Kentucky / Baptist Health La Grange
CMS certification 180138 · La Grange, KY · 3 entries in CMS's price-transparency list
Baptist Health La Grange: charges and Medicare payments
Baptist Health La Grange reported 91 Medicare inpatient stays across 5 DRGs in 2024. Across them it charged 5.38 times what it was paid. Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 24 stays at an average charge of $31,572, 44% below the national average. It also billed 717 outpatient services, charging 12.48 times what Medicare paid.
- 1Medicare inpatient stays 91
- 2Charge ÷ paid, inpatient 5.38×
- 3Rank in KY (highest ratio = 1) –
- 4CMS price-transparency actions 3
Inpatient stays
For the 5 DRGs that can be compared with the national average, Baptist Health La Grange charged more than the national average in 1 (20%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 24 | $31,572 | -44% | $9,780 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $30,937 | -48% | $10,948 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 18 | $333,978 | +170% | $41,637 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 17 | $38,956 | -57% | $13,996 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $41,495 | -41% | $12,422 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Excision/ Biopsy/ Incision and Drainage | 260 | $18,363 | $1,384 |
| Comprehensive Observation Services | 123 | $24,254 | $2,282 |
| Level 5 Musculoskeletal Procedures | 100 | $111,855 | $11,326 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 44 | $29,492 | $2,448 |
| Level 2 Upper GI Procedures | 42 | $16,692 | $1,622 |
| Level 1 Laparoscopy and Related Services | 25 | $34,591 | $4,971 |
| Level 4 Urology and Related Services | 22 | $27,039 | $3,004 |
| Level 6 Musculoskeletal Procedures | 20 | $163,330 | $16,023 |
| Level 4 Gynecologic Procedures | 20 | $21,286 | $2,694 |
| Level 4 Musculoskeletal Procedures | 18 | $65,134 | $5,901 |
| Level 6 Urology and Related Services | 18 | $62,942 | $7,937 |
| Level 3 Musculoskeletal Procedures | 14 | $33,245 | $2,634 |
| Level 2 Vascular Procedures | 11 | $28,386 | $1,380 |
Against the Kentucky average
For Heart Failure and Shock with MCC (DRG 291), Baptist Health La Grange charged $31,572 on average, 22% less than the Kentucky average of $40,730, and was paid $9,780 against a state average of $9,552. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Baptist Health La Grange charged $30,937 on average, 29% less than the Kentucky average of $43,745, and was paid $10,948 against a state average of $9,962. For Revision of Hip or Knee Replacement without CC/MCC (DRG 468), Baptist Health La Grange charged $333,978 on average, 66% more than the Kentucky average of $200,871, and was paid $41,637 against a state average of $25,356. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Baptist Health La Grange charged $38,956 on average, 39% less than the Kentucky average of $63,454, and was paid $13,996 against a state average of $14,765. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $18,363 was 54% above the state average of $11,961. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,254 was 19% above the state average of $20,333. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $111,855 was 28% above the state average of $87,601. For Level 3 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5073), its average charge of $29,492 was 59% above the state average of $18,530.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Baptist Health La Grange in La Grange, KY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-04-26 (CMS case 1542)
- Warning Notice — 2024-02-27 (CMS case 2246)
- Closure Notice — 2024-04-02 (CMS case 2246)
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.