Updated April 2026

Respiratory System Diagnosis with Ventilator Support >96 Hours in Texas

213 Texas hospitals report Medicare totals for this DRG, averaging $53,409 (close to the $53,417 national mean), with a 5× spread from $18,625 to $86,713. 6 carry an A grade, 1 carry an F.

Respiratory System Diagnosis with Ventilator Support >96 Hours (DRG 208) is a Respiratory procedure tracked in CMS Inpatient Payment files. Across Texas, 2,717 hospitals report payment data for 566,489 total discharges, with an average Medicare payment of $53,417 (median $51,850). The $15,600-to-$118,257 payment range is wide: the same DRG code can attract very different reimbursements across hospitals, reflecting differences in cost structure, patient complexity within the DRG, and regional pricing dynamics. The Medicare DRG system bundles cases by diagnosis-and-procedure groupings, so payment differences within a single DRG mostly track hospital-specific factors rather than case-mix.

Within Texas, the 2,717 hospitals reporting this procedure span the full range of ownership types and hospital sizes. The state-specific average ($53,417) is shaped by which hospitals in the state see enough volume to report the DRG code at all. For patients with elective scheduling on Respiratory System Diagnosis with Ventilator Support >96 Hours, the cost-comparison logic is straightforward: the per-procedure payment range is meaningfully wide, so the hospital chosen affects total cost. For patients in an emergency, the choice is functionally fixed — but the listed prices still matter for insurance-coverage and out-of-pocket planning.

About This Procedure

Respiratory DRGs include pneumonia, COPD, ventilator-supported respiratory failure, and chronic lung disease. Length of stay drives most of the cost spread, especially for ventilator cases that cross the 96-hour threshold.

Respiratory System Diagnosis with Ventilator Support >96 Hours is Medicare DRG 208 in the Respiratory category. National Medicare average for this DRG is $53,417 across 2,717 reporting hospitals. The state-level view here filters that universe down to Texas only.

Cost Picture in Texas

Texas's average for this DRG sits close to the national Medicare mean. State-level differences are explained primarily by the regional Medicare wage index — the multiplier CMS applies to standardize DRG payments to local labor costs — alongside hospital case mix and the concentration of academic referral centers in the state's larger metros.

Within the state, the 5× spread between the lowest- and highest-reporting facility usually reflects length-of-stay differences, complication adjustments for sicker patients, teaching-status add-ons, and outlier payments for unusually long stays. Two hospitals reporting the same DRG can post meaningfully different totals without anything “wrong” happening at either site. For non-Medicare patients, the more relevant figure is the negotiated commercial rate published in each hospital's machine-readable file under the CMS Hospital Price Transparency Rule.

Quality Alongside Price

For a planned admission, the most useful complement to the cost view is the hospital-specific quality data on CMS Care Compare. The site publishes risk-adjusted measures of mortality, readmission, complication, infection, and patient experience for every Medicare-participating hospital. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators feed many of these CMS measures.

For complex procedures, hospital-level case volume correlates with outcomes in published research, even after risk adjustment. CMS publishes case counts on Care Compare alongside outcome measures.

Hospitals in Texas Reporting Respiratory System Diagnosis with Ventilator Support >96 Hours

Sorted lowest to highest Medicare total payment. Pricing is informational and should be considered alongside CMS quality measures.

#	Hospital	City	Payment	Quality	Grade
1	Baylor St Lukes Medical Center Houston	Houston	$18,625	★★★☆☆	B
2	Childress Regional Medical Center Childress	Childress	$24,255	Not Rated	C
3	North Central Surgical Center Llp Dallas	Dallas	$24,787	Not Rated	C
4	Baylor Scott & White Texas Spine & Joint Hospital Tyler	Tyler	$26,795	★★★★★	B
5	The Medical Center Of Southeast Texas Port Arthur	Port Arthur	$29,255	★★★☆☆	C
6	Childrens Medical Center Plano Plano	Plano	$29,265	Not Rated	C
7	St Joseph Medical Center Houston	Houston	$31,265	★★☆☆☆	C
8	Medical City Decatur Decatur	Decatur	$31,487	Not Rated	C
9	Baylor Scott & White Medical Center - Centennial Frisco	Frisco	$32,014	★★★★★	A
10	Aspire Hospital Conroe	Conroe	$33,245	Not Rated	C
11	Memorial Hermann Hospital System Houston	Houston	$33,386	★★★☆☆	B
12	Ascension Seton Northwest Austin	Austin	$33,637	★★★★☆	B
13	Harris Health Houston	Houston	$34,274	★★★☆☆	B
14	Rio Vista Behavioral Health El Paso	El Paso	$34,732	Not Rated	C
15	Yoakum County Hospital Denver City	Denver City	$35,059	Not Rated	C
16	North Runnels Hospital Winters	Winters	$35,279	Not Rated	C
17	Texas Health Presbyterian Hospital Denton Denton	Denton	$35,992	★★★★★	A
18	St David's Medical Center Austin	Austin	$36,347	★★★★★	A
19	Baptist Beaumont Hospital Beaumont	Beaumont	$36,696	★★☆☆☆	D
20	Houston Va Medical Center Houston	Houston	$37,203	★★★★☆	B
21	Reeves Regional Health Pecos	Pecos	$37,373	Not Rated	C
22	Texas Health Hospital Mansfield Mansfield	Mansfield	$37,899	Not Rated	C
23	Baylor Scott & White Medical Center - Round Rock Round Rock	Round Rock	$38,614	★★★★☆	C
24	Baylor Scott & White Hospital Brenham Brenham	Brenham	$39,167	Not Rated	C
25	Hill Country Memorial Hospital Fredericksburg	Fredericksburg	$39,748	★★★★☆	C
26	Liberty Dayton Regional Medical Center Liberty	Liberty	$39,875	Not Rated	C
27	Hca Houston Healthcare Northwest Houston	Houston	$40,211	★★★☆☆	C
28	Hill Regional Hospital Hillsboro	Hillsboro	$40,402	★★★★☆	B
29	Texas Health Presbyterian Hospital Dallas Dallas	Dallas	$40,946	★★★★☆	B
30	Iraan General Hospital Iraan	Iraan	$40,995	Not Rated	C
31	Houston Methodist The Woodlands Hospital The Woodlands	The Woodlands	$41,378	★★★★★	A
32	University Medical Center Lubbock	Lubbock	$41,491	★★★☆☆	B
33	Texas Orthopedic Hospital Houston	Houston	$41,495	Not Rated	C
34	University Health System San Antonio	San Antonio	$41,671	★★★☆☆	B
35	Val Verde Regional Medical Center Del Rio	Del Rio	$41,687	Not Rated	C
36	Hemphill County Hospital Canadian	Canadian	$42,078	Not Rated	C
37	Clay County Memorial Hospital Henrietta	Henrietta	$42,644	Not Rated	C
38	Methodist Hospital San Antonio	San Antonio	$42,823	★★★☆☆	B
39	Methodist Midlothian Medical Center Midlothian	Midlothian	$42,901	★★★★☆	B
40	Medical City Arlington Arlington	Arlington	$42,952	★★☆☆☆	C
41	Altus Baytown Hospital Baytown	Baytown	$43,175	Not Rated	C
42	Mission Regional Medical Center Mission	Mission	$43,567	★★★☆☆	C
43	Advanced Dallas Hospitals And Clinics Dallas	Dallas	$43,820	Not Rated	C
44	Hendrick Medical Center Abilene	Abilene	$44,057	★★☆☆☆	C
45	Electra Memorial Hospital Electra	Electra	$44,069	Not Rated	C
46	Texas Health Harris Methodist Hospital Azle Azle	Azle	$44,176	Not Rated	C
47	Stonewall Memorial Hospital District Aspermont	Aspermont	$44,723	Not Rated	C
48	Parkland Health & Hospital System Dallas	Dallas	$44,846	★★☆☆☆	C
49	Cedar Hills Behavioral San Antonio	San Antonio	$44,913	Not Rated	C
50	Woodland Heights Medical Center Lufkin	Lufkin	$44,942	★★★☆☆	C
51	Pecos County Memorial Hospital Fort Stockton	Fort Stockton	$45,041	Not Rated	C
52	Palms Behavioral Health Harlingen	Harlingen	$45,199	Not Rated	C
53	Lamb Healthcare Center Littlefield	Littlefield	$45,446	Not Rated	C
54	Cochran Memorial Hospital Morton	Morton	$45,717	Not Rated	C
55	Baylor Scott And White Medical Center Lake Pointe Rowlett	Rowlett	$45,796	★★★☆☆	C
56	Sweeny Community Hospital Sweeny	Sweeny	$45,826	Not Rated	C
57	Houston Methodist West Hospital Houston	Houston	$45,884	★★★★☆	B
58	The University Of Texas Health Science Center At Tyler Tyler	Tyler	$46,107	★★★☆☆	C
59	Glen Rose Medical Center Glen Rose	Glen Rose	$46,165	Not Rated	C
60	Memorial Hermann Northeast Hospital Humble	Humble	$46,174	★★★☆☆	C
61	Texas Health Center For Diagnostics & Surgery Plano	Plano	$46,254	Not Rated	C
62	North Texas State Hospital Wichita Falls	Wichita Falls	$46,341	Not Rated	C
63	Ascension Seton Southwest Austin	Austin	$46,454	Not Rated	C
64	Terrell State Hospital Terrell	Terrell	$46,604	Not Rated	C
65	Cogdell Memorial Hospital Snyder	Snyder	$46,617	Not Rated	D
66	Rio Grande State Center Harlingen	Harlingen	$46,618	Not Rated	C
67	Comanche County Medical Center Comanche	Comanche	$46,977	★☆☆☆☆	D
68	Peterson Regional Medical Center Kerrville	Kerrville	$46,996	★★★★☆	C
69	St David's South Austin Medical Center Austin	Austin	$47,370	★★★★☆	B
70	Parkview Regional Hospital Mexia	Mexia	$47,684	Not Rated	C
71	Ochiltree General Hospital Perryton	Perryton	$47,696	Not Rated	C
72	Rice Medical Center Eagle Lake	Eagle Lake	$47,922	Not Rated	C
73	Baylor Scott & White Medical Center Pflugerville Pflugerville	Pflugerville	$47,924	★★★★☆	B
74	Navarro Regional Hospital Corsicana	Corsicana	$48,010	★★☆☆☆	C
75	Otto Kaiser Memorial Hospital Kenedy	Kenedy	$48,203	Not Rated	C
76	Texas Health Heart & Vascular Hospital Arlington Arlington	Arlington	$48,291	★★★★☆	C
77	United Regional Health Care System Wichita Falls	Wichita Falls	$48,450	★★★☆☆	C
78	Texas Health Harris Methodist Hospital Southwest F Fort Worth	Fort Worth	$48,472	★★★★☆	B
79	San Antonio Behavioral Healthcare Hospital San Antonio	San Antonio	$48,925	Not Rated	D
80	Grimes St Joseph Health Center Navasota	Navasota	$49,036	Not Rated	C
81	The Hospitals Of Providence - East Campus El Paso	El Paso	$49,348	★★☆☆☆	C
82	Hereford Regional Medical Center Hereford	Hereford	$49,500	Not Rated	C
83	Lubbock Heart Hospital Lp Lubbock	Lubbock	$49,692	★★☆☆☆	C
84	Baylor Scott & White Medical Center - Frisco Frisco	Frisco	$49,741	★★☆☆☆	C
85	Hca Houston Healthcare Clear Lake Webster	Webster	$49,874	★★★☆☆	C
86	Christus Mother Frances Hospital- Winnsboro Winnsboro	Winnsboro	$49,918	Not Rated	C
87	Memorial Hermann Surgical Hospital Kingwood Kingwood	Kingwood	$50,113	Not Rated	C
88	Freestone Medical Center Fairfield	Fairfield	$50,210	Not Rated	C
89	Heart Of Texas Memorial Hospital Brady	Brady	$50,342	Not Rated	C
90	Paris Regional Medical Center Paris	Paris	$50,380	★☆☆☆☆	D
91	Palestine Regional Medical Center Palestine	Palestine	$50,388	★★☆☆☆	C
92	Plains Memorial Hospital Dimmitt	Dimmitt	$50,597	Not Rated	C
93	Memorial Hospital Dumas	Dumas	$50,657	Not Rated	C
94	Christus Jasper Memorial Hospital Jasper	Jasper	$50,835	★★★★★	B
95	Ut Health East Texas Carthage Hospital Carthage	Carthage	$50,850	Not Rated	C
96	Childrens Medical Ctr Of Dallas Dallas	Dallas	$50,948	Not Rated	C
97	Chi St Luke's Health Brazosport Lake Jackson	Lake Jackson	$51,163	★★★★☆	B
98	Lynn County Hospital District Tahoka	Tahoka	$51,251	Not Rated	C
99	Memorial Hermann Houston Physicians Hospital Webster	Webster	$51,411	Not Rated	C
100	Crosbyton Clinic Hospital Crosbyton	Crosbyton	$51,612	Not Rated	C
101	Huntsville Memorial Hospital Huntsville	Huntsville	$51,627	★★★☆☆	C
102	Mc Camey Hospital Mccamey	Mccamey	$51,699	Not Rated	C
103	Bayside Community Hospital Anahuac	Anahuac	$51,851	Not Rated	C
104	Ascension Seton Smithville Smithville	Smithville	$51,870	Not Rated	C
105	Oakbend Medical Center Richmond	Richmond	$52,288	★★☆☆☆	C
106	Bellville Medical Center Bellville	Bellville	$52,851	Not Rated	C
107	Throckmorton County Memorial Hospital Throckmorton	Throckmorton	$53,030	Not Rated	C
108	White Rock Medical Center Dallas	Dallas	$53,103	★★☆☆☆	C
109	Hendrick Medical Center Brownwood Brownwood	Brownwood	$53,142	★☆☆☆☆	F
110	Dimmit Regional Hospital Carrizo Springs	Carrizo Springs	$53,332	Not Rated	C
111	Allegiance Behavioral Health Center Of Plainview Plainview	Plainview	$53,563	Not Rated	C
112	Seymour Hospital Seymour	Seymour	$53,666	Not Rated	C
113	Baptist Medical Center San Antonio	San Antonio	$53,754	★★★☆☆	B
114	Texas Health Harris Methodist Hospital Cleburne Cleburne	Cleburne	$53,956	★★★☆☆	C
115	El Campo Memorial Hospital El Campo	El Campo	$54,019	Not Rated	D
116	Carrollton Regional Medical Center Carrollton	Carrollton	$54,300	★★☆☆☆	D
117	Oceans Behavioral Hospital Of Abilene Abilene	Abilene	$54,604	Not Rated	D
118	William Beaumont Amg (ft Bliss) El Paso	El Paso	$54,873	Not Rated	C
119	Stephens Memorial Hospital Breckenridge	Breckenridge	$54,939	Not Rated	C
120	Coon Memorial Hospital Dalhart	Dalhart	$55,022	Not Rated	C
121	Shamrock General Hospital Shamrock	Shamrock	$55,382	Not Rated	C
122	Wilson N Jones Regional Medical Center Sherman	Sherman	$55,483	★★★★☆	C
123	Dallas Medical Center Dallas	Dallas	$55,496	Not Rated	D
124	Tops Surgical Specialty Hospital Houston	Houston	$55,968	Not Rated	C
125	Ut Health East Texas Athens Hospital Athens	Athens	$56,075	★★★☆☆	C
126	St Luke's Sugar Land Hospital Sugar Land	Sugar Land	$56,184	★★★☆☆	C
127	Schleicher County Medical Center Eldorado	Eldorado	$56,263	Not Rated	C
128	Knox County Hospital Knox City	Knox City	$56,330	Not Rated	C
129	Dallas Regional Medical Center Mesquite	Mesquite	$56,675	★★☆☆☆	C
130	Dell Seton Med Center At The University Of Tx Austin	Austin	$56,976	★★☆☆☆	C
131	Christus Mother Frances Hospital Tyler	Tyler	$56,990	★★★★☆	B
132	Sugar Land Surgical Hospital Llp Sugar Land	Sugar Land	$57,163	Not Rated	C
133	Methodist Hospital For Surgery Addison	Addison	$57,204	★★★★☆	B
134	Memorial Hermann Katy Hospital Katy	Katy	$57,484	★★★☆☆	C
135	Laurel Ridge Treatment Center San Antonio	San Antonio	$57,824	Not Rated	C
136	Nacogdoches Memorial Hospital Nacogdoches	Nacogdoches	$57,921	★☆☆☆☆	D
137	Texas Childrens Hospital North Austin Campus Austin	Austin	$57,972	Not Rated	C
138	Cedar Park Regional Medical Center Cedar Park	Cedar Park	$58,086	★★★★☆	B
139	Ut Health East Texas Jacksonville Hospital Jacksonville	Jacksonville	$58,270	Not Rated	C
140	Doctors Hospital Of Laredo Laredo	Laredo	$58,459	★★★☆☆	C
141	Baylor University Medical Center Dallas	Dallas	$58,517	★★★☆☆	C
142	Driscoll Children's Hospital Rio Grande Valley Edinburg	Edinburg	$58,620	Not Rated	D
143	Memorial Hermann Memorial City Hospital Houston	Houston	$58,769	★★★☆☆	B
144	Memorial Hermann - Texas Medical Center Houston	Houston	$59,008	★★★☆☆	B
145	West Oaks Hospital Houston	Houston	$59,163	Not Rated	C
146	Longview Regional Medical Center Longview	Longview	$59,279	★★★☆☆	C
147	Christus Good Shepherd Medical Center Longview	Longview	$59,402	★★★☆☆	C
148	Texas Health Arlington Memorial Hospital Arlington	Arlington	$59,504	★★☆☆☆	C
149	Shriners Hospitals For Children Galveston	Galveston	$59,586	Not Rated	C
150	Medical City Alliance Fort Worth	Fort Worth	$59,587	★★★★★	B
151	Ut Health San Antonio Multispecialty & Research Ho San Antonio	San Antonio	$59,629	Not Rated	C
152	Hansford County Hospital Spearman	Spearman	$59,681	Not Rated	C
153	Baylor Scott & White Medical Center At Irving Irving	Irving	$59,727	★★★★★	A
154	Cleveland Emergency Hospital Humble	Humble	$59,834	Not Rated	D
155	Saint Camillus Medical Center Hurst	Hurst	$60,078	Not Rated	D
156	St Luke's The Woodlands Hospital The Woodlands	The Woodlands	$60,302	★★★★☆	B
157	Oceans Behavioral Hospital Of Corpus Christi Corpus Christi	Corpus Christi	$60,343	Not Rated	D
158	Concho County Hospital Eden	Eden	$60,347	Not Rated	C
159	Limestone Medical Center Groesbeck	Groesbeck	$60,425	Not Rated	C
160	Baylor Scott And White Medical Center Mckinney Mc Kinney	Mc Kinney	$60,526	★★★★☆	B
161	Seton Medical Center Harker Heights Harker Heights	Harker Heights	$60,796	★★★★☆	B
162	Quail Creek Surgical Hospital Amarillo	Amarillo	$60,898	Not Rated	D
163	Sun Behavioral Houston Houston	Houston	$60,902	Not Rated	C
164	East Houston Medical Center Houston	Houston	$61,070	Not Rated	D
165	Harlingen Medical Center Harlingen	Harlingen	$61,161	★★★★☆	B
166	Methodist Southlake Medical Center Southlake	Southlake	$61,657	★★★★☆	C
167	Oceans Behavioral Hospital Of Waco Waco	Waco	$61,795	Not Rated	C
168	Texas Health Harris Methodist Hospital Southlake Southlake	Southlake	$62,361	Not Rated	D
169	Canyon Creek Behavioral Health Temple	Temple	$62,452	Not Rated	D
170	Baylor Scott And White Orthopedic And Spine Hospi Arlington	Arlington	$62,463	Not Rated	C
171	Ennis Regional Medical Center Ennis	Ennis	$63,046	Not Rated	C
172	Baylor Scott & White Medical Center -Taylor Taylor	Taylor	$63,267	Not Rated	C
173	Rock Springs Georgetown	Georgetown	$63,622	Not Rated	D
174	Kell West Regional Hospital Wichita Falls	Wichita Falls	$63,784	Not Rated	C
175	Riceland Medical Center Winnie	Winnie	$63,845	Not Rated	C
176	Medical City Fort Worth Fort Worth	Fort Worth	$64,030	★★☆☆☆	D
177	Covenant Hospital Plainview Plainview	Plainview	$64,473	Not Rated	C
178	Exceptional Community Hospital Lubbock Lubbock	Lubbock	$64,965	Not Rated	D
179	Red River Hospital Wichita Falls	Wichita Falls	$64,992	Not Rated	C
180	Muenster Memorial Hospital Muenster	Muenster	$65,150	Not Rated	C
181	Rio Grande Regional Hospital Mcallen	Mcallen	$65,393	★★★★☆	C
182	Lone Star Behavioral Health Cypress Cypress	Cypress	$65,454	Not Rated	D
183	Methodist Mansfield Medical Center Mansfield	Mansfield	$65,759	★★☆☆☆	D
184	Westpark Springs Llc Richmond	Richmond	$66,698	Not Rated	D
185	Christus Spohn Hospital Beeville Beeville	Beeville	$67,243	Not Rated	C
186	Culberson Hospital Van Horn	Van Horn	$67,255	Not Rated	C
187	Cornerstone Regional Hospital Edinburg	Edinburg	$67,417	Not Rated	D
188	Cross Creek Hospital Austin	Austin	$67,456	Not Rated	D
189	Cedar Crest Hospital & Rtc Belton	Belton	$67,640	Not Rated	C
190	Ut Health East Texas Pittsburg Hospital Pittsburg	Pittsburg	$67,722	★★☆☆☆	D
191	Houston Methodist Baytown Hospital Baytown	Baytown	$67,850	★★★★★	A
192	Hca Houston Healthcare Pearland Pearland	Pearland	$68,704	★★★☆☆	D
193	Voyages Behavioral Health Of Sugar Land Sugar Land	Sugar Land	$68,797	Not Rated	D
194	Texas Health Hospital Frisco Frisco	Frisco	$69,187	★★★★☆	C
195	Dallas Va Medical Center (va North Texas Healthcare System) Dallas	Dallas	$69,282	★★★★☆	B
196	Covenant Medical Center Lubbock	Lubbock	$70,999	★★☆☆☆	C
197	Baylor Scott & White Medical Center Grapevine Grapevine	Grapevine	$71,891	★★★★★	B
198	Houston Methodist Clear Lake Hospital Nassau Bay	Nassau Bay	$72,042	★★★★★	B
199	Chi St Joseph Health Regional Hospital Bryan	Bryan	$72,332	★★★☆☆	C
200	Westover Hills Baptist Hospital San Antonio	San Antonio	$73,787	Not Rated	D
201	Ad Hospital East, Llc Houston	Houston	$74,284	Not Rated	D
202	Christus Santa Rosa Hospital-San Marcos San Marcos	San Marcos	$75,002	★★★★☆	C
203	Baptist Neighborhood Hospital Thousand Oaks San Antonio	San Antonio	$77,154	Not Rated	D
204	Wellbridge Healthcare Fort Worth Fort Worth	Fort Worth	$77,708	Not Rated	D
205	Methodist Hospital Stone Oak San Antonio	San Antonio	$78,148	★★★☆☆	C
206	Carrus Behavioral Hospital Sherman	Sherman	$78,597	Not Rated	C
207	Methodist Mckinney Hospital Mckinney	Mckinney	$78,963	Not Rated	D
208	The Woodlands Specialty Hospital Spring	Spring	$80,722	Not Rated	C
209	Brushy Creek Family Hospital Llc Round Rock	Round Rock	$81,119	Not Rated	D
210	Glen Oaks Hospital Greenville	Greenville	$81,731	Not Rated	C
211	South Texas Health System Edinburg	Edinburg	$84,251	★★★★☆	B
212	Houston Behavioral Healthcare Hospital Llc Houston	Houston	$84,746	Not Rated	D
213	Valley Baptist Medical Center- Brownsville Brownsville	Brownsville	$86,713	★★★☆☆	C

Frequently Asked Questions

How much does respiratory system diagnosis with ventilator support >96 hours cost in Texas?

Respiratory System Diagnosis with Ventilator Support >96 Hours (DRG 208) averages $53,409 in total Medicare payment across 213 Texas hospitals reporting this code. Within the state, payments span $18,625 to $86,713 — about 5× from cheapest to most expensive.

Is Respiratory System Diagnosis with Ventilator Support >96 Hours more or less expensive in Texas than nationally?

Texas's state-level average of $53,409 sits close to the national Medicare average of $53,417 for this DRG. State differences are driven primarily by the regional Medicare wage index, case mix, and the share of high-acuity referral hospitals.

Why is the spread between hospitals so wide?

Variation within a state runs 5× because the same DRG can come with different lengths of stay, complication adjustments, teaching-status add-ons, and outlier payments. The CMS Hospital Price Transparency Rule publishes machine-readable rate files that allow direct comparisons against negotiated commercial rates, which often differ from Medicare totals.

Are these the prices a privately insured patient would pay?

No. Figures here are Medicare DRG payments. Privately insured patients are billed under their plan's negotiated network rate, published in each hospital's price-transparency file. Uninsured patients should ask the hospital for the cash-pay rate, also disclosed under federal price-transparency rules.

Should I choose a hospital based only on price?

No. HospitalCostData is informational. Surgeon experience, hospital volume for the procedure, complication rates, and your specific clinical situation matter at least as much as price. Always discuss options with your physician and review CMS Care Compare quality data alongside any pricing benchmark.

See the methodology page for DRG sourcing and Medicare wage-index context.

Sources & Citations

CMS Medicare Inpatient Hospital Payments (IPPS). DRG-level average covered charges, total payments, and Medicare payments per facility. data.cms.gov
CMS Hospital Compare (Care Compare). Star ratings, mortality, readmission, safety-of-care, and patient-experience measures. medicare.gov/care-compare
CMS Hospital Price Transparency Rule. Standard charge files required from every Medicare-participating hospital. cms.gov/hospital-price-transparency
Agency for Healthcare Research and Quality (AHRQ). National benchmarks, quality indicators, and clinical context for hospital outcome measures. ahrq.gov

Dataset last refreshed: April 2026. Underlying CMS files are public domain. Suggested citation: “HospitalCostData, hospitalcostdata.com, accessed May 24, 2026.”

This page is informational only and does not constitute medical, legal, or financial advice. Care decisions should be made with a licensed physician.

Source: CMS Hospital Price Transparency, 2026.