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New York falls near the bottom of the list in organ donation rates, yet the need for organs for transplants in the state ranks among the highest in the nation.

That’s the key finding by Univera Healthcare in a report that brings together a number of previously released statistics on organ donation.

Only 22 percent of adult New Yorkers are on the state’s organ and tissue donor registry, compared to the 48 percent average in the United States.

New York ranks above Vermont, 18 percent, and Puerto Rico, 17 percent, but far behind Montana’s 84 percent of adults registered to donate an organ or tissue.

Thirty-two states each have at least 50 percent of the adult population enrolled as donors, according to the report. The statistics come from a 2013 Donate Life America state comparison.

Nationwide, New York has the third most number of people waiting for organs -- 10,510 -- behind California and Texas, according to data Univera used from the Organ Procurement and Transplantation Network.

“When I first saw the analysis, I thought this can’t be right,” said Dr. Martin Lustick, senior vice president and corporate medical director of Univera Healthcare. “Then I realized that the numbers are less about New Yorkers being less inclined to donate organs, and more about the barriers that exist to becoming an organ donor in our state.

The health insurer Excellus BlueCross BlueShield based in Rochester does business in Western New York under the Univera Healthcare name.

Compared to other parts of the state, Erie and Niagara counties do well with donation rates among adults of 31.5 percent and 36.1 percent respectively.

The higher rates here reflect efforts to educate the public, according to Mark Simon, president and chief executive officer of UNYTS, the organ donation agency in Western New York.

“We have made more of an investment in advertising,” he said.

Earlier this year, state officials included funds in the budget to transfer administration of the state donor registry to a not-for-profit organization, a move expected to increase donation rates.

“The new organization will be more effective. But we obviously also need money. We need support for a statewide campaign about donation that is visible to people,” Simon said.