Alton Memorial Hospital: charges and Medicare payments

Alton Memorial Hospital reported 1,229 Medicare inpatient stays across 44 DRGs in 2024. Across them it charged 3.83 times what it was paid — mid-range in Illinois, number 63 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 152 stays at an average charge of $45,438, 19% below the national average. It also billed 1,082 outpatient services, charging 5.59 times what Medicare paid.

1Medicare inpatient stays 1,229
2Charge ÷ paid, inpatient 3.83×
3Rank in IL (highest ratio = 1) 63 of 106
4CMS price-transparency actions 1

Average charge per stay at Alton Memorial Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 44 DRGs that can be compared with the national average, Alton Memorial Hospital charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
291 Heart Failure and Shock with MCC	152	$45,438	-19%	$10,981
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	119	$53,451	-41%	$14,706
177 Respiratory Infections and Inflammations with MCC	60	$47,335	-33%	$14,862
193 Simple Pneumonia and Pleurisy with MCC	55	$50,313	-16%	$11,268
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	54	$27,447	-32%	$6,550
190 Chronic Obstructive Pulmonary Disease with MCC	44	$45,290	-10%	$8,921
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	42	$35,916	-40%	$10,375
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	37	$25,967	-30%	$7,032
470 Major Hip and Knee Joint Replacement or Reattachment of...	35	$64,101	-31%	$14,616
683 Renal Failure with CC	35	$35,362	-13%	$7,370
690 Kidney and Urinary Tract Infections without MCC	34	$26,004	-31%	$7,239
189 Pulmonary Edema and Respiratory Failure	29	$40,748	-29%	$9,551
689 Kidney and Urinary Tract Infections with MCC	29	$33,970	-34%	$9,387
603 Cellulitis without MCC	26	$24,484	-34%	$7,305
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	26	$30,664	-37%	$9,187
312 Syncope and Collapse	24	$29,690	-35%	$6,893
309 Cardiac Arrhythmia and Conduction Disorders with CC	23	$29,978	-17%	$9,748
698 Other Kidney and Urinary Tract Diagnoses with MCC	23	$47,993	-35%	$12,991
853 Infectious and Parasitic Diseases with O.R. Procedures with...	23	$101,537	-56%	$36,296
378 Gastrointestinal Hemorrhage with CC	21	$35,196	-28%	$8,136
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	20	$44,485	-20%	$8,236
178 Respiratory Infections and Inflammations with CC	18	$29,032	-36%	$7,931
194 Simple Pneumonia and Pleurisy with CC	18	$28,586	-26%	$7,398
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	17	$51,105	-22%	$10,783
322 Percutaneous Cardiovascular Procedures with Intraluminal...	17	$74,785	-35%	$17,166
101 Seizures without MCC	16	$24,076	-51%	$8,415
638 Diabetes with CC	16	$35,653	-14%	$8,204
682 Renal Failure with MCC	16	$50,346	-24%	$18,428
308 Cardiac Arrhythmia and Conduction Disorders with MCC	14	$35,454	-37%	$9,672
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	14	$29,095	-52%	$9,732
394 Other Digestive System Diagnoses with CC	14	$29,752	-37%	$7,422
552 Medical Back Problems without MCC	14	$29,837	-39%	$7,956
057 Degenerative Nervous System Disorders without MCC	13	$35,132	-38%	$10,689
069 Transient Ischemia without Thrombolytic	13	$34,455	-32%	$6,580
286 Circulatory Disorders except AMI, with Cardiac...	13	$72,652	-35%	$16,360
330 Major Small and Large Bowel Procedures with CC	13	$75,660	-36%	$18,163
377 Gastrointestinal Hemorrhage with MCC	12	$48,495	-43%	$13,741
644 Endocrine Disorders with CC	12	$35,460	-26%	$9,295
699 Other Kidney and Urinary Tract Diagnoses with CC	12	$33,580	-29%	$8,339
884 Organic Disturbances and Intellectual Disability	12	$39,315	-37%	$12,647
092 Other Disorders of Nervous System with CC	11	$28,332	-45%	$8,415
100 Seizures with MCC	11	$54,307	-42%	$15,557
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	11	$26,945	-6%	$5,164
389 Gastrointestinal Obstruction with CC	11	$28,236	-27%	$6,652

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	202	$48,141	$12,002
Comprehensive Observation Services	108	$16,178	$2,455
Level 1 Endovascular Procedures	94	$14,448	$2,970
Level 1 Nerve Procedures	81	$13,997	$1,784
Level 2 Excision/ Biopsy/ Incision and Drainage	71	$10,043	$1,498
Level 1 Laparoscopy and Related Services	66	$23,131	$5,207
Level 3 Musculoskeletal Procedures	51	$19,504	$2,945
Level 4 Musculoskeletal Procedures	43	$33,998	$6,611
Level 2 Upper GI Procedures	41	$6,625	$1,758
Level 3 Vascular Procedures	40	$17,210	$2,828
Level 6 Musculoskeletal Procedures	31	$58,506	$17,185
Level 5 Urology and Related Services	29	$25,896	$4,782
Level 2 Musculoskeletal Procedures	26	$10,740	$1,485
Level 4 Endovascular Procedures	24	$81,765	$15,173
Level 3 Urology and Related Services	23	$13,484	$1,882
Level 3 Excision/ Biopsy/ Incision and Drainage	21	$13,752	$2,501
Level 3 Pacemaker and Similar Procedures	20	$31,881	$9,449
Level 4 Urology and Related Services	20	$18,143	$3,222
Level 4 Airway Endoscopy	17	$20,809	$3,299
Level 5 Airway Endoscopy	17	$25,340	$6,325
Level 3 Endovascular Procedures	17	$48,631	$9,155
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	16	$22,488	$3,197
Level 2 Vascular Procedures	12	$12,493	$1,418
Level 2 Pacemaker and Similar Procedures	12	$25,795	$7,851

Against the Illinois average

For Heart Failure and Shock with MCC (DRG 291), Alton Memorial Hospital charged $45,438 on average, 2% less than the Illinois average of $46,293, and was paid $10,981 against a state average of $11,813. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Alton Memorial Hospital charged $53,451 on average, 28% less than the Illinois average of $73,987, and was paid $14,706 against a state average of $17,651. For Respiratory Infections and Inflammations with MCC (DRG 177), Alton Memorial Hospital charged $47,335 on average, 21% less than the Illinois average of $59,769, and was paid $14,862 against a state average of $14,404. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Alton Memorial Hospital charged $50,313 on average, 3% more than the Illinois average of $49,081, and was paid $11,268 against a state average of $11,857. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $48,141 was 28% below the state average of $67,146. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $16,178 was 25% below the state average of $21,498. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $14,448 was 42% below the state average of $25,004. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $13,997 was 8% above the state average of $12,903.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Alton Memorial Hospital in Alton, IL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2025-02-06 (CMS case 3093)

A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.

Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.

Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.