South Dakota / Avera Heart Hospital of South Dakota
CMS certification 430095 · Sioux Falls, SD
Avera Heart Hospital of South Dakota: charges and Medicare payments
Avera Heart Hospital of South Dakota reported 1,405 Medicare inpatient stays across 39 DRGs in 2024. Across them it charged 5.94 times what it was paid — among the higher ratios in South Dakota, number 1 of 12 hospitals with at least 100 stays (state median 3.53×, national 4.15×). Its most frequent stay was DRG 267, Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC: 147 stays at an average charge of $203,882, 8% below the national average. It also billed 2,477 outpatient services, charging 7.38 times what Medicare paid.
- 1Medicare inpatient stays 1,405
- 2Charge ÷ paid, inpatient 5.94×
- 3Rank in SD (highest ratio = 1) 1 of 12
- 4CMS price-transparency actions 0
Inpatient stays
For the 39 DRGs that can be compared with the national average, Avera Heart Hospital of South Dakota charged more than the national average in 1 (3%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 147 | $203,882 | -8% | $33,874 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 120 | $140,429 | -10% | $22,308 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 112 | $113,708 | -1% | $14,283 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 80 | $165,769 | -21% | $28,378 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 66 | $19,895 | -31% | $4,007 |
| 291 Heart Failure and Shock with MCC | 53 | $37,990 | -33% | $8,685 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 50 | $20,107 | -44% | $5,193 |
| 269 Aortic and Heart Assist Procedures except Pulsation Balloon... | 49 | $159,860 | -17% | $29,305 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 46 | $157,887 | -4% | $20,001 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 43 | $64,800 | -42% | $14,412 |
| 271 Other Major Cardiovascular Procedures with CC | 40 | $153,210 | -12% | $23,884 |
| 164 Major Chest Procedures with CC | 38 | $91,374 | -28% | $17,651 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 38 | $97,480 | -12% | $14,929 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 38 | $250,872 | -12% | $44,285 |
| 234 Coronary Bypass with Cardiac Catheterization or Open... | 36 | $200,836 | -25% | $35,410 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 35 | $59,268 | -22% | $10,483 |
| 039 Extracranial Procedures without CC/MCC | 31 | $49,404 | -23% | $7,885 |
| 253 Other Vascular Procedures with CC | 31 | $110,068 | -17% | $17,645 |
| 270 Other Major Cardiovascular Procedures with MCC | 27 | $191,197 | -26% | $33,956 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $32,783 | -42% | $8,129 |
| 220 Cardiac Valve and Other Major Cardiothoracic Procedures... | 23 | $209,461 | -24% | $37,098 |
| 244 Permanent Cardiac Pacemaker Implant without CC/MCC | 22 | $87,561 | -6% | $12,574 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 20 | $240,617 | -40% | $52,430 |
| 235 Coronary Bypass without Cardiac Catheterization with MCC | 20 | $230,410 | -21% | $41,378 |
| 324 Coronary Intravascular Lithotripsy with Intraluminal Device... | 20 | $160,888 | -8% | $20,953 |
| 163 Major Chest Procedures with MCC | 18 | $165,680 | -21% | $29,198 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 18 | $42,580 | -16% | $6,512 |
| 035 Carotid Artery Stent Procedures with CC | 16 | $76,904 | -32% | $15,943 |
| 323 Coronary Intravascular Lithotripsy with Intraluminal Device... | 16 | $179,982 | -22% | $28,748 |
| 038 Extracranial Procedures with CC | 14 | $58,125 | -34% | $11,033 |
| 233 Coronary Bypass with Cardiac Catheterization or Open... | 14 | $274,369 | -29% | $53,267 |
| 242 Permanent Cardiac Pacemaker Implant with MCC | 14 | $116,085 | -28% | $25,113 |
| 252 Other Vascular Procedures with MCC | 14 | $190,410 | +11% | $24,347 |
| 036 Carotid Artery Stent Procedures without CC/MCC | 12 | $61,019 | -31% | $12,524 |
| 165 Major Chest Procedures without CC/MCC | 12 | $68,262 | -34% | $12,956 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 12 | $48,756 | -25% | $11,757 |
| 229 Other Cardiothoracic Procedures without MCC | 12 | $149,492 | -9% | $21,876 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 12 | $50,409 | -21% | $7,543 |
| 282 Acute Myocardial Infarction, Discharged Alive without CC/MCC | 11 | $37,013 | -15% | $5,611 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Endovascular Procedures | 783 | $22,386 | $3,049 |
| Level 3 Endovascular Procedures | 404 | $76,329 | $10,240 |
| Level 3 Electrophysiologic Procedures | 278 | $103,356 | $22,135 |
| Level 3 Pacemaker and Similar Procedures | 237 | $71,916 | $9,897 |
| Level 4 Endovascular Procedures | 166 | $109,913 | $16,129 |
| Level 3 Vascular Procedures | 161 | $16,153 | $2,970 |
| Level 2 Pacemaker and Similar Procedures | 107 | $49,287 | $7,965 |
| Level 4 Vascular Procedures | 81 | $26,667 | $5,152 |
| Level 2 Endovascular Procedures | 81 | $40,993 | $5,306 |
| Level 2 ICD and Similar Procedures | 59 | $196,626 | $30,752 |
| Comprehensive Observation Services | 52 | $18,787 | $2,566 |
| Level 4 Pacemaker and Similar Procedures | 27 | $136,581 | $18,227 |
| Level 2 Electrophysiologic Procedures | 22 | $37,124 | $7,002 |
| Implantation Wireless PA Pressure Monitor | 19 | $196,751 | $27,171 |
Against the South Dakota average
For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Avera Heart Hospital of South Dakota charged $203,882 on average, 12% more than the South Dakota average of $182,813, and was paid $33,874 against a state average of $37,133. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Avera Heart Hospital of South Dakota charged $140,429 on average, 22% more than the South Dakota average of $115,253, and was paid $22,308 against a state average of $25,325. For Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC (DRG 322), Avera Heart Hospital of South Dakota charged $113,708 on average, 23% more than the South Dakota average of $92,229, and was paid $14,283 against a state average of $15,395. For Coronary Bypass without Cardiac Catheterization without MCC (DRG 236), Avera Heart Hospital of South Dakota charged $165,769 on average, 2% more than the South Dakota average of $162,098, and was paid $28,378 against a state average of $32,061. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $22,386 was 5% above the state average of $21,419. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $76,329 was 21% above the state average of $63,097. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $103,356 was 2% below the state average of $105,949. For Level 3 Pacemaker and Similar Procedures (outpatient APC 5223), its average charge of $71,916 was 31% above the state average of $55,012.
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.