardiac congenital and valvular disorders with major complications in other states
Questions
How much does cardiac congenital and valvular disorders with major complications cost in New York?
In 2024 Medicare data, a hospital stay for cardiac congenital and valvular disorders with major complications (DRG 306) at 7 hospitals in New York was billed at $154,758 on average, while the average total payment was $24,275, of which Medicare paid $18,656. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in New York, average charges were 6.4 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.