Peconic Bay Medical Center
Peconic Bay Medical Center in Riverhead, NY charges 6.0x the Medicare reimbursement rate across 95 analyzed procedures, according to our analysis of this nonprofit hospital's pricing data.
Riverhead, NY 11901 · 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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Pricing grade
D
High
Avg markup vs Medicare
6.05x
Charge / Medicare rate
Max markup
9.38x
Worst procedure
Procedures analyzed
95
With pricing data
Outlier procedures
1.1%
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 |
|---|---|---|---|---|---|
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $55,583 | $27,791 | — | 9.4x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $35,832 | $17,916 | — | 9.1x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $128,776 | $64,388 | — | 8.5x |
| DIABETES WITH CC | 638 | $60,352 | $30,176 | — | 8.2x |
| SEIZURES WITHOUT MCC | 101 | $58,234 | $29,117 | — | 7.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $65,654 | $32,827 | — | 7.9x |
| RENAL FAILURE WITHOUT CC/MCC | 684 | $35,752 | $17,876 | — | 7.5x |
| DIABETES WITH MCC | 637 | $86,695 | $43,347 | — | 7.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $62,492 | $31,246 | — | 7.3x |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $65,543 | $32,772 | — | 7.3x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $52,069 | $26,035 | — | 7.3x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $48,219 | $24,110 | — | 7.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $61,099 | $30,549 | — | 7.2x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $49,761 | $24,881 | — | 7.2x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | 442 | $59,420 | $29,710 | — | 7.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $47,238 | $23,619 | — | 7.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $46,911 | $23,456 | — | 7.1x |
| URINARY STONES WITHOUT MCC | 694 | $44,313 | $22,157 | — | 7.1x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $46,628 | $23,314 | — | 7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $51,064 | $25,532 | — | 7x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $46,614 | $23,307 | — | 7x |
| HYPERTENSION WITHOUT MCC | 305 | $40,978 | $20,489 | — | 7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $43,167 | $21,584 | — | 7x |
| TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | 558 | $49,426 | $24,713 | — | 6.9x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $54,724 | $27,362 | — | 6.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $56,020 | $28,010 | — | 6.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $112,547 | $56,273 | — | 6.8x |
| GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | 379 | $32,378 | $16,189 | — | 6.8x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $82,176 | $41,088 | — | 6.8x |
| RENAL FAILURE WITH CC | 683 | $49,129 | $24,565 | — | 6.7x |
| DYSEQUILIBRIUM | 149 | $39,292 | $19,646 | — | 6.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $26,468 | $13,234 | — | 6.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $59,535 | $29,768 | — | 6.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $37,709 | $18,855 | — | 6.6x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $59,496 | $29,748 | — | 6.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $41,255 | $20,628 | — | 6.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $74,094 | $37,047 | — | 6.6x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $44,898 | $22,449 | — | 6.5x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $69,529 | $34,764 | — | 6.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $50,466 | $25,233 | — | 6.5x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $48,173 | $24,087 | — | 6.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $59,661 | $29,831 | — | 6.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $63,249 | $31,624 | — | 6.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $71,978 | $35,989 | — | 6.2x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 809 | $64,194 | $32,097 | — | 6.2x |
| CELLULITIS WITHOUT MCC | 603 | $44,805 | $22,403 | — | 6.2x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $53,636 | $26,818 | — | 6.2x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $50,748 | $25,374 | — | 6.2x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $36,549 | $18,275 | — | 6.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $73,811 | $36,905 | — | 6x |
Showing 50 of 95 procedures
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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