Ohio / Avita Ontario
CMS certification 360365 · Ontario, OH · 3 entries in CMS's price-transparency list
Avita Ontario: charges and Medicare payments
Avita Ontario reported 117 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 4.29 times what it was paid — mid-range in Ohio, number 40 of 104 hospitals with at least 100 stays (state median 4.01×, national 4.15×). Its most frequent stay was DRG 189, Pulmonary Edema and Respiratory Failure: 20 stays at an average charge of $45,912, 20% below the national average. It also billed 755 outpatient services, charging 5.26 times what Medicare paid.
- 1Medicare inpatient stays 117
- 2Charge ÷ paid, inpatient 4.29×
- 3Rank in OH (highest ratio = 1) 40 of 104
- 4CMS price-transparency actions 3
Inpatient stays
For the 9 DRGs that can be compared with the national average, Avita Ontario 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 |
|---|---|---|---|---|
| 189 Pulmonary Edema and Respiratory Failure | 20 | $45,912 | -20% | $9,277 |
| 291 Heart Failure and Shock with MCC | 16 | $28,253 | -50% | $8,677 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $42,047 | -40% | $12,098 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 12 | $52,630 | -42% | $12,248 |
| 193 Simple Pneumonia and Pleurisy with MCC | 11 | $42,265 | -29% | $9,514 |
| 194 Simple Pneumonia and Pleurisy with CC | 11 | $23,380 | -39% | $6,029 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 11 | $31,777 | -44% | $8,760 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 11 | $125,451 | +1% | $23,731 |
| 603 Cellulitis without MCC | 11 | $26,433 | -29% | $6,699 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Urology and Related Services | 312 | $833 | $512 |
| Level 5 Musculoskeletal Procedures | 219 | $49,894 | $11,432 |
| Level 6 Musculoskeletal Procedures | 24 | $73,356 | $16,174 |
| Level 2 Musculoskeletal Procedures | 22 | $7,315 | $1,398 |
| Level 5 Urology and Related Services | 20 | $21,076 | $4,500 |
| Level 4 Musculoskeletal Procedures | 19 | $33,243 | $6,222 |
| Level 1 Laparoscopy and Related Services | 19 | $32,914 | $5,018 |
| Level 2 Upper GI Procedures | 18 | $12,088 | $1,655 |
| Level 3 Musculoskeletal Procedures | 17 | $12,387 | $2,815 |
| Level 4 Urology and Related Services | 16 | $14,602 | $3,032 |
| Level 1 Endovascular Procedures | 15 | $26,570 | $2,703 |
| Level 1 Nerve Procedures | 15 | $8,609 | $1,679 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 14 | $7,908 | $1,410 |
| Level 6 Urology and Related Services | 13 | $29,722 | $8,011 |
| Level 4 Gynecologic Procedures | 12 | $12,891 | $2,492 |
Against the Ohio average
For Pulmonary Edema and Respiratory Failure (DRG 189), Avita Ontario charged $45,912 on average, 4% more than the Ohio average of $44,002, and was paid $9,277 against a state average of $10,477. For Heart Failure and Shock with MCC (DRG 291), Avita Ontario charged $28,253 on average, 34% less than the Ohio average of $42,986, and was paid $8,677 against a state average of $10,652. For Respiratory Infections and Inflammations with MCC (DRG 177), Avita Ontario charged $42,047 on average, 17% less than the Ohio average of $50,577, and was paid $12,098 against a state average of $13,102. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Avita Ontario charged $52,630 on average, 18% less than the Ohio average of $64,290, and was paid $12,248 against a state average of $15,664. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $833 was 73% below the state average of $3,065. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $49,894 was 15% below the state average of $58,420. For Level 6 Musculoskeletal Procedures (outpatient APC 5116), its average charge of $73,356 was 6% below the state average of $78,314. For Level 2 Musculoskeletal Procedures (outpatient APC 5112), its average charge of $7,315 was 25% below the state average of $9,815.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Avita Ontario in Ontario, OH, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-09-08 (CMS case 6517)
- Closure Notice — 2025-11-14 (CMS case 6517)
- Met Requirements — 2026-04-09 (CMS case 7409)
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.