Kentucky / Baptist Health Lexington
CMS certification 180103 · Lexington, KY · 3 entries in CMS's price-transparency list
Baptist Health Lexington: charges and Medicare payments
Baptist Health Lexington reported 3,648 Medicare inpatient stays across 101 DRGs in 2024. Across them it charged 7.64 times what it was paid — among the higher ratios in Kentucky, number 1 of 51 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 295 stays at an average charge of $74,949, 17% below the national average. It also billed 3,574 outpatient services, charging 16 times what Medicare paid.
- 1Medicare inpatient stays 3,648
- 2Charge ÷ paid, inpatient 7.64×
- 3Rank in KY (highest ratio = 1) 1 of 51
- 4CMS price-transparency actions 3
Inpatient stays
For the 101 DRGs that can be compared with the national average, Baptist Health Lexington charged more than the national average in 45 (45%). 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 | 295 | $74,949 | -17% | $13,016 |
| 291 Heart Failure and Shock with MCC | 219 | $47,073 | -17% | $8,862 |
| 177 Respiratory Infections and Inflammations with MCC | 141 | $62,896 | -11% | $10,846 |
| 193 Simple Pneumonia and Pleurisy with MCC | 122 | $48,091 | -20% | $8,954 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 99 | $298,491 | +90% | $23,456 |
| 690 Kidney and Urinary Tract Infections without MCC | 99 | $36,190 | -4% | $5,557 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 95 | $61,351 | +10% | $6,875 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 84 | $44,470 | -9% | $7,043 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 71 | $38,000 | -25% | $7,536 |
| 194 Simple Pneumonia and Pleurisy with CC | 70 | $38,961 | +2% | $5,967 |
| 378 Gastrointestinal Hemorrhage with CC | 69 | $53,386 | +10% | $6,617 |
| 689 Kidney and Urinary Tract Infections with MCC | 67 | $48,270 | -6% | $8,040 |
| 189 Pulmonary Edema and Respiratory Failure | 64 | $57,028 | -1% | $8,376 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 63 | $30,803 | -15% | $5,251 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 60 | $34,403 | -14% | $5,544 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 58 | $37,291 | +1% | $5,309 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 57 | $64,944 | -14% | $10,440 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 57 | $206,942 | -10% | $33,647 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 54 | $84,356 | -16% | $12,991 |
| 312 Syncope and Collapse | 51 | $38,340 | -16% | $5,951 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 51 | $183,965 | +61% | $13,084 |
| 683 Renal Failure with CC | 49 | $37,945 | -7% | $6,114 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 48 | $117,008 | +14% | $14,569 |
| 682 Renal Failure with MCC | 44 | $55,280 | -16% | $10,417 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 41 | $491,417 | +122% | $42,134 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 40 | $53,561 | -5% | $8,812 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 39 | $47,837 | -21% | $9,039 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 38 | $65,489 | -24% | $12,649 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 38 | $58,350 | -21% | $11,076 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 34 | $255,948 | +56% | $21,447 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 33 | $231,685 | +10% | $28,276 |
| 389 Gastrointestinal Obstruction with CC | 33 | $29,133 | -25% | $5,616 |
| 330 Major Small and Large Bowel Procedures with CC | 32 | $113,456 | -5% | $16,420 |
| 057 Degenerative Nervous System Disorders without MCC | 30 | $72,781 | +29% | $9,207 |
| 812 Red Blood Cell Disorders without MCC | 30 | $38,849 | -12% | $6,181 |
| 178 Respiratory Infections and Inflammations with CC | 29 | $43,227 | -5% | $6,695 |
| 603 Cellulitis without MCC | 29 | $43,524 | +17% | $6,359 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 28 | $68,856 | +8% | $8,087 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 27 | $45,722 | +8% | $4,881 |
| 101 Seizures without MCC | 27 | $54,291 | +11% | $6,658 |
| 234 Coronary Bypass with Cardiac Catheterization or Open... | 27 | $316,045 | +18% | $40,791 |
| 481 Hip and Femur Procedures except Major Joint with CC | 27 | $119,999 | +19% | $13,689 |
| 039 Extracranial Procedures without CC/MCC | 26 | $64,812 | +2% | $7,744 |
| 377 Gastrointestinal Hemorrhage with MCC | 26 | $71,976 | -16% | $11,709 |
| 235 Coronary Bypass without Cardiac Catheterization with MCC | 25 | $306,145 | +5% | $39,700 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 25 | $18,580 | -35% | $3,998 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 24 | $42,181 | -31% | $8,719 |
| 292 Heart Failure and Shock with CC | 23 | $34,999 | -10% | $5,834 |
| 314 Other Circulatory System Diagnoses with MCC | 23 | $107,603 | +13% | $15,272 |
| 315 Other Circulatory System Diagnoses with CC | 23 | $42,165 | -12% | $6,594 |
| 329 Major Small and Large Bowel Procedures with MCC | 23 | $155,602 | -28% | $35,388 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 22 | $378,893 | +35% | $41,941 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 22 | $230,609 | +108% | $18,983 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 22 | $87,877 | -11% | $15,417 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 21 | $189,516 | +50% | $16,819 |
| 552 Medical Back Problems without MCC | 21 | $39,789 | -19% | $7,011 |
| 638 Diabetes with CC | 21 | $35,437 | -15% | $6,688 |
| 164 Major Chest Procedures with CC | 20 | $184,607 | +45% | $17,987 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 19 | $36,104 | -9% | $5,930 |
| 202 Bronchitis and Asthma with CC/MCC | 18 | $35,166 | -24% | $7,113 |
Showing the 60 most frequent of 101 DRGs.
Outpatient services
Against the Kentucky average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Baptist Health Lexington charged $74,949 on average, 18% more than the Kentucky average of $63,454, and was paid $13,016 against a state average of $14,765. For Heart Failure and Shock with MCC (DRG 291), Baptist Health Lexington charged $47,073 on average, 16% more than the Kentucky average of $40,730, and was paid $8,862 against a state average of $9,552. For Respiratory Infections and Inflammations with MCC (DRG 177), Baptist Health Lexington charged $62,896 on average, 17% more than the Kentucky average of $53,742, and was paid $10,846 against a state average of $12,118. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Baptist Health Lexington charged $48,091 on average, 10% more than the Kentucky average of $43,745, and was paid $8,954 against a state average of $9,962. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $28,930 was 42% above the state average of $20,333. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $39,257 was 34% above the state average of $29,393. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $17,898 was 50% above the state average of $11,961. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $112,466 was 28% above the state average of $87,601.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Baptist Health Lexington in Lexington, 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 1536)
- Warning Notice — 2024-02-27 (CMS case 2218)
- Closure Notice — 2024-03-29 (CMS case 2218)
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.