Highland Hospital
Highland Hospital in Rochester, NY charges 3.0x the Medicare reimbursement rate across 56 analyzed procedures, reflecting pricing patterns typical of nonprofit-private healthcare facilities.
Rochester, NY 14617 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
B
Good
Avg markup vs Medicare
2.96x
Charge / Medicare rate
Max markup
5.52x
Worst procedure
Procedures analyzed
56
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $20,524 | $10,262 | — | 5.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | 179 | $28,951 | $14,476 | — | 5x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $56,848 | $28,424 | — | 4.2x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $32,334 | $16,167 | — | 4.2x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $15,674 | $7,837 | — | 4.1x |
| RENAL FAILURE WITH CC | 683 | $23,350 | $11,675 | — | 3.9x |
| DIABETES WITH CC | 638 | $20,276 | $10,138 | — | 3.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $24,334 | $12,167 | — | 3.8x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $23,612 | $11,806 | — | 3.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $35,256 | $17,628 | — | 3.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $32,174 | $16,087 | — | 3.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $48,567 | $24,283 | — | 3.4x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $42,260 | $21,130 | — | 3.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $30,066 | $15,033 | — | 3.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $15,855 | $7,927 | — | 3.2x |
| DIABETES WITH MCC | 637 | $30,828 | $15,414 | — | 3.1x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $17,086 | $8,543 | — | 3.1x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $43,789 | $21,894 | — | 3.1x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $46,511 | $23,255 | — | 3.1x |
| BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | 554 | $18,252 | $9,126 | — | 3.1x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $47,720 | $23,860 | — | 3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $23,132 | $11,566 | — | 3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $15,208 | $7,604 | — | 2.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $26,857 | $13,428 | — | 2.9x |
| RENAL FAILURE WITH MCC | 682 | $29,009 | $14,505 | — | 2.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $14,170 | $7,085 | — | 2.9x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $20,816 | $10,408 | — | 2.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $22,767 | $11,383 | — | 2.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $39,722 | $19,861 | — | 2.8x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $14,050 | $7,025 | — | 2.7x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $16,480 | $8,240 | — | 2.7x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $17,016 | $8,508 | — | 2.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $155,417 | $77,709 | — | 2.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $24,250 | $12,125 | — | 2.6x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $25,598 | $12,799 | — | 2.6x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $35,334 | $17,667 | — | 2.6x |
| CELLULITIS WITHOUT MCC | 603 | $14,507 | $7,254 | — | 2.6x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | 542 | $33,174 | $16,587 | — | 2.6x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $61,327 | $30,663 | — | 2.6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $35,774 | $17,887 | — | 2.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $34,658 | $17,329 | — | 2.6x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $33,109 | $16,555 | — | 2.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $54,657 | $27,329 | — | 2.5x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $32,284 | $16,142 | — | 2.5x |
| COMPLICATIONS OF TREATMENT WITH MCC | 919 | $29,400 | $14,700 | — | 2.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $33,416 | $16,708 | — | 2.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $17,928 | $8,964 | — | 2.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $12,094 | $6,047 | — | 2.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $17,568 | $8,784 | — | 2.3x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $15,371 | $7,686 | — | 2.3x |
Showing 50 of 56 procedures
How HIGHLAND HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use