Phelps Hospital
Phelps Hospital in Sleepy Hollow, NY charges 7.8x the Medicare reimbursement rate on average across 54 analyzed procedures, with 13% showing significantly higher markups.
Sleepy Hollow, NY 10591 · Acute Care Hospitals · CMS Rating: 3/5
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
D
High
Avg markup vs Medicare
7.78x
Charge / Medicare rate
Max markup
12.64x
Worst procedure
Procedures analyzed
54
With pricing data
Outlier procedures
13%
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 |
|---|---|---|---|---|---|
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $80,173 | $40,086 | — | 12.6x |
| HYPERTENSION WITHOUT MCC | 305 | $71,601 | $35,800 | — | 11.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $106,691 | $53,345 | — | 11.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $92,264 | $46,132 | — | 11x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $64,176 | $32,088 | — | 9.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $60,232 | $30,116 | — | 9.5x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $68,735 | $34,368 | — | 9.5x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $117,521 | $58,760 | — | 9.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $58,159 | $29,080 | — | 9.3x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $70,410 | $35,205 | — | 9.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $49,704 | $24,852 | — | 9.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $85,616 | $42,808 | — | 8.7x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $74,564 | $37,282 | — | 8.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $73,410 | $36,705 | — | 8.6x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $65,069 | $32,535 | — | 8.5x |
| TRANSURETHRAL PROSTATECTOMY WITH CC/MCC | 713 | $100,591 | $50,295 | — | 8.5x |
| SYNCOPE AND COLLAPSE | 312 | $60,133 | $30,067 | — | 8.5x |
| COAGULATION DISORDERS | 813 | $120,962 | $60,481 | — | 8.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $68,472 | $34,236 | — | 8.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $136,397 | $68,198 | — | 8.3x |
| RENAL FAILURE WITH CC | 683 | $58,306 | $29,153 | — | 8.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $52,416 | $26,208 | — | 8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $99,333 | $49,666 | — | 8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $80,243 | $40,121 | — | 7.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $135,231 | $67,616 | — | 7.9x |
| CELLULITIS WITHOUT MCC | 603 | $53,354 | $26,677 | — | 7.9x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $101,200 | $50,600 | — | 7.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $104,443 | $52,222 | — | 7.6x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $67,121 | $33,561 | — | 7.6x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $83,571 | $41,785 | — | 7.5x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $51,381 | $25,691 | — | 7.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $82,218 | $41,109 | — | 7.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $61,753 | $30,876 | — | 7.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $80,515 | $40,258 | — | 7.3x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $90,351 | $45,175 | — | 7.2x |
| DIABETES WITH CC | 638 | $48,499 | $24,249 | — | 7.1x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $101,499 | $50,749 | — | 7.1x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | 895 | $98,350 | $49,175 | — | 6.9x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $102,184 | $51,092 | — | 6.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $94,907 | $47,454 | — | 6.7x |
| RENAL FAILURE WITH MCC | 682 | $86,727 | $43,364 | — | 6.6x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $93,593 | $46,796 | — | 6.6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $121,988 | $60,994 | — | 6.5x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $289,409 | $144,704 | — | 6.5x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $95,060 | $47,530 | — | 6.2x |
| SEIZURES WITHOUT MCC | 101 | $40,512 | $20,256 | — | 6.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $114,222 | $57,111 | — | 6x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $186,922 | $93,461 | — | 5.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $98,628 | $49,314 | — | 5.8x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $136,329 | $68,165 | — | 5.6x |
Showing 50 of 54 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