South Dakota / Avera St Mary's Hospital
CMS certification 430015 · Pierre, SD · 1 entry in CMS's price-transparency list
Avera St Mary's Hospital: charges and Medicare payments
Avera St Mary's Hospital reported 200 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 3.38 times what it was paid — mid-range in South Dakota, number 7 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: 91 stays at an average charge of $55,153, 39% below the national average. It also billed 1,336 outpatient services, charging 5.42 times what Medicare paid.
- 1Medicare inpatient stays 200
- 2Charge ÷ paid, inpatient 3.38×
- 3Rank in SD (highest ratio = 1) 7 of 12
- 4CMS price-transparency actions 1
Inpatient stays
For the 9 DRGs that can be compared with the national average, Avera St Mary's Hospital charged more than the national average in 1 (11%). 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 | 91 | $55,153 | -39% | $16,693 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 18 | $56,684 | -39% | $16,664 |
| 291 Heart Failure and Shock with MCC | 17 | $43,651 | -23% | $11,140 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $36,879 | -25% | $9,764 |
| 603 Cellulitis without MCC | 13 | $39,684 | +6% | $7,820 |
| 389 Gastrointestinal Obstruction with CC | 12 | $34,555 | -11% | $7,155 |
| 481 Hip and Femur Procedures except Major Joint with CC | 12 | $60,598 | -40% | $17,592 |
| 189 Pulmonary Edema and Respiratory Failure | 11 | $42,006 | -27% | $10,701 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 11 | $103,888 | -55% | $41,791 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Urology and Related Services | 269 | $2,381 | $686 |
| Level 1 Intraocular Procedures | 177 | $10,710 | $2,308 |
| Comprehensive Observation Services | 128 | $23,502 | $2,731 |
| Level 3 Urology and Related Services | 108 | $1,828 | $2,045 |
| Level 5 Musculoskeletal Procedures | 91 | $50,717 | $13,067 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 83 | $5,627 | $1,589 |
| Level 4 Musculoskeletal Procedures | 69 | $35,279 | $7,018 |
| Level 3 Musculoskeletal Procedures | 66 | $15,296 | $3,211 |
| Level 4 Urology and Related Services | 59 | $10,161 | $3,465 |
| Level 1 Laparoscopy and Related Services | 53 | $28,772 | $5,794 |
| Level 1 Nerve Procedures | 51 | $8,701 | $1,915 |
| Level 5 Urology and Related Services | 50 | $18,667 | $5,196 |
| Level 2 Musculoskeletal Procedures | 43 | $5,753 | $1,614 |
| Level 3 Vascular Procedures | 33 | $21,547 | $3,201 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 21 | $11,483 | $2,853 |
| Level 2 Vascular Procedures | 12 | $4,637 | $1,608 |
| Level 4 Gynecologic Procedures | 12 | $18,518 | $3,139 |
| Level 3 Intraocular Procedures | 11 | $19,099 | $5,248 |
Against the South Dakota average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Avera St Mary's Hospital charged $55,153 on average, 18% less than the South Dakota average of $67,007, and was paid $16,693 against a state average of $17,025. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Avera St Mary's Hospital charged $56,684 on average, 8% more than the South Dakota average of $52,397, and was paid $16,664 against a state average of $13,781. For Heart Failure and Shock with MCC (DRG 291), Avera St Mary's Hospital charged $43,651 on average, 1% less than the South Dakota average of $44,214, and was paid $11,140 against a state average of $11,100. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Avera St Mary's Hospital charged $36,879 on average, 3% less than the South Dakota average of $38,150, and was paid $9,764 against a state average of $9,216. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,381 was 1% above the state average of $2,357. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,710 was 34% above the state average of $7,991. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,502 was 28% above the state average of $18,366. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $1,828 was 75% below the state average of $7,172.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Avera St Mary's Hospital in Pierre, SD, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-22 (CMS case 4012)
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.