Healthcare Insights

Top hospitals by total operating expense

This may come as no surprise -- but operating a hospital can be expensive. Whether it’s a small rural facility or a highly specialized big city hospital, expenses add up fast.  

With medical supply costs, administrative and marketing fees and employee salaries increasing across the board, it’s more important than ever to understand the expenses that hospitals incur and what these facilities are doing to manage them.  

Below, we’ve ranked the top 20 hospitals in the U.S. by total operating expenses.  

Top 20 hospitals ranked by total operating expenses in 2021

Hospital nameCityStateDefinitive IDTotal operating expensesExplore dataset
New York-Presbyterian/Weill Cornell Medical CenterNew YorkNY541974$7,240,896,211 Explore
Tisch HospitalNew YorkNY2843$6,589,073,756 Explore
Cleveland Clinic Main CampusClevelandOH3120$6,240,384,003 Explore
Vanderbilt University Medical CenterNashvilleTN3742$5,356,674,083 Explore
Stanford HospitalStanfordCA588$5,257,860,974 Explore
Memorial Sloan Kettering Cancer CenterNew YorkNY2846$4,851,823,428 Explore
Massachusetts General HospitalBostonMA1973$4,759,986,061 Explore
UCSF Helen Diller Medical Center at Parnassus HeightsSan FranciscoCA560$4,575,166,953 Explore
Montefiore Hospital - Moses CampusBronxNY273024 $4,346,224,000 Explore
University of Texas MD Anderson Cancer CenterHoustonTX4017$4,063,530,890 Explore
University HospitalAnn ArborMI2096$3,988,374,149 Explore
Advent Health Orlando (FKA Florida Hospital Orlando)OrlandoFL873$3,960,690,702 Explore
IU Health Methodist HospitalIndianapolisIN1365$3,879,662,196 Explore
Cedars-Sinai Medical CenterLos AngelesCA430$3,609,143,674 Explore
Yale New Haven HospitalNew HavenCT731$3,603,821,862 Explore
Brigham and Women’s HospitalBostonMA1969$3,378,977,229 Explore
Mount Sinai Medical Center (AKA the Mount Sinai Hospital)New YorkNY2837$3,240,804,472 Explore
Long Island Jewish Medical CenterNew Hyde ParkNY2828$3,160,716,052 Explore
Hospital of the University of PennsylvaniaPhiladelphiaPA3571$3,014,605,493 Explore
North Shore University HospitalManhassetNY2824$2,897,840,845 Explore

Fig 1. Data is from the Definitive Healthcare HospitalView product. Financial data is from the April 2022 Medicare Cost Report. Data accessed July 2022.

The New York-Presbyterian/Weill Cornell Medical Center ranks at the top of our list with an operating expense of $7,240,896,211. Other hospitals on our list include Massachusetts General Hospital with more than $4 billion and Yale New Haven Hospital with more than $3 billion in total operating expenses in 2021.  

Hospital operating expenses breakdown 

The Health Resources & Services Administration (HRSA) defines operating expenses as the “expenses incurred as part of the delivery of care.” This includes: 

  • Wages and benefits 
  • Contracted and employed physicians 
  • Medical supplies and prescription drugs 
  • Interest and depreciation on buildings and equipment used to provide care 

The HRSA does not consider gains or losses made on investments, charitable contributions and any costs on property not used for direct patient care as reportable operating expenses.  

What is a hospital’s biggest expense? 

According to a 2016 report by Statista, a hospital’s biggest expenses are wages and benefits, accounting for about 56% of a facility’s spending. This figure may be even higher for the hospitals found on our list, as many are teaching hospitals. These facilities are generally staffed by highly qualified physicians and medical specialists who research new therapies and educate and train students.  

These occupations are among the highest paid in hospitals. According to 2021 data by the U.S. Bureau of Labor Statistics, the average physician and surgeon across a variety of specialties have an annual salary in the upper six digits. 

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