Ascension Seton Hays: charges and Medicare payments

Ascension Seton Hays reported 1,148 Medicare inpatient stays across 45 DRGs in 2024. Across them it charged 7.98 times what it was paid — among the higher ratios in Texas, number 57 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 199 stays at an average charge of $107,910, 20% above the national average. It also billed 870 outpatient services, charging 17.31 times what Medicare paid.

1Medicare inpatient stays 1,148
2Charge ÷ paid, inpatient 7.98×
3Rank in TX (highest ratio = 1) 57 of 190
4CMS price-transparency actions 0

Average charge per stay at Ascension Seton Hays, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 45 DRGs that can be compared with the national average, Ascension Seton Hays charged more than the national average in 41 (91%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	199	$107,910	+20%	$14,321
291 Heart Failure and Shock with MCC	66	$77,500	+37%	$10,839
193 Simple Pneumonia and Pleurisy with MCC	63	$92,178	+54%	$10,699
690 Kidney and Urinary Tract Infections without MCC	51	$42,478	+12%	$8,213
280 Acute Myocardial Infarction, Discharged Alive with MCC	37	$114,130	+51%	$13,004
177 Respiratory Infections and Inflammations with MCC	36	$84,735	+20%	$12,676
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	35	$62,631	+28%	$8,685
481 Hip and Femur Procedures except Major Joint with CC	33	$134,249	+33%	$15,360
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$56,842	+42%	$7,192
689 Kidney and Urinary Tract Infections with MCC	29	$52,454	+2%	$9,662
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	28	$181,653	+78%	$15,956
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	26	$92,416	-7%	$14,099
286 Circulatory Disorders except AMI, with Cardiac...	26	$170,554	+52%	$16,440
853 Infectious and Parasitic Diseases with O.R. Procedures with...	26	$296,445	+29%	$34,844
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	24	$64,057	+15%	$8,495
189 Pulmonary Edema and Respiratory Failure	24	$64,912	+13%	$9,775
378 Gastrointestinal Hemorrhage with CC	23	$52,022	+7%	$8,135
682 Renal Failure with MCC	23	$68,047	+3%	$11,461
603 Cellulitis without MCC	19	$41,016	+10%	$7,771
480 Hip and Femur Procedures except Major Joint with MCC	18	$192,906	+39%	$20,635
322 Percutaneous Cardiovascular Procedures with Intraluminal...	17	$259,281	+126%	$14,180
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	17	$40,674	+10%	$7,392
683 Renal Failure with CC	17	$47,464	+17%	$7,732
194 Simple Pneumonia and Pleurisy with CC	16	$34,888	-9%	$7,318
208 Respiratory System Diagnosis with Ventilator Support <=96...	16	$119,436	-12%	$18,576
552 Medical Back Problems without MCC	15	$50,559	+3%	$8,351
082 Traumatic Stupor and Coma >1 Hour with MCC	14	$126,042	+9%	$17,393
312 Syncope and Collapse	14	$53,999	+19%	$7,792
377 Gastrointestinal Hemorrhage with MCC	14	$88,460	+4%	$12,763
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	14	$61,788	+2%	$10,537
101 Seizures without MCC	13	$47,034	-4%	$10,991
309 Cardiac Arrhythmia and Conduction Disorders with CC	13	$44,492	+23%	$6,975
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	13	$96,901	+59%	$10,322
025 Craniotomy and Endovascular Intracranial Procedures with MCC	12	$233,313	+1%	$29,523
184 Major Chest Trauma with CC	12	$70,044	+26%	$8,958
281 Acute Myocardial Infarction, Discharged Alive with CC	12	$90,235	+79%	$8,588
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	12	$31,298	+9%	$5,751
394 Other Digestive System Diagnoses with CC	12	$58,719	+25%	$8,268
638 Diabetes with CC	12	$50,012	+20%	$7,779
698 Other Kidney and Urinary Tract Diagnoses with MCC	12	$105,770	+44%	$13,000
308 Cardiac Arrhythmia and Conduction Disorders with MCC	11	$103,531	+83%	$10,273
321 Percutaneous Cardiovascular Procedures with Intraluminal...	11	$388,393	+137%	$21,711
482 Hip and Femur Procedures except Major Joint without CC/MCC	11	$102,129	+31%	$12,558
551 Medical Back Problems with MCC	11	$127,699	+62%	$12,073
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	11	$43,977	+3%	$10,230

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	275	$35,088	$2,402
Level 1 Endovascular Procedures	107	$40,852	$2,815
Level 5 Musculoskeletal Procedures	78	$194,537	$11,442
Level 3 Endovascular Procedures	50	$192,991	$9,676
Level 1 Laparoscopy and Related Services	40	$63,648	$5,079
Level 3 Vascular Procedures	34	$29,472	$2,806
Level 2 Excision/ Biopsy/ Incision and Drainage	30	$15,323	$1,427
Level 4 Musculoskeletal Procedures	27	$82,925	$6,111
Level 4 Vascular Procedures	26	$27,806	$4,837
Level 2 Endovascular Procedures	24	$90,991	$5,031
Level 4 Urology and Related Services	23	$32,943	$3,068
Level 3 Musculoskeletal Procedures	20	$40,793	$2,849
Level 3 Electrophysiologic Procedures	17	$164,529	$20,852
Level 6 Musculoskeletal Procedures	15	$192,423	$15,386
Level 2 Pacemaker and Similar Procedures	15	$82,478	$6,683
Level 5 Urology and Related Services	15	$51,089	$4,554
Level 3 Excision/ Biopsy/ Incision and Drainage	13	$20,694	$2,501
Level 2 Musculoskeletal Procedures	13	$18,798	$1,415
Level 4 Endovascular Procedures	13	$198,790	$15,404
Level 2 Upper GI Procedures	13	$12,054	$1,675
Level 2 Breast/Lymphatic Surgery and Related Procedures	11	$69,332	$5,740
Level 3 Pacemaker and Similar Procedures	11	$164,419	$9,393

Against the Texas average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Ascension Seton Hays charged $107,910 on average, 3% less than the Texas average of $111,133, and was paid $14,321 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), Ascension Seton Hays charged $77,500 on average, 14% more than the Texas average of $67,944, and was paid $10,839 against a state average of $11,820. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Ascension Seton Hays charged $92,178 on average, 25% more than the Texas average of $73,756, and was paid $10,699 against a state average of $11,597. For Kidney and Urinary Tract Infections without MCC (DRG 690), Ascension Seton Hays charged $42,478 on average, 1% less than the Texas average of $42,965, and was paid $8,213 against a state average of $8,372. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $35,088 was 26% above the state average of $27,955. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $40,852 was 13% above the state average of $36,220. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $194,537 was 97% above the state average of $98,771. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $192,991 was 106% above the state average of $93,719.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

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.