Kentucky / Clark Regional Medical Center
CMS certification 180092 · Winchester, KY
Clark Regional Medical Center: charges and Medicare payments
Clark Regional Medical Center reported 235 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 7.12 times what it was paid — among the higher ratios in Kentucky, number 7 of 51 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: 46 stays at an average charge of $93,726, 4% above the national average. It also billed 673 outpatient services, charging 11.47 times what Medicare paid.
- 1Medicare inpatient stays 235
- 2Charge ÷ paid, inpatient 7.12×
- 3Rank in KY (highest ratio = 1) 7 of 51
- 4CMS price-transparency actions 0
Inpatient stays
For the 9 DRGs that can be compared with the national average, Clark Regional Medical Center charged more than the national average in 5 (56%). 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 | 46 | $93,726 | +4% | $13,209 |
| 291 Heart Failure and Shock with MCC | 34 | $62,737 | +11% | $8,679 |
| 189 Pulmonary Edema and Respiratory Failure | 33 | $60,835 | +6% | $8,666 |
| 177 Respiratory Infections and Inflammations with MCC | 32 | $90,968 | +29% | $11,601 |
| 193 Simple Pneumonia and Pleurisy with MCC | 32 | $65,608 | +10% | $9,000 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 19 | $75,538 | 0% | $10,255 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 13 | $44,466 | -21% | $8,268 |
| 682 Renal Failure with MCC | 13 | $64,977 | -1% | $10,078 |
| 683 Renal Failure with CC | 13 | $40,576 | 0% | $6,415 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 121 | $33,179 | $2,335 |
| Level 1 Intraocular Procedures | 101 | $11,743 | $1,986 |
| Level 2 Upper GI Procedures | 60 | $10,261 | $1,626 |
| Level 5 Musculoskeletal Procedures | 55 | $90,461 | $11,206 |
| Level 4 Musculoskeletal Procedures | 35 | $46,108 | $5,913 |
| Level 1 Laparoscopy and Related Services | 34 | $33,750 | $4,880 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 33 | $11,859 | $1,370 |
| Level 4 Urology and Related Services | 31 | $28,252 | $3,019 |
| Level 5 Urology and Related Services | 31 | $32,432 | $4,481 |
| Level 3 Urology and Related Services | 24 | $17,112 | $1,705 |
| Level 3 Vascular Procedures | 22 | $29,021 | $2,760 |
| Level 2 Musculoskeletal Procedures | 20 | $15,214 | $1,336 |
| Level 2 Vascular Procedures | 19 | $12,719 | $1,387 |
| Level 3 Endovascular Procedures | 17 | $148,092 | $9,521 |
| Level 1 Endovascular Procedures | 16 | $42,458 | $2,826 |
| Level 1 Nerve Procedures | 16 | $13,775 | $1,672 |
| Level 4 Endovascular Procedures | 15 | $189,100 | $15,156 |
| Level 3 Musculoskeletal Procedures | 12 | $22,293 | $2,617 |
| Level 6 Musculoskeletal Procedures | 11 | $118,011 | $16,106 |
Against the Kentucky average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Clark Regional Medical Center charged $93,726 on average, 48% more than the Kentucky average of $63,454, and was paid $13,209 against a state average of $14,765. For Heart Failure and Shock with MCC (DRG 291), Clark Regional Medical Center charged $62,737 on average, 54% more than the Kentucky average of $40,730, and was paid $8,679 against a state average of $9,552. For Pulmonary Edema and Respiratory Failure (DRG 189), Clark Regional Medical Center charged $60,835 on average, 45% more than the Kentucky average of $42,054, and was paid $8,666 against a state average of $9,410. For Respiratory Infections and Inflammations with MCC (DRG 177), Clark Regional Medical Center charged $90,968 on average, 69% more than the Kentucky average of $53,742, and was paid $11,601 against a state average of $12,118. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $33,179 was 63% above the state average of $20,333. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $11,743 was 6% above the state average of $11,097. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $10,261 was 23% below the state average of $13,357. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $90,461 was 3% above the state average of $87,601.
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.