42/100
#1,532 nationally
Pikeville Medical Center
911 Bypass Road, Pikeville, KY 41501 · (606) 437-3500
Charges well above the national norm
For every $1 of care Medicare actually paid for here, Pikeville Medical Center billed $5.06 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
- 5.1x
- volume-weighted across all its priced work
- Procedures priced
- 91
- inpatient and outpatient combined
- Rank in KY
- #29
- lower markup ranks higher
- CMS quality stars
- 1/5
- 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 38% of U.S. hospitals.
Better than 47% of U.S. hospitals.
Better than 41% of U.S. hospitals.
Better than 50% 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 |
383 | $22,986 | $2,429 | +18% |
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
299 | $8,748 | $2,085 | -26% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
298 | $81,227 | $18,279 | +24% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
216 | $58,461 | $11,795 | -6% |
|
Level 2 Urology and Related Services
APC 5372 · Hospital outpatient visit |
181 | $3,654 | $618 | +16% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
162 | $11,421 | $1,444 | +13% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
150 | $28,727 | $2,865 | +14% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
142 | $62,685 | $12,358 | +44% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
106 | $37,286 | $6,351 | -6% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
102 | $58,205 | $11,786 | +25% |
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 Icd and Similar Procedures
APC 5232 · Hospital outpatient visit |
$278,054 | $28,568 | +87% |
|
Level 2 Vascular Procedures
APC 5182 · Hospital outpatient visit |
$15,591 | $1,455 | +82% |
|
Irregular Heartbeat (severe)
MS-DRG 308 · Inpatient stay |
$76,769 | $12,187 | +62% |
|
Level 3 ENT Procedures
APC 5163 · Hospital outpatient visit |
$10,143 | $1,327 | +59% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
$85,863 | $15,106 | +56% |
|
Kidney or Urinary Disorder (severe)
MS-DRG 698 · Inpatient stay |
$86,504 | $16,356 | +52% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
$62,685 | $12,358 | +44% |
|
Level 3 Pacemaker and Similar Procedures
APC 5223 · Hospital outpatient visit |
$73,084 | $9,692 | +42% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
$15,799 | $4,700 | -42% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$12,266 | $3,166 | -41% |
|
Endovascular Cardiac Valve Replacement and Supplement Procedures without Major
MS-DRG 267 · Inpatient stay |
$123,470 | $46,013 | -35% |
|
Level 6 Urology and Related Services
APC 5376 · Hospital outpatient visit |
$30,789 | $8,011 | -31% |
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
$8,748 | $2,085 | -26% |
|
Level 2 Laparoscopy and Related Services
APC 5362 · Hospital outpatient visit |
$46,849 | $9,344 | -22% |
|
Cirrhosis and Alcoholic Hepatitis with Major Complications
MS-DRG 432 · Inpatient stay |
$62,912 | $18,665 | -21% |
|
Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications
MS-DRG 522 · Inpatient stay |
$68,263 | $19,246 | -20% |
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.