CHI St Alexius Health: charges and Medicare payments

CHI St Alexius Health reported 1,023 Medicare inpatient stays across 39 DRGs in 2024. Across them it charged 3.1 times what it was paid — among the lower ratios in North Dakota, number 6 of 6 hospitals with at least 100 stays (state median 3.17×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 215 stays at an average charge of $49,292, 45% below the national average. It also billed 2,495 outpatient services, charging 4.15 times what Medicare paid.

1Medicare inpatient stays 1,023
2Charge ÷ paid, inpatient 3.1×
3Rank in ND (highest ratio = 1) 6 of 6
4CMS price-transparency actions 0

Average charge per stay at CHI St Alexius Health, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 39 DRGs that can be compared with the national average, CHI St Alexius Health charged more than the national average in 1 (3%). 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	215	$49,292	-45%	$15,212
291 Heart Failure and Shock with MCC	71	$36,130	-36%	$11,295
280 Acute Myocardial Infarction, Discharged Alive with MCC	58	$36,012	-53%	$12,547
177 Respiratory Infections and Inflammations with MCC	34	$44,779	-37%	$13,893
853 Infectious and Parasitic Diseases with O.R. Procedures with...	33	$97,340	-57%	$37,544
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	30	$23,641	-52%	$8,663
698 Other Kidney and Urinary Tract Diagnoses with MCC	28	$28,070	-62%	$12,230
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	27	$41,333	-59%	$14,637
481 Hip and Femur Procedures except Major Joint with CC	27	$48,739	-52%	$16,148
281 Acute Myocardial Infarction, Discharged Alive with CC	25	$28,885	-43%	$7,518
309 Cardiac Arrhythmia and Conduction Disorders with CC	25	$16,030	-56%	$5,901
189 Pulmonary Edema and Respiratory Failure	24	$67,671	+18%	$18,641
682 Renal Failure with MCC	23	$28,397	-57%	$11,368
378 Gastrointestinal Hemorrhage with CC	22	$25,235	-48%	$8,036
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	21	$14,463	-50%	$4,668
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	20	$29,658	-47%	$7,727
454 Combined Anterior and Posterior Spinal Fusion with CC	20	$107,443	-62%	$44,388
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	19	$16,929	-58%	$6,610
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	19	$28,977	-52%	$10,020
683 Renal Failure with CC	18	$29,027	-29%	$7,449
193 Simple Pneumonia and Pleurisy with MCC	17	$40,577	-32%	$11,693
287 Circulatory Disorders except AMI, with Cardiac...	17	$39,281	-39%	$9,303
312 Syncope and Collapse	17	$24,276	-47%	$6,786
690 Kidney and Urinary Tract Infections without MCC	17	$19,763	-48%	$6,311
689 Kidney and Urinary Tract Infections with MCC	16	$27,318	-47%	$9,003
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	15	$92,611	-54%	$33,399
286 Circulatory Disorders except AMI, with Cardiac...	14	$57,860	-48%	$16,324
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	14	$70,328	-48%	$21,320
039 Extracranial Procedures without CC/MCC	13	$34,863	-45%	$8,567
274 Percutaneous and Other Intracardiac Procedures without MCC	13	$101,467	-35%	$23,241
308 Cardiac Arrhythmia and Conduction Disorders with MCC	13	$22,267	-61%	$9,184
322 Percutaneous Cardiovascular Procedures with Intraluminal...	13	$71,139	-38%	$13,424
470 Major Hip and Knee Joint Replacement or Reattachment of...	13	$50,996	-45%	$13,958
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	13	$46,567	-54%	$15,582
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	13	$26,699	-37%	$7,160
025 Craniotomy and Endovascular Intracranial Procedures with MCC	12	$83,792	-64%	$30,258
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	12	$29,022	-55%	$10,609
389 Gastrointestinal Obstruction with CC	11	$17,692	-55%	$6,225
659 Kidney and Ureter Procedures for Non-Neoplasm with MCC	11	$56,912	-52%	$18,749

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	418	$35,579	$12,245
Level 2 Urology and Related Services	400	$1,546	$640
Level 3 Urology and Related Services	247	$4,836	$1,617
Level 4 Musculoskeletal Procedures	152	$21,619	$6,707
Level 6 Musculoskeletal Procedures	119	$55,865	$17,168
Level 1 Endovascular Procedures	118	$19,186	$3,060
Level 5 Urology and Related Services	92	$21,681	$4,851
Comprehensive Observation Services	86	$13,142	$2,519
Level 2 Excision/ Biopsy/ Incision and Drainage	85	$6,564	$1,520
Level 1 Nerve Procedures	73	$4,151	$1,810
Level 2 Upper GI Procedures	62	$7,067	$1,755
Level 4 Urology and Related Services	62	$13,531	$3,268
Level 3 Vascular Procedures	48	$11,209	$2,943
Level 1 Laparoscopy and Related Services	47	$26,138	$5,410
Level 3 Musculoskeletal Procedures	43	$13,209	$3,035
Level 2 Neurostimulator and Related Procedures	43	$12,408	$6,293
Level 3 Pacemaker and Similar Procedures	38	$45,108	$10,003
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	38	$7,385	$3,244
Level 3 Endovascular Procedures	37	$58,536	$10,305
Level 5 Airway Endoscopy	35	$29,204	$6,417
Level 2 Endovascular Procedures	34	$27,132	$5,359
Level 4 Neurostimulator and Related Procedures	33	$72,712	$20,459
Level 3 Electrophysiologic Procedures	30	$98,008	$22,209
Level 5 Gynecologic Procedures	21	$18,767	$4,664
Level 4 Airway Endoscopy	17	$18,676	$3,511

Against the North Dakota average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), CHI St Alexius Health charged $49,292 on average, 2% less than the North Dakota average of $50,165, and was paid $15,212 against a state average of $16,037. For Heart Failure and Shock with MCC (DRG 291), CHI St Alexius Health charged $36,130 on average, 17% more than the North Dakota average of $30,902, and was paid $11,295 against a state average of $10,520. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), CHI St Alexius Health charged $36,012 on average, 9% less than the North Dakota average of $39,718, and was paid $12,547 against a state average of $13,470. For Respiratory Infections and Inflammations with MCC (DRG 177), CHI St Alexius Health charged $44,779 on average, 5% more than the North Dakota average of $42,554, and was paid $13,893 against a state average of $13,746. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $35,579 was 8% below the state average of $38,474. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,546 was 4% above the state average of $1,482. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $4,836 was 14% below the state average of $5,633. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $21,619 was 9% below the state average of $23,712.

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.