Massachusetts / Cape Cod Hospital

CMS certification 220012 · Hyannis, MA · 6 entries in CMS's price-transparency list

Cape Cod Hospital: charges and Medicare payments

Cape Cod Hospital reported 7,999 Medicare inpatient stays across 170 DRGs in 2024. Across them it charged 1.93 times what it was paid — mid-range in Massachusetts, number 34 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: 1060 stays at an average charge of $33,090, 63% below the national average. It also billed 5,765 outpatient services, charging 4.36 times what Medicare paid.

1Medicare inpatient stays 7,999
2Charge ÷ paid, inpatient 1.93×
3Rank in MA (highest ratio = 1) 34 of 52
4CMS price-transparency actions 6

Average charge per stay at Cape Cod Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 170 DRGs that can be compared with the national average, Cape Cod 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	1060	$33,090	-63%	$20,890
291 Heart Failure and Shock with MCC	469	$23,594	-58%	$13,316
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	221	$20,066	-59%	$10,602
193 Simple Pneumonia and Pleurisy with MCC	207	$23,858	-60%	$13,719
177 Respiratory Infections and Inflammations with MCC	196	$26,627	-62%	$17,826
189 Pulmonary Edema and Respiratory Failure	174	$24,380	-58%	$12,657
378 Gastrointestinal Hemorrhage with CC	174	$24,218	-50%	$10,361
689 Kidney and Urinary Tract Infections with MCC	153	$20,775	-60%	$12,141
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	152	$18,661	-54%	$8,074
853 Infectious and Parasitic Diseases with O.R. Procedures with...	126	$67,692	-70%	$52,095
280 Acute Myocardial Infarction, Discharged Alive with MCC	124	$36,719	-52%	$16,126
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	110	$27,785	-50%	$10,697
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	109	$36,582	-63%	$20,599
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	108	$24,420	-59%	$13,636
682 Renal Failure with MCC	105	$27,099	-59%	$15,474
377 Gastrointestinal Hemorrhage with MCC	101	$37,324	-56%	$18,501
690 Kidney and Urinary Tract Infections without MCC	100	$18,585	-51%	$8,329
683 Renal Failure with CC	98	$18,196	-55%	$9,392
267 Endovascular Cardiac Valve Replacement and Supplement...	90	$112,941	-49%	$49,894
274 Percutaneous and Other Intracardiac Procedures without MCC	86	$48,015	-69%	$32,511
322 Percutaneous Cardiovascular Procedures with Intraluminal...	86	$91,729	-20%	$19,802
603 Cellulitis without MCC	85	$17,292	-54%	$9,199
309 Cardiac Arrhythmia and Conduction Disorders with CC	84	$20,027	-45%	$8,014
698 Other Kidney and Urinary Tract Diagnoses with MCC	84	$25,988	-65%	$17,194
481 Hip and Femur Procedures except Major Joint with CC	82	$40,600	-60%	$21,424
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	79	$15,796	-57%	$8,094
312 Syncope and Collapse	78	$23,630	-48%	$9,027
480 Hip and Femur Procedures except Major Joint with MCC	77	$50,281	-64%	$32,118
190 Chronic Obstructive Pulmonary Disease with MCC	67	$20,669	-59%	$11,417
308 Cardiac Arrhythmia and Conduction Disorders with MCC	65	$28,349	-50%	$13,089
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	61	$24,891	-59%	$13,257
281 Acute Myocardial Infarction, Discharged Alive with CC	54	$30,876	-39%	$9,489
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	52	$28,921	-56%	$14,472
390 Gastrointestinal Obstruction without CC/MCC	51	$12,941	-54%	$5,993
552 Medical Back Problems without MCC	51	$22,557	-54%	$9,963
194 Simple Pneumonia and Pleurisy with CC	50	$20,402	-47%	$8,514
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	50	$16,429	-43%	$6,045
389 Gastrointestinal Obstruction with CC	49	$15,160	-61%	$8,723
069 Transient Ischemia without Thrombolytic	47	$25,089	-50%	$8,273
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	47	$44,942	-56%	$21,786
917 Poisoning and Toxic Effects of Drugs with MCC	46	$29,005	-61%	$16,555
394 Other Digestive System Diagnoses with CC	45	$19,319	-59%	$9,690
854 Infectious and Parasitic Diseases with O.R. Procedures with...	45	$34,122	-65%	$21,078
330 Major Small and Large Bowel Procedures with CC	43	$57,747	-51%	$24,408
321 Percutaneous Cardiovascular Procedures with Intraluminal...	40	$114,889	-30%	$32,515
282 Acute Myocardial Infarction, Discharged Alive without CC/MCC	39	$29,615	-32%	$7,978
266 Endovascular Cardiac Valve Replacement and Supplement...	38	$140,897	-51%	$64,874
178 Respiratory Infections and Inflammations with CC	36	$20,393	-55%	$10,193
036 Carotid Artery Stent Procedures without CC/MCC	35	$34,693	-61%	$18,707
286 Circulatory Disorders except AMI, with Cardiac...	35	$56,441	-50%	$22,525
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	35	$54,167	-60%	$31,329
602 Cellulitis with MCC	35	$26,843	-55%	$15,301
092 Other Disorders of Nervous System with CC	34	$24,957	-52%	$10,682
270 Other Major Cardiovascular Procedures with MCC	34	$165,933	-36%	$67,359
813 Coagulation Disorders	34	$27,906	-65%	$16,153
287 Circulatory Disorders except AMI, with Cardiac...	33	$40,300	-37%	$11,164
314 Other Circulatory System Diagnoses with MCC	33	$35,582	-62%	$22,043
100 Seizures with MCC	32	$33,741	-64%	$20,476
637 Diabetes with MCC	32	$25,323	-62%	$14,951
242 Permanent Cardiac Pacemaker Implant with MCC	31	$100,322	-38%	$37,188

Showing the 60 most frequent of 170 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	1,097	$19,933	$2,905
Level 5 Musculoskeletal Procedures	480	$29,009	$14,058
Level 2 Excision/ Biopsy/ Incision and Drainage	446	$7,132	$1,717
Level 4 Musculoskeletal Procedures	424	$16,983	$7,683
Level 1 Endovascular Procedures	329	$19,353	$3,482
Level 1 Nerve Procedures	273	$13,659	$2,074
Level 5 Urology and Related Services	266	$15,492	$5,524
Level 1 Laparoscopy and Related Services	243	$18,763	$6,151
Level 4 Urology and Related Services	230	$11,433	$3,744
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	196	$12,332	$3,700
Level 3 Urology and Related Services	159	$9,958	$2,166
Level 3 Musculoskeletal Procedures	138	$10,000	$3,476
Level 3 Excision/ Biopsy/ Incision and Drainage	131	$16,330	$3,005
Level 3 Endovascular Procedures	131	$73,359	$11,644
Level 3 Electrophysiologic Procedures	117	$102,258	$25,436
Level 3 Vascular Procedures	107	$17,179	$3,423
Level 1 Breast/Lymphatic Surgery and Related Procedures	90	$16,700	$4,094
Level 6 Musculoskeletal Procedures	81	$31,993	$19,966
Level 4 Airway Endoscopy	68	$13,202	$4,022
Level 2 Laparoscopy and Related Services	66	$38,795	$10,900
Level 4 Endovascular Procedures	63	$115,890	$18,788
Level 2 Upper GI Procedures	62	$7,910	$2,027
Level 2 Breast/Lymphatic Surgery and Related Procedures	59	$30,039	$6,909
Level 3 Pacemaker and Similar Procedures	58	$46,389	$11,454
Level 4 Vascular Procedures	55	$29,909	$5,387

Against the Massachusetts average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Cape Cod Hospital charged $33,090 on average, 27% less than the Massachusetts average of $45,229, and was paid $20,890 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), Cape Cod Hospital charged $23,594 on average, 22% less than the Massachusetts average of $30,373, and was paid $13,316 against a state average of $12,996. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Cape Cod Hospital charged $20,066 on average, 18% less than the Massachusetts average of $24,420, and was paid $10,602 against a state average of $10,272. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Cape Cod Hospital charged $23,858 on average, 15% less than the Massachusetts average of $28,077, and was paid $13,719 against a state average of $12,627. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,933 was 42% above the state average of $14,010. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $29,009 was 18% below the state average of $35,549. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,132 was 8% above the state average of $6,596. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $16,983 was 32% below the state average of $25,145.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Cape Cod Hospital in Hyannis, MA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2023-05-24 (CMS case 566)
CAP Request — 2023-08-30 (CMS case 566)
Closure Notice — 2023-09-18 (CMS case 566)
Warning Notice — 2025-04-09 (CMS case 3701)
Closure Notice — 2025-06-04 (CMS case 3701)
Met Requirements — 2026-04-09 (CMS case 7431)

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.