Massachusetts / Cambridge Health Alliance
CMS certification 220011 · Cambridge, MA
Cambridge Health Alliance: charges and Medicare payments
Cambridge Health Alliance reported 605 Medicare inpatient stays across 20 DRGs in 2024. Across them it charged 1.1 times what it was paid — among the lower ratios in Massachusetts, number 52 of 52 hospitals with at least 100 stays (state median 2×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 109 stays at an average charge of $31,295, 65% below the national average. It also billed 596 outpatient services, charging 2.34 times what Medicare paid.
- 1Medicare inpatient stays 605
- 2Charge ÷ paid, inpatient 1.1×
- 3Rank in MA (highest ratio = 1) 52 of 52
- 4CMS price-transparency actions 0
Inpatient stays
For the 20 DRGs that can be compared with the national average, Cambridge Health Alliance 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 | 109 | $31,295 | -65% | $27,491 |
| 291 Heart Failure and Shock with MCC | 85 | $26,435 | -53% | $22,034 |
| 193 Simple Pneumonia and Pleurisy with MCC | 53 | $23,171 | -61% | $21,212 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 51 | $18,202 | -64% | $18,546 |
| 177 Respiratory Infections and Inflammations with MCC | 40 | $28,791 | -59% | $24,604 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 28 | $15,438 | -58% | $15,330 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 24 | $36,427 | -52% | $28,117 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 23 | $13,461 | -64% | $15,699 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $19,821 | -51% | $15,617 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 21 | $20,965 | -78% | $27,365 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $24,063 | -58% | $20,793 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $30,802 | -69% | $28,872 |
| 682 Renal Failure with MCC | 19 | $32,335 | -51% | $27,390 |
| 683 Renal Failure with CC | 16 | $15,111 | -63% | $16,146 |
| 690 Kidney and Urinary Tract Infections without MCC | 16 | $15,549 | -59% | $15,474 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 13 | $23,284 | -68% | $24,189 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 12 | $18,884 | -61% | $18,253 |
| 312 Syncope and Collapse | 11 | $16,056 | -65% | $16,148 |
| 603 Cellulitis without MCC | 11 | $16,202 | -57% | $16,572 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $19,207 | -68% | $21,398 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 113 | $4,987 | $2,485 |
| Level 2 Urology and Related Services | 84 | $2,405 | $734 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 56 | $3,049 | $1,741 |
| Level 3 Urology and Related Services | 39 | $4,931 | $2,143 |
| Level 2 Musculoskeletal Procedures | 35 | $4,423 | $1,726 |
| Level 5 Musculoskeletal Procedures | 34 | $15,824 | $13,750 |
| Level 3 Musculoskeletal Procedures | 33 | $6,123 | $3,476 |
| Level 4 Musculoskeletal Procedures | 28 | $10,867 | $7,683 |
| Level 1 Laparoscopy and Related Services | 27 | $10,242 | $6,197 |
| Level 2 Upper GI Procedures | 25 | $6,130 | $2,003 |
| Comprehensive Observation Services | 25 | $11,753 | $2,940 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 17 | $8,034 | $3,052 |
| Level 5 Urology and Related Services | 17 | $8,251 | $5,557 |
| Level 4 Urology and Related Services | 15 | $8,344 | $3,744 |
| Level 4 Gynecologic Procedures | 14 | $6,076 | $3,358 |
| Level 2 Endovascular Procedures | 12 | $15,086 | $6,138 |
| Level 3 Vascular Procedures | 11 | $13,107 | $3,423 |
| Level 1 Nerve Procedures | 11 | $4,531 | $2,074 |
Against the Massachusetts average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Cambridge Health Alliance charged $31,295 on average, 31% less than the Massachusetts average of $45,229, and was paid $27,491 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), Cambridge Health Alliance charged $26,435 on average, 13% less than the Massachusetts average of $30,373, and was paid $22,034 against a state average of $12,996. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Cambridge Health Alliance charged $23,171 on average, 17% less than the Massachusetts average of $28,077, and was paid $21,212 against a state average of $12,627. For Chronic Obstructive Pulmonary Disease with MCC (DRG 190), Cambridge Health Alliance charged $18,202 on average, 26% less than the Massachusetts average of $24,763, and was paid $18,546 against a state average of $11,047. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $4,987 was 30% below the state average of $7,172. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,405 was 8% below the state average of $2,606. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $3,049 was 54% below the state average of $6,596. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $4,931 was 36% below the state average of $7,692.
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.