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PECONIC BAY MEDICAL CENTER

RIVERHEAD, NY 11901 · Acute Care Hospitals

95 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024

By BillRazor Research · Last updated March 27, 2026 · Methodology

Procedures Analyzed

95

With CMS pricing data

Avg Charge-to-Medicare Ratio

6.0x

Chargemaster ÷ Medicare

CMS Quality Rating

Patient experience & outcomes

Hospital Type

Acute Care Hospitals

Voluntary non-profit - Other

Above 90th Percentile

1%

Compared to NY hospitals

Understanding Your Costs

When you receive a bill from PECONIC BAY MEDICAL CENTER, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, PECONIC BAY MEDICAL CENTER lists chargemaster rates that average 6.0x the corresponding Medicare reimbursement amount across 95 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).

The median hospital in NY has a chargemaster-to-Medicare ratio of 3.8x, with ratios across the state ranging from 1.1x to 12.4x. At 6.0x, this facility’s average ratio is above the state median. 124 hospitals in NY report pricing data to CMS (Source: CMS IPPS Provider Summary).

The procedure with the largest gap between the listed price and Medicare reimbursement at PECONIC BAY MEDICAL CENTER is Signs and Symptoms without Major Complications (DRG 948). The listed chargemaster rate is $55,583, while Medicare reimburses $5,924 for the same procedure — a ratio of 9.4x (Source: CMS IPPS Provider Summary, FY2024).

What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.

1 of 95 procedures (1%) at this facility have listed rates above the 90th percentile compared to other NY hospitals reporting the same procedure data to CMS (Source: CMS IPPS Provider Summary).

PECONIC BAY MEDICAL CENTER is a voluntary non-profit - other acute care hospitals facility with a CMS quality rating of 3/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.

Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio

Listed Chargemaster Rate Medicare Reimbursement

Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.

Procedure Pricing Lookup

Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.

ProcedureDRGListed ChargeMedicare Reimb.RatioState Position
Signs and Symptoms without Major Complications948$55,583$5,9249.4x
1th
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Gastrointestinal Obstruction without Complications390$35,832$3,9429.1x
1th
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Endocrine Disorders with Major Complications or Comorbidities643$128,776$15,2228.5x
1th
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Diabetes with Complications638$60,352$7,3488.2x
1th
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Seizures without Major Complications101$58,234$7,3397.9x
1th
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Intracranial Hemorrhage or Cerebral Infarction with Complications or Tpa in 24 Hours065$65,654$8,3187.9x
1th
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Renal Failure without Complications684$35,752$4,7767.5x
1th
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Diabetes with Major Complications or Comorbidities637$86,695$11,6597.4x
1th
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Other Disorders of Nervous System with Complications092$62,492$8,5097.3x
1th
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Cranial and Peripheral Nerve Disorders without Major Complications074$65,543$8,9607.3x
1th
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Other Circulatory System Diagnoses with Complications315$52,069$7,1637.3x
1th
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Gastrointestinal Obstruction with Complications389$48,219$6,7007.2x
1th
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Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours without Major Complications872$61,099$8,4937.2x
1th
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Chronic Obstructive Pulmonary Disease with Complications191$49,761$6,9397.2x
1th
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Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Complications442$59,420$8,2957.2x
1th
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Simple Pneumonia and Pleurisy with Complications194$47,238$6,6337.1x
1th
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Kidney and Urinary Tract Infections without Major Complications690$46,911$6,6057.1x
1th
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Urinary Stones without Major Complications694$44,313$6,2597.1x
1th
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Transient Ischemia without Thrombolytic069$46,628$6,6197.0x
1th
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Acute Myocardial Infarction, Discharged Alive with Complications281$51,064$7,2807.0x
1th
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Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without Major Complications563$46,614$6,6477.0x
1th
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Hypertension without Major Complications305$40,978$5,8837.0x
1th
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Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without Major Complications641$43,167$6,2007.0x
1th
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Tendonitis, Myositis and Bursitis without Major Complications558$49,426$7,1236.9x
1th
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Bronchitis and Asthma with Complications or Comorbidities202$54,724$7,9706.9x
1th
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Gastrointestinal Hemorrhage with Complications378$56,020$8,1706.9x
1th
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Intracranial Hemorrhage or Cerebral Infarction with Major Complications or Comorbidities064$112,547$16,6036.8x
1th
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Gastrointestinal Hemorrhage without Complications379$32,378$4,7776.8x
1th
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Kidney and Ureter Procedures for Non-Neoplasm with Complications660$82,176$12,1366.8x
1th
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Renal Failure with Complications683$49,129$7,3106.7x
1th
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Dysequilibrium149$39,292$5,8866.7x
1th
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Cardiac Arrhythmia and Conduction Disorders without Complications310$26,468$3,9836.7x
1th
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Chronic Obstructive Pulmonary Disease with Major Complications or Comorbidities190$59,535$8,9986.6x
1th
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Cardiac Arrhythmia and Conduction Disorders with Complications309$37,709$5,7016.6x
1th
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Kidney and Ureter Procedures for Non-Neoplasm without Complications661$59,496$9,0146.6x
1th
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Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without Major Complications392$41,255$6,2776.6x
1th
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Simple Pneumonia and Pleurisy with Major Complications or Comorbidities193$74,094$11,3066.5x
1th
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Disorders of Pancreas Except Malignancy with Complications439$44,898$6,9086.5x
1th
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Pulmonary Edema and Respiratory Failure189$69,529$10,7346.5x
1th
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Other Digestive System Diagnoses with Complications394$50,466$7,8076.5x
1th
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Red Blood Cell Disorders without Major Complications812$48,173$7,5256.4x
1th
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Respiratory Infections and Inflammations with Complications178$59,661$9,4166.3x
1th
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Kidney and Urinary Tract Infections with Major Complications or Comorbidities689$63,249$10,0846.3x
1th
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Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with Major Complications or Comorbidities391$71,978$11,5896.2x
1th
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Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio809$64,194$10,3766.2x
1th
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Cellulitis without Major Complications603$44,805$7,2556.2x
1th
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Peripheral Vascular Disorders with Complications300$53,636$8,6806.2x
1th
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Other Kidney and Urinary Tract Diagnoses with Complications699$50,748$8,2076.2x
1th
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Fractures of Hip and Pelvis without Major Complications536$36,549$5,9266.2x
1th
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Acute Myocardial Infarction, Discharged Alive with Major Complications or Comorbidities280$73,811$12,2516.0x
1th
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Showing 50 of 95 procedures

All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.

Statewide Context

Charge-to-Medicare ratio range across NY hospitals

1.1x
Median: 3.8x
12.4x
6.0x

124 hospitals in NY report pricing data to CMS. This facility's average ratio of 6.0x places it at the lower-middle range of the state range (Source: CMS IPPS Provider Summary).

What You Can Do

Compare Your Bill

Upload your bill and our system compares every line item against CMS reimbursement data. Free, takes 60 seconds.

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Request an Itemized Bill

Federal law entitles you to a detailed breakdown of every charge. If you haven't received one, knowing what to ask for is the first step.

Learn how

Check for Common Errors

Research suggests 49-80% of hospital bills contain errors — from duplicate charges to incorrect procedure codes.

How it works

Data: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).

Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.

Read our methodology·Report a data error

Frequently Asked Questions About PECONIC BAY MEDICAL CENTER

How much does PECONIC BAY MEDICAL CENTER charge compared to Medicare?

According to CMS IPPS data, PECONIC BAY MEDICAL CENTER's listed chargemaster rates average 6.0x the Medicare reimbursement amount across 95 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.

What is the most expensive procedure at PECONIC BAY MEDICAL CENTER?

The procedure with the highest chargemaster-to-Medicare ratio at PECONIC BAY MEDICAL CENTER is Signs and Symptoms without Major Complications (DRG 948), with a listed charge of $55,583 compared to Medicare reimbursement of $5,924 — a ratio of 9.4x. Source: CMS IPPS Provider Summary.

Is PECONIC BAY MEDICAL CENTER expensive compared to other NY hospitals?

PECONIC BAY MEDICAL CENTER's average chargemaster-to-Medicare ratio is 6.0x. Ratios vary significantly across NY hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.

Where does the pricing data for PECONIC BAY MEDICAL CENTER come from?

All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.

How can I check if my bill from PECONIC BAY MEDICAL CENTER is correct?

You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.

Does PECONIC BAY MEDICAL CENTER in RIVERHEAD, NY accept Medicare?

PECONIC BAY MEDICAL CENTER is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact PECONIC BAY MEDICAL CENTER directly or check with your insurance provider.

Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.