Decatur Memorial Hospital: charges and Medicare payments

Decatur Memorial Hospital reported 2,197 Medicare inpatient stays across 67 DRGs in 2024. Across them it charged 4.07 times what it was paid — mid-range in Illinois, number 52 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: 192 stays at an average charge of $59,569, 34% below the national average. It also billed 2,974 outpatient services, charging 7.42 times what Medicare paid.

1Medicare inpatient stays 2,197
2Charge ÷ paid, inpatient 4.07×
3Rank in IL (highest ratio = 1) 52 of 106
4CMS price-transparency actions 0

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

Inpatient stays

For the 67 DRGs that can be compared with the national average, Decatur Memorial Hospital charged more than the national average in 3 (4%). 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	192	$59,569	-34%	$15,080
291 Heart Failure and Shock with MCC	188	$33,789	-40%	$10,500
177 Respiratory Infections and Inflammations with MCC	93	$42,542	-40%	$12,384
189 Pulmonary Edema and Respiratory Failure	86	$55,165	-4%	$12,352
193 Simple Pneumonia and Pleurisy with MCC	72	$40,673	-32%	$10,454
690 Kidney and Urinary Tract Infections without MCC	67	$23,484	-38%	$6,499
689 Kidney and Urinary Tract Infections with MCC	65	$30,517	-41%	$8,783
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	59	$36,007	-35%	$7,748
194 Simple Pneumonia and Pleurisy with CC	58	$25,086	-35%	$6,578
190 Chronic Obstructive Pulmonary Disease with MCC	51	$39,127	-23%	$8,474
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	48	$28,568	-23%	$6,683
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	47	$27,455	-32%	$6,437
812 Red Blood Cell Disorders without MCC	44	$26,361	-41%	$7,718
309 Cardiac Arrhythmia and Conduction Disorders with CC	41	$22,193	-39%	$6,339
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	41	$80,719	-21%	$15,104
682 Renal Failure with MCC	41	$47,810	-27%	$14,290
683 Renal Failure with CC	41	$28,191	-31%	$7,010
308 Cardiac Arrhythmia and Conduction Disorders with MCC	39	$30,103	-47%	$12,289
378 Gastrointestinal Hemorrhage with CC	39	$32,204	-34%	$7,744
603 Cellulitis without MCC	38	$28,039	-25%	$7,086
481 Hip and Femur Procedures except Major Joint with CC	37	$79,820	-21%	$15,617
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	37	$34,709	-42%	$9,989
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	31	$34,975	-29%	$7,935
305 Hypertension without MCC	26	$27,770	-31%	$6,200
853 Infectious and Parasitic Diseases with O.R. Procedures with...	26	$140,344	-39%	$36,550
389 Gastrointestinal Obstruction with CC	25	$27,343	-30%	$6,243
176 Pulmonary Embolism without MCC	24	$28,713	-31%	$7,421
483 Major Joint or Limb Reattachment Procedures of Upper...	24	$164,293	+30%	$22,730
322 Percutaneous Cardiovascular Procedures with Intraluminal...	23	$105,058	-8%	$14,895
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	23	$40,869	-33%	$11,356
698 Other Kidney and Urinary Tract Diagnoses with MCC	23	$45,115	-39%	$11,680
313 Chest Pain	20	$26,437	-34%	$5,818
468 Revision of Hip or Knee Replacement without CC/MCC	20	$127,695	+3%	$26,738
638 Diabetes with CC	20	$32,212	-23%	$7,361
178 Respiratory Infections and Inflammations with CC	19	$30,213	-33%	$7,926
280 Acute Myocardial Infarction, Discharged Alive with MCC	19	$64,848	-14%	$13,701
637 Diabetes with MCC	19	$36,194	-46%	$13,612
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	18	$51,937	-48%	$13,080
321 Percutaneous Cardiovascular Procedures with Intraluminal...	18	$133,260	-19%	$24,432
377 Gastrointestinal Hemorrhage with MCC	18	$32,399	-62%	$13,116
394 Other Digestive System Diagnoses with CC	18	$24,009	-49%	$7,315
811 Red Blood Cell Disorders with MCC	18	$39,932	-41%	$11,048
066 Intracranial Hemorrhage or Cerebral Infarction without...	17	$33,439	-21%	$7,424
312 Syncope and Collapse	16	$28,547	-37%	$9,443
329 Major Small and Large Bowel Procedures with MCC	16	$141,143	-34%	$42,052
467 Revision of Hip or Knee Replacement with CC	16	$149,726	-5%	$23,944
948 Signs and Symptoms without MCC	16	$22,847	-40%	$6,407
208 Respiratory System Diagnosis with Ventilator Support <=96...	15	$82,167	-39%	$20,497
330 Major Small and Large Bowel Procedures with CC	15	$75,420	-37%	$17,475
331 Major Small and Large Bowel Procedures without CC/MCC	15	$55,637	-35%	$12,645
393 Other Digestive System Diagnoses with MCC	15	$37,387	-51%	$12,417
470 Major Hip and Knee Joint Replacement or Reattachment of...	15	$94,217	+1%	$15,539
699 Other Kidney and Urinary Tract Diagnoses with CC	15	$25,327	-47%	$8,260
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	14	$53,490	-18%	$11,118
286 Circulatory Disorders except AMI, with Cardiac...	14	$53,397	-52%	$17,118
287 Circulatory Disorders except AMI, with Cardiac...	14	$46,593	-27%	$9,994
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	13	$26,473	-8%	$4,694
418 Laparoscopic Cholecystectomy without C.D.E. with CC	13	$54,270	-42%	$12,448
460 Spinal Fusion except Cervical without MCC	12	$115,164	-32%	$30,947
602 Cellulitis with MCC	12	$40,881	-32%	$11,335

Showing the 60 most frequent of 67 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Excision/ Biopsy/ Incision and Drainage	414	$10,746	$1,493
Comprehensive Observation Services	245	$16,023	$2,522
Level 5 Musculoskeletal Procedures	236	$74,214	$12,057
Level 3 Urology and Related Services	234	$8,620	$1,882
Level 1 Nerve Procedures	158	$14,886	$1,776
Level 4 Urology and Related Services	138	$15,643	$3,222
Level 2 Musculoskeletal Procedures	109	$9,709	$1,465
Level 3 Musculoskeletal Procedures	108	$19,403	$2,991
Level 5 Urology and Related Services	104	$27,787	$4,782
Level 4 Musculoskeletal Procedures	103	$40,605	$6,562
Level 3 Vascular Procedures	98	$17,156	$2,922
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	86	$17,126	$3,179
Level 1 Laparoscopy and Related Services	83	$26,563	$5,281
Level 3 Excision/ Biopsy/ Incision and Drainage	77	$14,543	$2,626
Level 2 Upper GI Procedures	72	$10,197	$1,739
Level 1 Intraocular Procedures	71	$12,842	$2,154
Level 3 Endovascular Procedures	69	$76,713	$10,158
Level 1 Endovascular Procedures	65	$20,928	$2,983
Level 2 Vascular Procedures	61	$6,722	$1,480
Level 2 Urology and Related Services	55	$3,662	$631
Level 6 Musculoskeletal Procedures	53	$119,918	$17,185
Level 2 Breast/Lymphatic Surgery and Related Procedures	44	$37,947	$6,027
Level 1 Breast/Lymphatic Surgery and Related Procedures	41	$19,857	$3,523
Level 3 Airway Endoscopy	39	$7,031	$1,548
Level 2 Endovascular Procedures	30	$33,994	$5,282

Against the Illinois average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Decatur Memorial Hospital charged $59,569 on average, 19% less than the Illinois average of $73,987, and was paid $15,080 against a state average of $17,651. For Heart Failure and Shock with MCC (DRG 291), Decatur Memorial Hospital charged $33,789 on average, 27% less than the Illinois average of $46,293, and was paid $10,500 against a state average of $11,813. For Respiratory Infections and Inflammations with MCC (DRG 177), Decatur Memorial Hospital charged $42,542 on average, 29% less than the Illinois average of $59,769, and was paid $12,384 against a state average of $14,404. For Pulmonary Edema and Respiratory Failure (DRG 189), Decatur Memorial Hospital charged $55,165 on average, 9% more than the Illinois average of $50,573, and was paid $12,352 against a state average of $11,480. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,746 was 9% below the state average of $11,818. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $16,023 was 25% below the state average of $21,498. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $74,214 was 11% above the state average of $67,146. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $8,620 was 37% below the state average of $13,661.

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.