Kentucky / Baptist Health Richmond
CMS certification 180049 · Richmond, KY · 5 entries in CMS's price-transparency list
Baptist Health Richmond: charges and Medicare payments
Baptist Health Richmond reported 482 Medicare inpatient stays across 18 DRGs in 2024. Across them it charged 4.72 times what it was paid — mid-range in Kentucky, number 19 of 51 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 92 stays at an average charge of $38,659, 31% below the national average. It also billed 981 outpatient services, charging 11.87 times what Medicare paid.
- 1Medicare inpatient stays 482
- 2Charge ÷ paid, inpatient 4.72×
- 3Rank in KY (highest ratio = 1) 19 of 51
- 4CMS price-transparency actions 5
Inpatient stays
For the 18 DRGs that can be compared with the national average, Baptist Health Richmond charged more than the national average in 1 (6%). 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 | 92 | $38,659 | -31% | $9,162 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 81 | $55,797 | -38% | $13,686 |
| 193 Simple Pneumonia and Pleurisy with MCC | 40 | $46,255 | -23% | $9,447 |
| 177 Respiratory Infections and Inflammations with MCC | 32 | $44,467 | -37% | $11,527 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 26 | $37,778 | -25% | $7,953 |
| 690 Kidney and Urinary Tract Infections without MCC | 24 | $33,348 | -12% | $5,854 |
| 683 Renal Failure with CC | 21 | $30,401 | -25% | $6,733 |
| 689 Kidney and Urinary Tract Infections with MCC | 18 | $33,735 | -34% | $8,406 |
| 885 Psychoses | 18 | $27,353 | -38% | $9,578 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $35,766 | -38% | $8,911 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $41,079 | -32% | $9,393 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 16 | $27,522 | -24% | $5,492 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $176,483 | +54% | $15,535 |
| 194 Simple Pneumonia and Pleurisy with CC | 14 | $35,985 | -6% | $6,093 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $26,060 | -30% | $5,716 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $34,452 | -14% | $5,815 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 13 | $38,932 | -21% | $7,328 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 11 | $39,555 | -22% | $7,416 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 387 | $15,380 | $1,985 |
| Comprehensive Observation Services | 226 | $29,176 | $2,311 |
| Level 2 Upper GI Procedures | 67 | $14,302 | $1,638 |
| Level 1 Laparoscopy and Related Services | 60 | $41,054 | $4,915 |
| Level 3 Vascular Procedures | 27 | $24,836 | $2,743 |
| Level 5 Urology and Related Services | 24 | $49,401 | $4,316 |
| Level 4 Gynecologic Procedures | 23 | $19,820 | $2,691 |
| Level 6 Urology and Related Services | 21 | $55,452 | $7,059 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 20 | $13,022 | $1,361 |
| Level 1 Endovascular Procedures | 18 | $37,974 | $2,809 |
| Level 2 Musculoskeletal Procedures | 17 | $14,890 | $1,279 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 17 | $40,786 | $2,851 |
| Level 5 Musculoskeletal Procedures | 14 | $105,663 | $10,622 |
| Level 3 Lower GI Procedures | 13 | $27,944 | $2,415 |
| Level 4 Urology and Related Services | 13 | $26,291 | $3,000 |
| Level 2 Breast/Lymphatic Surgery and Related Procedures | 12 | $34,218 | $5,612 |
| Level 3 Musculoskeletal Procedures | 11 | $19,651 | $2,382 |
| Level 4 Musculoskeletal Procedures | 11 | $37,242 | $5,719 |
Against the Kentucky average
For Heart Failure and Shock with MCC (DRG 291), Baptist Health Richmond charged $38,659 on average, 5% less than the Kentucky average of $40,730, and was paid $9,162 against a state average of $9,552. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Baptist Health Richmond charged $55,797 on average, 12% less than the Kentucky average of $63,454, and was paid $13,686 against a state average of $14,765. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Baptist Health Richmond charged $46,255 on average, 6% more than the Kentucky average of $43,745, and was paid $9,447 against a state average of $9,962. For Respiratory Infections and Inflammations with MCC (DRG 177), Baptist Health Richmond charged $44,467 on average, 17% less than the Kentucky average of $53,742, and was paid $11,527 against a state average of $12,118. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $15,380 was 39% above the state average of $11,097. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $29,176 was 43% above the state average of $20,333. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $14,302 was 7% above the state average of $13,357. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $41,054 was 20% above the state average of $34,303.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Baptist Health Richmond in Richmond, KY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-06-23 (CMS case 281)
- Closure Notice — 2021-12-01 (CMS case 281)
- Met Requirements — 2023-05-08 (CMS case 1544)
- Warning Notice — 2024-02-29 (CMS case 2220)
- Closure Notice — 2024-04-02 (CMS case 2220)
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.