Delaware / Bayhealth Hospital, Sussex Campus
CMS certification 080009 · Milford, DE · 4 entries in CMS's price-transparency list
Bayhealth Hospital, Sussex Campus: charges and Medicare payments
Bayhealth Hospital, Sussex Campus reported 1,877 Medicare inpatient stays across 59 DRGs in 2024. Across them it charged 3.54 times what it was paid — mid-range in Delaware, number 3 of 6 hospitals with at least 100 stays (state median 3.5×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 275 stays at an average charge of $55,323, 39% below the national average. It also billed 1,439 outpatient services, charging 6.42 times what Medicare paid.
- 1Medicare inpatient stays 1,877
- 2Charge ÷ paid, inpatient 3.54×
- 3Rank in DE (highest ratio = 1) 3 of 6
- 4CMS price-transparency actions 4
Inpatient stays
For the 59 DRGs that can be compared with the national average, Bayhealth Hospital, Sussex Campus charged more than the national average in 1 (2%). 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 | 275 | $55,323 | -39% | $16,239 |
| 291 Heart Failure and Shock with MCC | 197 | $38,077 | -32% | $10,999 |
| 193 Simple Pneumonia and Pleurisy with MCC | 77 | $38,061 | -36% | $10,974 |
| 177 Respiratory Infections and Inflammations with MCC | 67 | $56,728 | -20% | $13,092 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 65 | $35,913 | -29% | $11,589 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 55 | $25,464 | -37% | $7,177 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 55 | $39,376 | -20% | $9,380 |
| 690 Kidney and Urinary Tract Infections without MCC | 50 | $24,462 | -35% | $6,766 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 43 | $32,174 | -47% | $11,393 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 42 | $27,203 | -27% | $6,544 |
| 689 Kidney and Urinary Tract Infections with MCC | 41 | $31,666 | -38% | $9,653 |
| 194 Simple Pneumonia and Pleurisy with CC | 38 | $28,248 | -26% | $7,464 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 36 | $25,429 | -30% | $6,472 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 35 | $39,196 | -30% | $10,212 |
| 603 Cellulitis without MCC | 35 | $28,116 | -25% | $7,776 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 35 | $101,132 | -56% | $38,736 |
| 389 Gastrointestinal Obstruction with CC | 32 | $27,431 | -30% | $6,992 |
| 682 Renal Failure with MCC | 32 | $50,754 | -23% | $14,114 |
| 683 Renal Failure with CC | 32 | $30,708 | -25% | $7,767 |
| 312 Syncope and Collapse | 26 | $33,847 | -26% | $7,531 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $45,960 | -19% | $10,120 |
| 481 Hip and Femur Procedures except Major Joint with CC | 25 | $64,215 | -36% | $16,656 |
| 378 Gastrointestinal Hemorrhage with CC | 24 | $32,106 | -34% | $9,091 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 23 | $20,847 | -27% | $5,000 |
| 812 Red Blood Cell Disorders without MCC | 22 | $26,881 | -39% | $7,610 |
| 189 Pulmonary Edema and Respiratory Failure | 21 | $45,505 | -21% | $9,954 |
| 813 Coagulation Disorders | 21 | $42,626 | -47% | $14,281 |
| 100 Seizures with MCC | 20 | $63,024 | -33% | $18,058 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 20 | $34,605 | -54% | $12,060 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 20 | $43,839 | -28% | $11,724 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 19 | $71,070 | -29% | $14,698 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $44,523 | -39% | $12,520 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 16 | $48,405 | -26% | $11,359 |
| 811 Red Blood Cell Disorders with MCC | 16 | $68,882 | +1% | $16,788 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 15 | $33,063 | -22% | $6,043 |
| 101 Seizures without MCC | 15 | $42,849 | -12% | $7,912 |
| 388 Gastrointestinal Obstruction with MCC | 15 | $33,984 | -50% | $11,540 |
| 390 Gastrointestinal Obstruction without CC/MCC | 15 | $20,795 | -26% | $6,580 |
| 661 Kidney and Ureter Procedures for Non-Neoplasm without CC/MCC | 15 | $30,506 | -46% | $8,859 |
| 314 Other Circulatory System Diagnoses with MCC | 14 | $48,419 | -49% | $17,051 |
| 377 Gastrointestinal Hemorrhage with MCC | 14 | $41,297 | -52% | $13,831 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 14 | $32,303 | -32% | $10,889 |
| 202 Bronchitis and Asthma with CC/MCC | 13 | $34,794 | -25% | $8,237 |
| 304 Hypertension with MCC | 13 | $33,777 | -41% | $12,222 |
| 305 Hypertension without MCC | 13 | $21,137 | -47% | $6,563 |
| 393 Other Digestive System Diagnoses with MCC | 13 | $45,954 | -40% | $13,541 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 13 | $41,143 | -39% | $11,032 |
| 300 Peripheral Vascular Disorders with CC | 12 | $28,178 | -43% | $8,540 |
| 330 Major Small and Large Bowel Procedures with CC | 12 | $99,734 | -16% | $22,719 |
| 552 Medical Back Problems without MCC | 12 | $37,309 | -24% | $12,141 |
| 637 Diabetes with MCC | 12 | $34,274 | -48% | $12,165 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 12 | $24,495 | -34% | $11,036 |
| 149 Dysequilibrium | 11 | $34,156 | -23% | $6,528 |
| 178 Respiratory Infections and Inflammations with CC | 11 | $27,394 | -40% | $8,141 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 11 | $30,776 | -22% | $7,181 |
| 205 Other Respiratory System Diagnoses with MCC | 11 | $43,624 | -51% | $13,952 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 11 | $30,542 | -36% | $8,895 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 11 | $70,299 | -31% | $16,679 |
| 602 Cellulitis with MCC | 11 | $42,430 | -29% | $12,462 |
Outpatient services
Against the Delaware average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Bayhealth Hospital, Sussex Campus charged $55,323 on average, 5% less than the Delaware average of $58,234, and was paid $16,239 against a state average of $17,988. For Heart Failure and Shock with MCC (DRG 291), Bayhealth Hospital, Sussex Campus charged $38,077 on average, 1% more than the Delaware average of $37,607, and was paid $10,999 against a state average of $11,734. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Bayhealth Hospital, Sussex Campus charged $38,061 on average, 2% less than the Delaware average of $38,798, and was paid $10,974 against a state average of $12,102. For Respiratory Infections and Inflammations with MCC (DRG 177), Bayhealth Hospital, Sussex Campus charged $56,728 on average, 11% more than the Delaware average of $51,272, and was paid $13,092 against a state average of $14,904. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,249 was 20% above the state average of $16,076. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $11,395 was 3% above the state average of $11,027. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $52,394 was 24% above the state average of $42,292. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,775 was 48% above the state average of $7,975.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Bayhealth Hospital, Sussex Campus in Milford, DE, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-09-29 (CMS case 496)
- CAP Request — 2022-06-29 (CMS case 496)
- Closure Notice — 2022-08-26 (CMS case 496)
- Met Requirements — 2026-02-03 (CMS case 6937)
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.