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Suny/stony Brook University Hospital

SUNY/Stony Brook University Hospital in Stony Brook, NY charges 6.2x the Medicare reimbursement rate across 258 analyzed procedures, with 17% showing significantly higher markups than typical government hospital pricing.

Stony Brook, NY 11794 · Acute Care Hospitals · CMS Rating: 4/5

By David Park , Healthcare Cost Researcher · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

258 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 4.4x2.5x15.0x
6.2x
Medicare markup ratio
NY lowestSuny/stony Brook Unive...NY highest
6.2x
Avg markup ratio
6.2x
Median markup
258
Procedures
17%
Outlier procedures
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Billing patterns — government

Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.

Pricing grade

D

High

Avg markup vs Medicare

6.22x

Charge / Medicare rate

Max markup

12.19x

Worst procedure

Procedures analyzed

258

With pricing data

Outlier procedures

17.1%

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.

ProcedureCodeGross chargeCash priceMedicareMarkup
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC440$57,540$28,77012.2x
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY895$194,165$97,08211.3x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC066$70,098$35,04910.4x
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC057$130,075$65,03710.2x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$97,967$48,9839.8x
TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC086$134,611$67,3069.7x
KIDNEY TRANSPLANT652$298,106$149,0539.6x
PNEUMOTHORAX WITH CC200$104,912$52,4569.4x
GASTROINTESTINAL OBSTRUCTION WITH CC389$73,464$36,7329.4x
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC433$95,176$47,5889.2x
GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC379$54,289$27,1448.9x
TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC558$76,155$38,0788.9x
TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC087$77,867$38,9348.8x
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC841$140,916$70,4588.7x
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC542$158,639$79,3208.6x
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC071$97,329$48,6658.6x
TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC083$120,806$60,4038.6x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC390$45,943$22,9728.6x
POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC918$71,080$35,5408.5x
INFLAMMATORY BOWEL DISEASE WITH CC386$88,749$44,3748.4x
FRACTURES OF HIP AND PELVIS WITHOUT MCC536$66,230$33,1158.4x
NERVOUS SYSTEM NEOPLASMS WITH MCC054$112,867$56,4348.4x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$66,254$33,1278.3x
MAJOR CHEST TRAUMA WITH CC184$87,987$43,9938.3x
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC917$134,153$67,0768.2x
DIABETES WITH CC638$72,964$36,4828.2x
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC068$78,034$39,0178.2x
PULMONARY EMBOLISM WITHOUT MCC176$66,202$33,1018x
DYSEQUILIBRIUM149$60,734$30,3678x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$64,390$32,1957.8x
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC964$122,593$61,2967.8x
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC840$312,173$156,0877.8x
RENAL FAILURE WITH MCC682$129,141$64,5707.8x
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC438$134,967$67,4847.8x
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC206$70,575$35,2887.7x
GASTROINTESTINAL HEMORRHAGE WITH CC378$78,618$39,3097.7x
FRACTURES OF HIP AND PELVIS WITH MCC535$103,976$51,9887.7x
RENAL FAILURE WITH CC683$68,998$34,4997.7x
PSYCHOSES885$131,499$65,7497.6x
SEIZURES WITHOUT MCC101$71,552$35,7767.6x
URINARY STONES WITHOUT MCC694$62,157$31,0797.6x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC394$72,478$36,2397.6x
RED BLOOD CELL DISORDERS WITHOUT MCC812$67,233$33,6167.5x
DIGESTIVE MALIGNANCY WITH CC375$82,448$41,2247.5x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC064$170,114$85,0577.5x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$73,406$36,7037.5x
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC641$60,986$30,4937.4x
DIGESTIVE MALIGNANCY WITH MCC374$157,742$78,8717.4x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC690$60,087$30,0447.4x
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC070$150,697$75,3497.4x

Showing 50 of 258 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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — government hospital billing

How do government hospital billing rates compare to Medicare benchmarks?
Based on available data from 374 government hospitals, charges average 4.2 times the Medicare benchmark rates. Government hospitals, while publicly owned, still establish their own pricing structures that can result in charges above standard Medicare rates.
Why do government hospitals charge above Medicare rates if they're publicly owned?
Government hospitals operate as independent entities that must cover operational costs, equipment, and staffing expenses. Public ownership doesn't require hospitals to limit charges to Medicare benchmark levels, as they still need to maintain financial sustainability for continued operations.
What should I expect when reviewing a government hospital bill?
Government hospital bills typically show charges that may be several times higher than Medicare benchmark rates, with the average markup being approximately 4.2x across sampled facilities. The final amount you pay will depend on your insurance coverage, negotiated rates, and any applicable financial assistance programs.
Are there potential billing differences between government hospitals and other facility types?
Government hospitals show similar billing patterns to other hospital types, with charges typically set above Medicare benchmarks. The potential difference in what patients ultimately pay often depends more on individual insurance plans and hospital financial assistance policies than on the ownership structure of the facility.

Related pricing data

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

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