Montana / Great Falls Clinic Hospital
CMS certification 270086 · Great Falls, MT
Great Falls Clinic Hospital: charges and Medicare payments
Great Falls Clinic Hospital reported 247 Medicare inpatient stays across 11 DRGs in 2024. Across them it charged 4.44 times what it was paid — among the higher ratios in Montana, number 2 of 10 hospitals with at least 100 stays (state median 3.38×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 65 stays at an average charge of $42,273, 53% below the national average. It also billed 1,857 outpatient services, charging 7.46 times what Medicare paid.
- 1Medicare inpatient stays 247
- 2Charge ÷ paid, inpatient 4.44×
- 3Rank in MT (highest ratio = 1) 2 of 10
- 4CMS price-transparency actions 0
Inpatient stays
For the 11 DRGs that can be compared with the national average, Great Falls Clinic Hospital charged more than the national average in 1 (9%). 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 | 65 | $42,273 | -53% | $13,751 |
| 291 Heart Failure and Shock with MCC | 28 | $47,595 | -16% | $10,330 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 24 | $26,550 | -46% | $10,119 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 23 | $81,696 | -12% | $13,276 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 21 | $96,707 | -38% | $22,573 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 17 | $239,887 | +18% | $34,245 |
| 189 Pulmonary Edema and Respiratory Failure | 16 | $39,722 | -31% | $8,664 |
| 193 Simple Pneumonia and Pleurisy with MCC | 15 | $33,039 | -45% | $9,136 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $32,871 | -42% | $9,391 |
| 177 Respiratory Infections and Inflammations with MCC | 13 | $46,230 | -35% | $11,688 |
| 690 Kidney and Urinary Tract Infections without MCC | 11 | $21,337 | -44% | $5,681 |
Outpatient services
Against the Montana average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Great Falls Clinic Hospital charged $42,273 on average, 1% less than the Montana average of $42,642, and was paid $13,751 against a state average of $15,860. For Heart Failure and Shock with MCC (DRG 291), Great Falls Clinic Hospital charged $47,595 on average, 56% more than the Montana average of $30,559, and was paid $10,330 against a state average of $10,456. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Great Falls Clinic Hospital charged $26,550 on average, 12% more than the Montana average of $23,658, and was paid $10,119 against a state average of $8,589. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Great Falls Clinic Hospital charged $81,696 on average, 41% more than the Montana average of $57,762, and was paid $13,276 against a state average of $14,352. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $13,252 was 50% above the state average of $8,811. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,503 was 14% above the state average of $10,951. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $67,710 was 58% above the state average of $42,843. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $47,637 was 65% above the state average of $28,834.
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.