Benefis Hospitals Inc: charges and Medicare payments

Benefis Hospitals Inc reported 1,786 Medicare inpatient stays across 72 DRGs in 2024. Across them it charged 3.61 times what it was paid — among the higher ratios in Montana, number 3 of 10 hospitals with at least 100 stays (state median 3.38×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 188 stays at an average charge of $53,060, 41% below the national average. It also billed 3,196 outpatient services, charging 5.78 times what Medicare paid.

1Medicare inpatient stays 1,786
2Charge ÷ paid, inpatient 3.61×
3Rank in MT (highest ratio = 1) 3 of 10
4CMS price-transparency actions 0

Average charge per stay at Benefis Hospitals Inc, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 72 DRGs that can be compared with the national average, Benefis Hospitals Inc 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
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	188	$53,060	-41%	$15,156
291 Heart Failure and Shock with MCC	80	$30,449	-46%	$9,743
193 Simple Pneumonia and Pleurisy with MCC	73	$35,986	-40%	$10,096
177 Respiratory Infections and Inflammations with MCC	51	$47,140	-33%	$12,593
378 Gastrointestinal Hemorrhage with CC	46	$33,023	-32%	$7,520
683 Renal Failure with CC	42	$22,678	-44%	$6,962
853 Infectious and Parasitic Diseases with O.R. Procedures with...	39	$131,846	-42%	$40,241
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	39	$27,480	-44%	$8,327
190 Chronic Obstructive Pulmonary Disease with MCC	38	$28,256	-44%	$8,762
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	36	$41,518	-58%	$13,818
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	36	$30,628	-45%	$8,296
377 Gastrointestinal Hemorrhage with MCC	36	$56,876	-33%	$13,328
690 Kidney and Urinary Tract Infections without MCC	36	$29,630	-22%	$6,297
481 Hip and Femur Procedures except Major Joint with CC	35	$58,956	-41%	$15,479
309 Cardiac Arrhythmia and Conduction Disorders with CC	34	$22,462	-38%	$6,077
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	34	$29,219	-21%	$6,371
885 Psychoses	34	$30,794	-30%	$13,009
698 Other Kidney and Urinary Tract Diagnoses with MCC	31	$46,116	-37%	$13,243
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$17,834	-56%	$6,223
603 Cellulitis without MCC	30	$17,559	-53%	$7,516
689 Kidney and Urinary Tract Infections with MCC	30	$33,646	-34%	$8,809
280 Acute Myocardial Infarction, Discharged Alive with MCC	29	$42,868	-43%	$12,163
322 Percutaneous Cardiovascular Procedures with Intraluminal...	29	$64,447	-44%	$13,584
189 Pulmonary Edema and Respiratory Failure	27	$38,016	-34%	$9,775
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	26	$29,179	-52%	$10,382
460 Spinal Fusion except Cervical without MCC	24	$124,768	-27%	$30,371
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	23	$62,476	-39%	$18,794
682 Renal Failure with MCC	23	$27,306	-59%	$11,074
330 Major Small and Large Bowel Procedures with CC	20	$74,285	-38%	$20,510
267 Endovascular Cardiac Valve Replacement and Supplement...	19	$122,209	-45%	$35,440
638 Diabetes with CC	19	$41,182	-1%	$9,596
312 Syncope and Collapse	18	$24,954	-45%	$6,691
331 Major Small and Large Bowel Procedures without CC/MCC	18	$53,594	-38%	$15,731
025 Craniotomy and Endovascular Intracranial Procedures with MCC	17	$105,294	-55%	$31,900
281 Acute Myocardial Infarction, Discharged Alive with CC	17	$28,976	-43%	$6,992
389 Gastrointestinal Obstruction with CC	17	$15,018	-61%	$6,075
274 Percutaneous and Other Intracardiac Procedures without MCC	16	$85,487	-45%	$26,554
308 Cardiac Arrhythmia and Conduction Disorders with MCC	16	$30,156	-47%	$9,265
329 Major Small and Large Bowel Procedures with MCC	16	$109,778	-49%	$35,707
418 Laparoscopic Cholecystectomy without C.D.E. with CC	16	$47,745	-49%	$12,448
552 Medical Back Problems without MCC	16	$21,594	-56%	$7,431
069 Transient Ischemia without Thrombolytic	15	$24,418	-52%	$6,202
854 Infectious and Parasitic Diseases with O.R. Procedures with...	15	$80,117	-18%	$16,720
057 Degenerative Nervous System Disorders without MCC	14	$33,493	-41%	$9,972
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	14	$45,318	-30%	$10,812
178 Respiratory Infections and Inflammations with CC	14	$24,809	-45%	$7,675
194 Simple Pneumonia and Pleurisy with CC	14	$25,759	-33%	$6,391
483 Major Joint or Limb Reattachment Procedures of Upper...	14	$90,692	-28%	$18,343
884 Organic Disturbances and Intellectual Disability	14	$54,049	-13%	$15,353
208 Respiratory System Diagnosis with Ventilator Support <=96...	13	$86,338	-36%	$20,233
243 Permanent Cardiac Pacemaker Implant with CC	13	$83,888	-24%	$16,920
287 Circulatory Disorders except AMI, with Cardiac...	13	$41,533	-35%	$10,267
314 Other Circulatory System Diagnoses with MCC	13	$74,646	-21%	$17,346
536 Fractures of Hip and Pelvis without MCC	13	$21,176	-44%	$6,042
100 Seizures with MCC	12	$48,564	-49%	$13,573
101 Seizures without MCC	12	$28,087	-42%	$6,755
176 Pulmonary Embolism without MCC	12	$22,654	-45%	$6,314
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	12	$16,234	-43%	$4,407
480 Hip and Femur Procedures except Major Joint with MCC	12	$93,304	-33%	$23,080
086 Traumatic Stupor and Coma <1 Hour with CC	11	$22,376	-67%	$9,944

Showing the 60 most frequent of 72 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	507	$13,156	$2,554
Level 2 Urology and Related Services	449	$1,562	$641
Level 3 Urology and Related Services	252	$4,694	$1,872
Level 5 Musculoskeletal Procedures	188	$52,228	$12,152
Level 1 Intraocular Procedures	160	$7,462	$2,163
Level 2 Upper GI Procedures	142	$8,992	$1,765
Level 2 Excision/ Biopsy/ Incision and Drainage	136	$8,428	$1,502
Level 4 Urology and Related Services	127	$14,090	$3,227
Level 1 Laparoscopy and Related Services	119	$25,786	$5,373
Level 1 Endovascular Procedures	101	$21,441	$3,060
Level 4 Musculoskeletal Procedures	95	$38,105	$6,707
Level 5 Urology and Related Services	84	$19,354	$4,851
Level 3 Vascular Procedures	65	$19,014	$2,929
Level 1 Nerve Procedures	61	$8,046	$1,787
Level 3 Electrophysiologic Procedures	54	$127,896	$22,209
Level 2 Laparoscopy and Related Services	51	$41,257	$9,016
Level 2 Musculoskeletal Procedures	48	$4,684	$1,451
Level 3 Airway Endoscopy	47	$6,615	$1,564
Level 3 Musculoskeletal Procedures	45	$14,569	$2,927
Level 3 Endovascular Procedures	43	$62,435	$10,305
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	38	$23,276	$3,244
Level 3 Excision/ Biopsy/ Incision and Drainage	36	$13,389	$2,606
Level 2 Endovascular Procedures	36	$31,332	$5,359
Level 2 Breast/Lymphatic Surgery and Related Procedures	35	$25,463	$6,114
Level 3 Pacemaker and Similar Procedures	30	$46,205	$10,004

Against the Montana average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Benefis Hospitals Inc charged $53,060 on average, 24% more than the Montana average of $42,642, and was paid $15,156 against a state average of $15,860. For Heart Failure and Shock with MCC (DRG 291), Benefis Hospitals Inc charged $30,449 on average, 0% less than the Montana average of $30,559, and was paid $9,743 against a state average of $10,456. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Benefis Hospitals Inc charged $35,986 on average, 24% more than the Montana average of $29,130, and was paid $10,096 against a state average of $10,599. For Respiratory Infections and Inflammations with MCC (DRG 177), Benefis Hospitals Inc charged $47,140 on average, 32% more than the Montana average of $35,729, and was paid $12,593 against a state average of $13,317. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $13,156 was 20% above the state average of $10,951. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,562 was 38% above the state average of $1,133. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $4,694 was 5% above the state average of $4,484. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $52,228 was 22% above the state average of $42,843.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

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.