8/100
#2,444 nationally
Merit Health Madison
161 River Oaks Drive, Canton, MS 39046 · (601) 855-4000
Among the highest charge markups in the country
For every $1 of care Medicare actually paid for here, Merit Health Madison billed $12.47 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
- 12.5x
- volume-weighted across all its priced work
- Procedures priced
- 15
- inpatient and outpatient combined
- Rank in MS
- #32
- 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 3% of U.S. hospitals.
Better than 5% of U.S. hospitals.
Better than 6% 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 |
|---|---|---|---|---|
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
44 | $37,470 | $2,292 | +93% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
35 | $57,533 | $2,486 | +201% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
28 | $93,403 | $15,486 | +43% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
23 | $51,762 | $2,817 | +151% |
|
Level 4 Vascular Procedures
APC 5184 · Hospital outpatient visit |
22 | $103,873 | $4,601 | +187% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
19 | $39,726 | $1,634 | +207% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
19 | $73,302 | $4,332 | +167% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
16 | $98,806 | $11,513 | +112% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
16 | $70,979 | $10,455 | +64% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
16 | $136,352 | $11,006 | +118% |
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 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
$44,077 | $1,357 | +337% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$39,726 | $1,634 | +207% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
$57,533 | $2,486 | +201% |
|
Level 4 Vascular Procedures
APC 5184 · Hospital outpatient visit |
$103,873 | $4,601 | +187% |
|
Level 2 Breast/lymphatic Surgery and Related Procedures
APC 5092 · Hospital outpatient visit |
$111,400 | $5,459 | +182% |
|
Level 3 Lower GI Procedures
APC 5313 · Hospital outpatient visit |
$45,660 | $2,351 | +175% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
$73,302 | $4,332 | +167% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$51,762 | $2,817 | +151% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
$93,403 | $15,486 | +43% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
$70,979 | $10,455 | +64% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
$37,470 | $2,292 | +93% |
|
Respiratory Failure
MS-DRG 189 · Inpatient stay |
$94,391 | $11,744 | +95% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
$98,806 | $11,513 | +112% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
$136,352 | $11,006 | +118% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
$81,362 | $4,654 | +132% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$51,762 | $2,817 | +151% |
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.