South Dakota / Avera Mckennan Hospital & University Health Center
CMS certification 430016 · Sioux Falls, SD · 5 entries in CMS's price-transparency list
Avera Mckennan Hospital & University Health Center: charges and Medicare payments
Avera Mckennan Hospital & University Health Center reported 5,621 Medicare inpatient stays across 158 DRGs in 2024. Across them it charged 4.93 times what it was paid — among the higher ratios in South Dakota, number 2 of 12 hospitals with at least 100 stays (state median 3.53×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 424 stays at an average charge of $82,876, 8% below the national average. It also billed 8,311 outpatient services, charging 6.7 times what Medicare paid.
- 1Medicare inpatient stays 5,621
- 2Charge ÷ paid, inpatient 4.93×
- 3Rank in SD (highest ratio = 1) 2 of 12
- 4CMS price-transparency actions 5
Inpatient stays
For the 158 DRGs that can be compared with the national average, Avera Mckennan Hospital & University Health Center charged more than the national average in 19 (12%). 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 | 424 | $82,876 | -8% | $16,293 |
| 885 Psychoses | 320 | $29,592 | -33% | $11,486 |
| 291 Heart Failure and Shock with MCC | 177 | $51,481 | -9% | $10,780 |
| 177 Respiratory Infections and Inflammations with MCC | 130 | $63,243 | -10% | $13,315 |
| 193 Simple Pneumonia and Pleurisy with MCC | 127 | $50,123 | -16% | $10,765 |
| 189 Pulmonary Edema and Respiratory Failure | 116 | $51,451 | -11% | $10,209 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 109 | $95,702 | -4% | $16,324 |
| 378 Gastrointestinal Hemorrhage with CC | 102 | $33,276 | -31% | $8,118 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 95 | $56,984 | +2% | $8,554 |
| 481 Hip and Femur Procedures except Major Joint with CC | 93 | $85,654 | -15% | $16,402 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 84 | $188,354 | -18% | $39,321 |
| 330 Major Small and Large Bowel Procedures with CC | 79 | $84,688 | -29% | $17,690 |
| 377 Gastrointestinal Hemorrhage with MCC | 73 | $73,685 | -14% | $14,163 |
| 690 Kidney and Urinary Tract Infections without MCC | 73 | $32,540 | -14% | $6,689 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 70 | $49,659 | -18% | $10,287 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 69 | $78,560 | -16% | $14,573 |
| 682 Renal Failure with MCC | 69 | $55,078 | -16% | $11,906 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 65 | $48,793 | -1% | $8,833 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 64 | $55,851 | -24% | $12,884 |
| 467 Revision of Hip or Knee Replacement with CC | 62 | $118,118 | -25% | $25,635 |
| 683 Renal Failure with CC | 59 | $34,500 | -15% | $7,458 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 59 | $37,380 | -21% | $8,324 |
| 603 Cellulitis without MCC | 58 | $30,004 | -20% | $7,444 |
| 882 Neuroses except Depressive | 58 | $15,185 | -61% | $7,978 |
| 552 Medical Back Problems without MCC | 56 | $40,603 | -17% | $8,162 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 54 | $209,924 | -9% | $38,156 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 53 | $30,478 | -24% | $6,701 |
| 689 Kidney and Urinary Tract Infections with MCC | 52 | $47,347 | -8% | $9,621 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 51 | $126,008 | -7% | $21,942 |
| 460 Spinal Fusion except Cervical without MCC | 51 | $157,755 | -7% | $28,782 |
| 329 Major Small and Large Bowel Procedures with MCC | 48 | $152,478 | -29% | $34,946 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 48 | $43,495 | -36% | $10,628 |
| 069 Transient Ischemia without Thrombolytic | 46 | $39,767 | -21% | $6,722 |
| 312 Syncope and Collapse | 44 | $36,880 | -19% | $7,322 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 43 | $78,982 | +4% | $13,860 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 43 | $135,299 | -2% | $23,630 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 41 | $225,722 | -20% | $46,130 |
| 389 Gastrointestinal Obstruction with CC | 41 | $28,363 | -27% | $6,709 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 39 | $34,729 | -6% | $6,565 |
| 057 Degenerative Nervous System Disorders without MCC | 38 | $54,219 | -4% | $10,706 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 36 | $79,721 | -22% | $16,317 |
| 394 Other Digestive System Diagnoses with CC | 35 | $42,390 | -10% | $7,938 |
| 101 Seizures without MCC | 34 | $54,180 | +11% | $7,586 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 34 | $216,826 | 0% | $40,140 |
| 194 Simple Pneumonia and Pleurisy with CC | 32 | $33,875 | -12% | $6,943 |
| 393 Other Digestive System Diagnoses with MCC | 32 | $51,399 | -33% | $13,085 |
| 445 Disorders of The Biliary Tract with CC | 32 | $46,572 | -20% | $9,497 |
| 039 Extracranial Procedures without CC/MCC | 30 | $48,026 | -25% | $8,994 |
| 092 Other Disorders of Nervous System with CC | 30 | $54,957 | +7% | $8,750 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 30 | $66,814 | -22% | $13,415 |
| 813 Coagulation Disorders | 30 | $43,079 | -46% | $12,463 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 29 | $37,350 | -39% | $10,171 |
| 659 Kidney and Ureter Procedures for Non-Neoplasm with MCC | 29 | $109,104 | -9% | $21,408 |
| 035 Carotid Artery Stent Procedures with CC | 28 | $133,604 | +18% | $19,323 |
| 314 Other Circulatory System Diagnoses with MCC | 28 | $88,319 | -7% | $17,998 |
| 091 Other Disorders of Nervous System with MCC | 27 | $67,349 | -19% | $14,164 |
| 673 Other Kidney and Urinary Tract Procedures with MCC | 27 | $130,566 | -25% | $30,588 |
| 253 Other Vascular Procedures with CC | 26 | $99,510 | -25% | $22,109 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 26 | $36,126 | -24% | $8,429 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 25 | $51,546 | -21% | $11,142 |
Showing the 60 most frequent of 158 DRGs.
Outpatient services
Against the South Dakota average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Avera Mckennan Hospital & University Health Center charged $82,876 on average, 24% more than the South Dakota average of $67,007, and was paid $16,293 against a state average of $17,025. For Psychoses (DRG 885), Avera Mckennan Hospital & University Health Center charged $29,592 on average, 11% less than the South Dakota average of $33,069, and was paid $11,486 against a state average of $12,028. For Heart Failure and Shock with MCC (DRG 291), Avera Mckennan Hospital & University Health Center charged $51,481 on average, 16% more than the South Dakota average of $44,214, and was paid $10,780 against a state average of $11,100. For Respiratory Infections and Inflammations with MCC (DRG 177), Avera Mckennan Hospital & University Health Center charged $63,243 on average, 17% more than the South Dakota average of $53,881, and was paid $13,315 against a state average of $14,370. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,963 was 32% above the state average of $8,333. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $9,517 was 1% above the state average of $9,405. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $56,353 was 16% above the state average of $48,584. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $12,112 was 21% above the state average of $10,045.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Avera Mckennan Hospital & University Health Center in Sioux Falls, SD, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-05-18 (CMS case 115)
- CAP Request — 2021-10-27 (CMS case 115)
- Closure Notice — 2021-12-20 (CMS case 115)
- Met Requirements — 2025-07-07 (CMS case 5527)
- Met Requirements — 2026-04-09 (CMS case 7410)
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.