Texas / Baylor Scott & White Texas Spine & Joint Hospital
CMS certification 450864 · Tyler, TX · 2 entries in CMS's price-transparency list
Baylor Scott & White Texas Spine & Joint Hospital: charges and Medicare payments
Baylor Scott & White Texas Spine & Joint Hospital reported 491 Medicare inpatient stays across 12 DRGs in 2024. Across them it charged 3.48 times what it was paid — among the lower ratios in Texas, number 164 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 470, Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC: 157 stays at an average charge of $57,953, 38% below the national average. It also billed 2,866 outpatient services, charging 6.63 times what Medicare paid.
- 1Medicare inpatient stays 491
- 2Charge ÷ paid, inpatient 3.48×
- 3Rank in TX (highest ratio = 1) 164 of 190
- 4CMS price-transparency actions 2
Inpatient stays
For the 12 DRGs that can be compared with the national average, Baylor Scott & White Texas Spine & Joint Hospital charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 157 | $57,953 | -38% | $12,040 |
| 460 Spinal Fusion except Cervical without MCC | 76 | $78,555 | -54% | $23,414 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 57 | $89,901 | -56% | $31,482 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 49 | $104,652 | -63% | $39,595 |
| 472 Cervical Spinal Fusion with CC | 30 | $73,057 | -49% | $20,682 |
| 473 Cervical Spinal Fusion without CC/MCC | 30 | $64,750 | -44% | $17,983 |
| 402 Single Level Combined Anterior and Posterior Spinal Fusion... | 20 | $100,664 | -46% | $25,670 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 18 | $52,331 | -50% | $12,372 |
| 448 Multiple Level Spinal Fusion except Cervical without MCC | 15 | $91,584 | -54% | $29,870 |
| 520 Back and Neck Procedures except Spinal Fusion without CC/MCC | 15 | $50,023 | -37% | $9,156 |
| 451 Single Level Spinal Fusion except Cervical without MCC | 12 | $67,437 | -55% | $20,257 |
| 467 Revision of Hip or Knee Replacement with CC | 12 | $88,585 | -44% | $27,331 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Nerve Procedures | 853 | $13,092 | $1,651 |
| Level 5 Musculoskeletal Procedures | 620 | $62,142 | $11,311 |
| Level 4 Musculoskeletal Procedures | 424 | $38,014 | $6,126 |
| Level 3 Musculoskeletal Procedures | 383 | $22,114 | $2,762 |
| Level 2 Musculoskeletal Procedures | 225 | $10,472 | $1,385 |
| Level 6 Musculoskeletal Procedures | 125 | $74,378 | $15,441 |
| Level 2 Neurostimulator and Related Procedures | 84 | $22,589 | $5,879 |
| Level 5 Neurostimulator and Related Procedures | 64 | $82,331 | $25,291 |
| Implantation of Drug Infusion Device | 30 | $59,685 | $15,444 |
| Level 1 Neurostimulator and Related Procedures | 20 | $29,041 | $2,717 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 13 | $16,625 | $2,466 |
| Level 4 Neurostimulator and Related Procedures | 13 | $80,494 | $18,936 |
| Level 3 Extraocular, Repair, and Plastic Eye Procedures | 12 | $17,903 | $2,028 |
Against the Texas average
For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Baylor Scott & White Texas Spine & Joint Hospital charged $57,953 on average, 50% less than the Texas average of $116,220, and was paid $12,040 against a state average of $15,157. For Spinal Fusion except Cervical without MCC (DRG 460), Baylor Scott & White Texas Spine & Joint Hospital charged $78,555 on average, 63% less than the Texas average of $213,248, and was paid $23,414 against a state average of $30,622. For Combined Anterior and Posterior Spinal Fusion without CC/MCC (DRG 455), Baylor Scott & White Texas Spine & Joint Hospital charged $89,901 on average, 66% less than the Texas average of $268,184, and was paid $31,482 against a state average of $39,409. For Combined Anterior and Posterior Spinal Fusion with CC (DRG 454), Baylor Scott & White Texas Spine & Joint Hospital charged $104,652 on average, 77% less than the Texas average of $446,825, and was paid $39,595 against a state average of $54,675. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $13,092 was 28% below the state average of $18,063. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $62,142 was 37% below the state average of $98,771. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $38,014 was 35% below the state average of $58,833. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $22,114 was 27% below the state average of $30,502.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Baylor Scott & White Texas Spine & Joint Hospital in Tyler, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-09-26 (CMS case 1626)
- Met Requirements — 2025-07-17 (CMS case 5816)
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.