Wisconsin / Fort Memorial Hospital
CMS certification 520071 · Fort Atkinson, WI
Fort Memorial Hospital: charges and Medicare payments
Fort Memorial Hospital reported 173 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 2.93 times what it was paid — among the lower ratios in Wisconsin, number 39 of 55 hospitals with at least 100 stays (state median 3.47×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 55 stays at an average charge of $38,965, 57% below the national average. It also billed 1,119 outpatient services, charging 5.61 times what Medicare paid.
- 1Medicare inpatient stays 173
- 2Charge ÷ paid, inpatient 2.93×
- 3Rank in WI (highest ratio = 1) 39 of 55
- 4CMS price-transparency actions 0
Inpatient stays
For the 7 DRGs that can be compared with the national average, Fort Memorial 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 | 55 | $38,965 | -57% | $14,377 |
| 189 Pulmonary Edema and Respiratory Failure | 38 | $40,475 | -30% | $10,033 |
| 291 Heart Failure and Shock with MCC | 20 | $29,549 | -48% | $9,999 |
| 177 Respiratory Infections and Inflammations with MCC | 16 | $28,256 | -60% | $13,263 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 16 | $21,953 | -55% | $8,042 |
| 193 Simple Pneumonia and Pleurisy with MCC | 14 | $32,220 | -46% | $10,979 |
| 481 Hip and Femur Procedures except Major Joint with CC | 14 | $44,130 | -56% | $16,452 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 405 | $17,331 | $2,479 |
| Level 3 Musculoskeletal Procedures | 106 | $18,924 | $2,927 |
| Level 5 Musculoskeletal Procedures | 106 | $31,457 | $11,974 |
| Level 1 Nerve Procedures | 98 | $9,071 | $1,759 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 89 | $5,089 | $1,477 |
| Level 4 Musculoskeletal Procedures | 81 | $31,089 | $6,325 |
| Level 1 Intraocular Procedures | 73 | $11,890 | $2,108 |
| Level 2 Musculoskeletal Procedures | 46 | $8,781 | $1,464 |
| Level 6 Musculoskeletal Procedures | 27 | $44,002 | $16,941 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 18 | $13,874 | $2,589 |
| Level 1 Laparoscopy and Related Services | 17 | $26,195 | $5,256 |
| Level 3 Urology and Related Services | 16 | $10,705 | $1,856 |
| Level 3 Vascular Procedures | 14 | $12,684 | $2,904 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 12 | $20,097 | $3,152 |
| Level 2 Upper GI Procedures | 11 | $14,197 | $1,733 |
Against the Wisconsin average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Fort Memorial Hospital charged $38,965 on average, 34% less than the Wisconsin average of $59,481, and was paid $14,377 against a state average of $16,719. For Pulmonary Edema and Respiratory Failure (DRG 189), Fort Memorial Hospital charged $40,475 on average, 0% less than the Wisconsin average of $40,535, and was paid $10,033 against a state average of $10,823. For Heart Failure and Shock with MCC (DRG 291), Fort Memorial Hospital charged $29,549 on average, 25% less than the Wisconsin average of $39,564, and was paid $9,999 against a state average of $10,862. For Respiratory Infections and Inflammations with MCC (DRG 177), Fort Memorial Hospital charged $28,256 on average, 46% less than the Wisconsin average of $52,035, and was paid $13,263 against a state average of $14,345. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,331 was 2% below the state average of $17,717. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $18,924 was 6% above the state average of $17,806. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $31,457 was 37% below the state average of $50,282. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $9,071 was 3% below the state average of $9,348.
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.