Mount Sinai West
Mount Sinai West in New York, NY charges 6.0x the Medicare reimbursement rate on average, with 33% of the 145 procedures analyzed showing significant pricing variations.
New York, NY 10019 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
D
High
Avg markup vs Medicare
5.97x
Charge / Medicare rate
Max markup
11.83x
Worst procedure
Procedures analyzed
145
With pricing data
Outlier procedures
33.1%
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 |
|---|---|---|---|---|---|
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $321,233 | $160,616 | — | 11.8x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $84,054 | $42,027 | — | 9.8x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $79,077 | $39,538 | — | 9.8x |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $97,715 | $48,857 | — | 9.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $106,180 | $53,090 | — | 9.3x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $105,442 | $52,721 | — | 8.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $91,950 | $45,975 | — | 8.7x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $78,541 | $39,270 | — | 8.5x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $70,159 | $35,079 | — | 8.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $117,907 | $58,954 | — | 8.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $81,248 | $40,624 | — | 8.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $61,243 | $30,622 | — | 8x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC | 562 | $140,690 | $70,345 | — | 8x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $146,405 | $73,203 | — | 7.9x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $45,184 | $22,592 | — | 7.9x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $74,954 | $37,477 | — | 7.7x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $199,060 | $99,530 | — | 7.7x |
| COAGULATION DISORDERS | 813 | $139,300 | $69,650 | — | 7.7x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $185,080 | $92,540 | — | 7.5x |
| DIGESTIVE MALIGNANCY WITH MCC | 374 | $184,025 | $92,013 | — | 7.5x |
| SEIZURES WITH MCC | 100 | $176,801 | $88,400 | — | 7.4x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $148,166 | $74,083 | — | 7.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $77,273 | $38,636 | — | 7.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $54,876 | $27,438 | — | 7.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $110,934 | $55,467 | — | 7.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | 093 | $64,656 | $32,328 | — | 7.4x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $76,835 | $38,418 | — | 7.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $64,022 | $32,011 | — | 7.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $80,546 | $40,273 | — | 7.2x |
| CELLULITIS WITHOUT MCC | 603 | $70,611 | $35,305 | — | 7.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $167,147 | $83,573 | — | 7.2x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $127,760 | $63,880 | — | 7.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $79,554 | $39,777 | — | 7.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $108,864 | $54,432 | — | 7x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $139,672 | $69,836 | — | 7x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $80,175 | $40,088 | — | 7x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $108,329 | $54,164 | — | 7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $75,145 | $37,573 | — | 7x |
| MAJOR CHEST TRAUMA WITH CC | 184 | $77,537 | $38,769 | — | 7x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $237,626 | $118,813 | — | 7x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC | 085 | $197,501 | $98,751 | — | 7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $163,324 | $81,662 | — | 6.9x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $77,548 | $38,774 | — | 6.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $62,440 | $31,220 | — | 6.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $591,910 | $295,955 | — | 6.9x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $143,303 | $71,651 | — | 6.9x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $79,027 | $39,514 | — | 6.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $120,932 | $60,466 | — | 6.9x |
| DIABETES WITH CC | 638 | $64,202 | $32,101 | — | 6.9x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $104,284 | $52,142 | — | 6.9x |
Showing 50 of 145 procedures
How MOUNT SINAI WEST 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.
FAQ — nonprofit-religious hospital billing
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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