Illinois / Carle Health Pekin Hospital
CMS certification 140120 · Pekin, IL
Carle Health Pekin Hospital: charges and Medicare payments
Carle Health Pekin Hospital reported 306 Medicare inpatient stays across 13 DRGs in 2024. Across them it charged 4.44 times what it was paid — mid-range in Illinois, number 40 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 62 stays at an average charge of $51,954, 42% below the national average. It also billed 343 outpatient services, charging 11.18 times what Medicare paid.
- 1Medicare inpatient stays 306
- 2Charge ÷ paid, inpatient 4.44×
- 3Rank in IL (highest ratio = 1) 40 of 106
- 4CMS price-transparency actions 0
Inpatient stays
For the 13 DRGs that can be compared with the national average, Carle Health Pekin 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 | 62 | $51,954 | -42% | $13,427 |
| 291 Heart Failure and Shock with MCC | 53 | $44,823 | -20% | $8,914 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $28,256 | -25% | $5,855 |
| 177 Respiratory Infections and Inflammations with MCC | 22 | $57,716 | -18% | $11,840 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $36,311 | -37% | $8,694 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 19 | $38,151 | -22% | $7,392 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $35,715 | -40% | $9,392 |
| 683 Renal Failure with CC | 17 | $35,269 | -13% | $6,486 |
| 603 Cellulitis without MCC | 16 | $32,135 | -14% | $6,486 |
| 682 Renal Failure with MCC | 16 | $38,110 | -42% | $9,849 |
| 689 Kidney and Urinary Tract Infections with MCC | 15 | $40,451 | -21% | $8,304 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $25,728 | -31% | $5,764 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 11 | $45,792 | -38% | $11,091 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 124 | $20,792 | $2,154 |
| Comprehensive Observation Services | 90 | $23,596 | $2,485 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 33 | $10,584 | $1,498 |
| Level 1 Nerve Procedures | 24 | $17,950 | $1,784 |
| Level 3 Musculoskeletal Procedures | 22 | $30,829 | $2,992 |
| Level 4 Musculoskeletal Procedures | 20 | $41,585 | $6,348 |
| Level 3 Vascular Procedures | 19 | $18,256 | $2,946 |
| Level 4 Urology and Related Services | 11 | $32,560 | $3,222 |
Against the Illinois average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Carle Health Pekin Hospital charged $51,954 on average, 30% less than the Illinois average of $73,987, and was paid $13,427 against a state average of $17,651. For Heart Failure and Shock with MCC (DRG 291), Carle Health Pekin Hospital charged $44,823 on average, 3% less than the Illinois average of $46,293, and was paid $8,914 against a state average of $11,813. For Kidney and Urinary Tract Infections without MCC (DRG 690), Carle Health Pekin Hospital charged $28,256 on average, 9% less than the Illinois average of $30,972, and was paid $5,855 against a state average of $7,470. For Respiratory Infections and Inflammations with MCC (DRG 177), Carle Health Pekin Hospital charged $57,716 on average, 3% less than the Illinois average of $59,769, and was paid $11,840 against a state average of $14,404. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $20,792 was 39% above the state average of $14,917. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,596 was 10% above the state average of $21,498. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,584 was 10% below the state average of $11,818. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $17,950 was 39% above the state average of $12,903.
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.