23/100
#2,084 nationally
Highpoint Health-Sumner With Ascension Saint Thoma
555 Hartsville Pike, Gallatin, TN 37066 · (615) 328-8888
Charges far above the national norm
For every $1 of care Medicare actually paid for here, Highpoint Health-Sumner With Ascension Saint Thoma billed $7.34 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 7.3x
- volume-weighted across all its priced work
- Procedures priced
- 58
- inpatient and outpatient combined
- Rank in TN
- #47
- lower markup ranks higher
- CMS quality stars
- 3/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 15% of U.S. hospitals.
Better than 18% of U.S. hospitals.
Better than 27% of U.S. hospitals.
Better than 49% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
231 | $95,376 | $13,391 | +46% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
98 | $29,719 | $2,339 | +53% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
88 | $73,602 | $9,704 | +70% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
78 | $29,614 | $4,372 | +8% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
59 | $13,987 | $1,397 | +39% |
|
Urinary Tract Infection (severe)
MS-DRG 689 · Inpatient stay |
51 | $52,929 | $8,171 | +30% |
|
Sepsis (without major complications)
MS-DRG 872 · Inpatient stay |
48 | $50,626 | $7,402 | +29% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
48 | $28,708 | $2,658 | +50% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
45 | $67,557 | $9,822 | +45% |
|
COPD (severe)
MS-DRG 190 · Inpatient stay |
44 | $78,101 | $8,544 | +87% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 3 Excision/ Biopsy/ Incision and Drainage
APC 5073 · Hospital outpatient visit |
$37,541 | $2,437 | +112% |
|
Pulmonary Embolism with Major Complications or Acute Cor Pulmonale
MS-DRG 175 · Inpatient stay |
$115,473 | $9,394 | +112% |
|
COPD (severe)
MS-DRG 190 · Inpatient stay |
$78,101 | $8,544 | +87% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
$69,257 | $5,905 | +74% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
$73,602 | $9,704 | +70% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
$56,475 | $4,971 | +61% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
$29,719 | $2,339 | +53% |
|
Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications
MS-DRG 522 · Inpatient stay |
$130,773 | $14,191 | +53% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Diabetes with Major Complications
MS-DRG 637 · Inpatient stay |
$48,202 | $10,062 | -15% |
|
Red Blood Cell Disorders without Major Complications
MS-DRG 812 · Inpatient stay |
$36,012 | $6,620 | -3% |
|
Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without
MS-DRG 563 · Inpatient stay |
$36,290 | $6,612 | about average |
|
Hypertension without Major Complications
MS-DRG 305 · Inpatient stay |
$33,725 | $5,874 | about average |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$12,100 | $1,598 | about average |
|
Heart Attack (with complications)
MS-DRG 281 · Inpatient stay |
$46,087 | $7,113 | +5% |
|
Fractures of Hip and Pelvis without Major Complications
MS-DRG 536 · Inpatient stay |
$35,166 | $5,732 | +7% |
|
Fluid and Electrolyte Disorder (severe)
MS-DRG 640 · Inpatient stay |
$52,110 | $9,337 | +7% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.