CMS Releases Hospital Pricing Data

Margaret Dick Tocknell, May 9, 2013

For the first time, the federal government has made public chargemaster data for the 100 most common Medicare inpatient diagnostic related groups or DRGs. Hospital prices vary widely even within the same within the same city or region.

In an unprecedented move Wednesday, the Centers for Medicare & Medicaid Services made public extensive hospital cost data, jolting healthcare providers, payers, and consumers alike.


MU proposed rules

How much hospitals charge for the same procedures (source: The New York Times)

The massive file contains chargemaster data or what some call the "sticker price" for the 100 most common Medicare inpatient diagnostic related groups or DRGs. The data does not include physician costs. But it does provide an inside look at how average covered Medicare charges can significantly vary from hospital to hospital within the same city or geographic area.

The data is for 3,400 hospitals and represent 92% of all hospital inpatient charges in fiscal year 2011. Here's a sampling:

  • In Birmingham, AL, the charges for of a hospital stay to treat chronic obstructive pulmonary disease with major complications range from $23,245 at St. Vincent's Birmingham to $87,065 at Brookwood Medical Center.
  • In Jacksonville, FL, the charges for treating simple pneumonia and pleurisy range from $13,923 at St. Vincent's Medical Center to $41,411 at Memorial Hospital.
  • In Seattle, WA, average covered Medicare charges for joint replacement with major complications range from $44,328 at the University of Washington Medical Center to $92,165 at Swedish Medical Center.
Margaret Dick Tocknell Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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