Montana / Billings Clinic Hospital
CMS certification 270004 · Billings, MT · 2 entries in CMS's price-transparency list
Billings Clinic Hospital: charges and Medicare payments
Billings Clinic Hospital reported 3,703 Medicare inpatient stays across 120 DRGs in 2024. Across them it charged 2.45 times what it was paid — among the lower ratios in Montana, number 9 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: 274 stays at an average charge of $38,823, 57% below the national average. It also billed 6,387 outpatient services, charging 3.24 times what Medicare paid.
- 1Medicare inpatient stays 3,703
- 2Charge ÷ paid, inpatient 2.45×
- 3Rank in MT (highest ratio = 1) 9 of 10
- 4CMS price-transparency actions 2
Inpatient stays
For the 120 DRGs that can be compared with the national average, Billings Clinic 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 |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 274 | $38,823 | -57% | $15,877 |
| 885 Psychoses | 164 | $16,496 | -63% | $11,320 |
| 291 Heart Failure and Shock with MCC | 132 | $22,684 | -60% | $10,520 |
| 193 Simple Pneumonia and Pleurisy with MCC | 113 | $24,497 | -59% | $10,771 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 100 | $58,693 | -63% | $25,679 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 77 | $50,500 | -56% | $14,699 |
| 177 Respiratory Infections and Inflammations with MCC | 76 | $36,561 | -48% | $14,517 |
| 378 Gastrointestinal Hemorrhage with CC | 67 | $16,634 | -66% | $8,225 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 66 | $102,739 | -55% | $42,897 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 65 | $21,008 | -62% | $8,441 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 65 | $33,460 | -56% | $13,020 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 60 | $19,721 | -60% | $8,570 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 54 | $39,921 | -60% | $15,721 |
| 460 Spinal Fusion except Cervical without MCC | 54 | $82,288 | -52% | $31,554 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 54 | $39,674 | -57% | $15,365 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 53 | $23,950 | -53% | $9,287 |
| 481 Hip and Femur Procedures except Major Joint with CC | 52 | $50,237 | -50% | $16,530 |
| 689 Kidney and Urinary Tract Infections with MCC | 50 | $19,123 | -63% | $9,605 |
| 377 Gastrointestinal Hemorrhage with MCC | 48 | $30,831 | -64% | $14,367 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 47 | $101,253 | -56% | $36,186 |
| 329 Major Small and Large Bowel Procedures with MCC | 47 | $66,260 | -69% | $34,528 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 45 | $69,682 | -57% | $22,624 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 42 | $23,801 | -63% | $11,503 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 40 | $113,270 | -60% | $48,798 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 39 | $40,697 | -60% | $16,457 |
| 163 Major Chest Procedures with MCC | 37 | $90,502 | -57% | $35,418 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 37 | $89,765 | -59% | $40,141 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 35 | $105,120 | -63% | $44,097 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 35 | $14,076 | -61% | $6,379 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 35 | $21,972 | -64% | $10,979 |
| 690 Kidney and Urinary Tract Infections without MCC | 35 | $12,673 | -66% | $6,907 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 34 | $20,875 | -59% | $7,656 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 34 | $22,493 | -60% | $9,919 |
| 330 Major Small and Large Bowel Procedures with CC | 34 | $41,499 | -65% | $19,991 |
| 683 Renal Failure with CC | 31 | $14,864 | -63% | $7,769 |
| 189 Pulmonary Edema and Respiratory Failure | 30 | $23,051 | -60% | $10,133 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 30 | $78,040 | -62% | $35,664 |
| 682 Renal Failure with MCC | 30 | $23,538 | -64% | $12,200 |
| 070 Other Cerebrovascular Disorders with MCC | 29 | $40,373 | -47% | $16,607 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 29 | $197,393 | -50% | $65,809 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 27 | $53,588 | -52% | $19,816 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 27 | $18,209 | -70% | $10,487 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 27 | $35,315 | -53% | $14,193 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 26 | $56,391 | -46% | $17,270 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 24 | $13,587 | -66% | $6,685 |
| 603 Cellulitis without MCC | 24 | $14,395 | -61% | $7,709 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 23 | $42,317 | -62% | $17,801 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 23 | $23,267 | -64% | $8,973 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 23 | $60,953 | -56% | $22,756 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 22 | $16,690 | -61% | $5,927 |
| 292 Heart Failure and Shock with CC | 22 | $17,351 | -55% | $7,287 |
| 312 Syncope and Collapse | 22 | $18,321 | -60% | $7,309 |
| 389 Gastrointestinal Obstruction with CC | 22 | $11,107 | -71% | $6,839 |
| 473 Cervical Spinal Fusion without CC/MCC | 22 | $51,441 | -55% | $19,206 |
| 552 Medical Back Problems without MCC | 22 | $16,286 | -67% | $8,068 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 21 | $61,822 | -54% | $21,459 |
| 220 Cardiac Valve and Other Major Cardiothoracic Procedures... | 21 | $139,093 | -50% | $40,943 |
| 441 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic... | 21 | $28,727 | -67% | $14,770 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 21 | $91,970 | -57% | $37,159 |
| 035 Carotid Artery Stent Procedures with CC | 20 | $52,046 | -54% | $18,198 |
Showing the 60 most frequent of 120 DRGs.
Outpatient services
Against the Montana average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Billings Clinic Hospital charged $38,823 on average, 9% less than the Montana average of $42,642, and was paid $15,877 against a state average of $15,860. For Psychoses (DRG 885), Billings Clinic Hospital charged $16,496 on average, 29% less than the Montana average of $23,290, and was paid $11,320 against a state average of $11,292. For Heart Failure and Shock with MCC (DRG 291), Billings Clinic Hospital charged $22,684 on average, 26% less than the Montana average of $30,559, and was paid $10,520 against a state average of $10,456. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Billings Clinic Hospital charged $24,497 on average, 16% less than the Montana average of $29,130, and was paid $10,771 against a state average of $10,599. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $861 was 24% below the state average of $1,133. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $3,364 was 25% below the state average of $4,484. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $8,375 was 24% below the state average of $10,951. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $3,590 was 46% below the state average of $6,661.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Billings Clinic Hospital in Billings, MT, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-05-04 (CMS case 11)
- Met Requirements — 2025-04-21 (CMS case 4009)
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.