Erlanger Health System: charges and Medicare payments

Erlanger Health System reported 3,399 Medicare inpatient stays across 123 DRGs in 2024. Across them it charged 3.55 times what it was paid — among the lower ratios in Tennessee, number 44 of 65 hospitals with at least 100 stays (state median 4.42×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 306 stays at an average charge of $58,521, 35% below the national average. It also billed 4,325 outpatient services, charging 5.24 times what Medicare paid.

1Medicare inpatient stays 3,399
2Charge ÷ paid, inpatient 3.55×
3Rank in TN (highest ratio = 1) 44 of 65
4CMS price-transparency actions 0

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

Inpatient stays

For the 123 DRGs that can be compared with the national average, Erlanger Health System charged more than the national average in 8 (7%). 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	306	$58,521	-35%	$17,930
470 Major Hip and Knee Joint Replacement or Reattachment of...	138	$43,357	-53%	$16,702
291 Heart Failure and Shock with MCC	133	$41,545	-26%	$13,267
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	75	$39,345	-29%	$10,659
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	71	$72,063	-28%	$18,044
853 Infectious and Parasitic Diseases with O.R. Procedures with...	69	$168,185	-27%	$43,710
481 Hip and Femur Procedures except Major Joint with CC	65	$69,890	-31%	$18,954
177 Respiratory Infections and Inflammations with MCC	51	$44,558	-37%	$15,755
330 Major Small and Large Bowel Procedures with CC	50	$80,882	-32%	$21,314
280 Acute Myocardial Infarction, Discharged Alive with MCC	48	$47,036	-38%	$15,307
025 Craniotomy and Endovascular Intracranial Procedures with MCC	45	$127,609	-45%	$36,723
193 Simple Pneumonia and Pleurisy with MCC	43	$38,929	-35%	$13,297
309 Cardiac Arrhythmia and Conduction Disorders with CC	43	$22,901	-37%	$8,615
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	43	$63,840	-38%	$18,807
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	43	$51,121	-15%	$14,623
683 Renal Failure with CC	43	$28,750	-29%	$10,037
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	42	$38,633	-4%	$10,628
698 Other Kidney and Urinary Tract Diagnoses with MCC	42	$43,289	-41%	$15,769
023 Craniotomy with Major Device Implant or Acute Complex Cns...	41	$151,537	-46%	$48,166
083 Traumatic Stupor and Coma >1 Hour with CC	41	$52,835	-28%	$12,408
189 Pulmonary Edema and Respiratory Failure	41	$47,355	-18%	$12,215
086 Traumatic Stupor and Coma <1 Hour with CC	40	$53,315	-22%	$11,975
552 Medical Back Problems without MCC	40	$39,789	-19%	$11,069
092 Other Disorders of Nervous System with CC	39	$39,094	-24%	$10,913
329 Major Small and Large Bowel Procedures with MCC	39	$121,804	-43%	$34,812
682 Renal Failure with MCC	39	$49,563	-25%	$14,673
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	37	$38,209	-22%	$11,124
274 Percutaneous and Other Intracardiac Procedures without MCC	36	$70,990	-55%	$25,993
483 Major Joint or Limb Reattachment Procedures of Upper...	36	$66,677	-47%	$21,213
378 Gastrointestinal Hemorrhage with CC	34	$38,487	-21%	$10,743
312 Syncope and Collapse	31	$33,954	-25%	$9,513
389 Gastrointestinal Obstruction with CC	31	$27,674	-29%	$9,685
690 Kidney and Urinary Tract Infections without MCC	30	$21,728	-43%	$8,733
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	29	$31,502	-15%	$9,242
091 Other Disorders of Nervous System with MCC	28	$58,322	-30%	$16,970
101 Seizures without MCC	28	$33,660	-31%	$10,236
377 Gastrointestinal Hemorrhage with MCC	28	$94,044	+10%	$18,483
308 Cardiac Arrhythmia and Conduction Disorders with MCC	26	$39,198	-31%	$12,576
057 Degenerative Nervous System Disorders without MCC	25	$36,343	-36%	$12,765
287 Circulatory Disorders except AMI, with Cardiac...	25	$39,381	-38%	$11,157
468 Revision of Hip or Knee Replacement without CC/MCC	25	$68,921	-44%	$22,350
071 Other Cerebrovascular Disorders with CC	24	$36,361	-28%	$11,399
082 Traumatic Stupor and Coma >1 Hour with MCC	23	$93,639	-19%	$22,279
331 Major Small and Large Bowel Procedures without CC/MCC	23	$49,576	-42%	$15,423
480 Hip and Femur Procedures except Major Joint with MCC	23	$93,179	-33%	$24,951
100 Seizures with MCC	22	$52,484	-44%	$18,089
418 Laparoscopic Cholecystectomy without C.D.E. with CC	22	$66,643	-29%	$15,924
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	22	$78,513	-34%	$20,100
603 Cellulitis without MCC	22	$17,686	-53%	$9,667
267 Endovascular Cardiac Valve Replacement and Supplement...	21	$107,429	-51%	$38,016
472 Cervical Spinal Fusion with CC	21	$83,964	-41%	$25,057
638 Diabetes with CC	21	$30,808	-26%	$9,528
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	20	$636,405	-40%	$149,560
281 Acute Myocardial Infarction, Discharged Alive with CC	20	$38,401	-24%	$10,196
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	20	$20,350	-29%	$7,384
394 Other Digestive System Diagnoses with CC	20	$30,595	-35%	$9,925
654 Major Bladder Procedures with CC	20	$96,683	-38%	$24,263
854 Infectious and Parasitic Diseases with O.R. Procedures with...	20	$53,101	-46%	$19,274
884 Organic Disturbances and Intellectual Disability	20	$44,236	-29%	$18,321
069 Transient Ischemia without Thrombolytic	19	$37,556	-26%	$9,262

Showing the 60 most frequent of 123 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	366	$21,380	$2,275
Level 5 Musculoskeletal Procedures	359	$35,080	$11,031
Level 4 Musculoskeletal Procedures	274	$26,794	$5,902
Level 3 Urology and Related Services	252	$8,880	$1,718
Level 5 Urology and Related Services	240	$19,903	$4,334
Level 2 Upper GI Procedures	182	$10,066	$1,597
Level 1 Endovascular Procedures	176	$16,477	$2,770
Level 2 Musculoskeletal Procedures	172	$7,780	$1,356
Level 4 Urology and Related Services	164	$13,189	$2,925
Level 1 Laparoscopy and Related Services	155	$20,725	$4,783
Level 2 Laparoscopy and Related Services	142	$34,570	$8,455
Level 1 Nerve Procedures	142	$9,051	$1,623
Level 2 Excision/ Biopsy/ Incision and Drainage	134	$9,414	$1,378
Level 3 Musculoskeletal Procedures	131	$16,450	$2,685
Level 3 Vascular Procedures	125	$15,335	$2,725
Level 2 Intraocular Procedures	103	$15,195	$3,444
Level 3 Electrophysiologic Procedures	73	$60,167	$19,539
Level 2 Breast/Lymphatic Surgery and Related Procedures	69	$26,400	$5,511
Level 3 Lower GI Procedures	69	$13,155	$2,391
Level 4 Gynecologic Procedures	67	$11,779	$2,594
Level 3 Endovascular Procedures	62	$48,000	$9,400
Level 3 Excision/ Biopsy/ Incision and Drainage	58	$14,958	$2,337
Level 1 Breast/Lymphatic Surgery and Related Procedures	54	$19,181	$3,259
Level 4 Vascular Procedures	53	$33,288	$4,277
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	45	$17,630	$2,926

Against the Tennessee average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Erlanger Health System charged $58,521 on average, 17% less than the Tennessee average of $70,379, and was paid $17,930 against a state average of $15,065. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Erlanger Health System charged $43,357 on average, 48% less than the Tennessee average of $82,835, and was paid $16,702 against a state average of $14,500. For Heart Failure and Shock with MCC (DRG 291), Erlanger Health System charged $41,545 on average, 10% less than the Tennessee average of $46,128, and was paid $13,267 against a state average of $10,346. For Intracranial Hemorrhage or Cerebral Infarction with CC or Tpa in 24 Hours (DRG 065), Erlanger Health System charged $39,345 on average, 16% less than the Tennessee average of $46,946, and was paid $10,659 against a state average of $8,503. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $21,380 was 7% above the state average of $19,917. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $35,080 was 47% below the state average of $65,840. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $26,794 was 33% below the state average of $40,281. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $8,880 was 37% below the state average of $14,067.

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.