Hamilton Medical Center: charges and Medicare payments

Hamilton Medical Center reported 1,654 Medicare inpatient stays across 53 DRGs in 2024. Across them it charged 4.68 times what it was paid — mid-range in Georgia, number 35 of 74 hospitals with at least 100 stays (state median 4.44×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 198 stays at an average charge of $54,370, 4% below the national average. It also billed 1,787 outpatient services, charging 8.28 times what Medicare paid.

1Medicare inpatient stays 1,654
2Charge ÷ paid, inpatient 4.68×
3Rank in GA (highest ratio = 1) 35 of 74
4CMS price-transparency actions 1

Average charge per stay at Hamilton Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 53 DRGs that can be compared with the national average, Hamilton Medical Center charged more than the national average in 11 (21%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
291 Heart Failure and Shock with MCC	198	$54,370	-4%	$12,131
193 Simple Pneumonia and Pleurisy with MCC	124	$53,912	-10%	$12,212
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	121	$90,070	0%	$17,754
177 Respiratory Infections and Inflammations with MCC	59	$53,195	-25%	$14,123
189 Pulmonary Edema and Respiratory Failure	57	$64,071	+11%	$12,708
378 Gastrointestinal Hemorrhage with CC	55	$41,673	-14%	$9,792
683 Renal Failure with CC	51	$35,155	-14%	$8,952
689 Kidney and Urinary Tract Infections with MCC	49	$44,642	-13%	$11,208
690 Kidney and Urinary Tract Infections without MCC	47	$31,699	-16%	$8,450
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	43	$35,743	-11%	$8,614
309 Cardiac Arrhythmia and Conduction Disorders with CC	41	$35,490	-2%	$7,675
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	36	$59,068	-2%	$12,279
308 Cardiac Arrhythmia and Conduction Disorders with MCC	35	$53,715	-5%	$11,579
274 Percutaneous and Other Intracardiac Procedures without MCC	34	$153,666	-2%	$26,520
312 Syncope and Collapse	33	$31,050	-32%	$8,409
190 Chronic Obstructive Pulmonary Disease with MCC	32	$55,350	+9%	$10,881
286 Circulatory Disorders except AMI, with Cardiac...	31	$81,339	-28%	$19,365
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	30	$45,910	+24%	$8,486
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	28	$37,079	-33%	$9,606
481 Hip and Femur Procedures except Major Joint with CC	27	$90,360	-10%	$18,252
603 Cellulitis without MCC	27	$31,106	-17%	$8,887
682 Renal Failure with MCC	27	$69,305	+5%	$15,120
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	25	$94,503	-8%	$18,432
287 Circulatory Disorders except AMI, with Cardiac...	24	$49,244	-23%	$10,255
322 Percutaneous Cardiovascular Procedures with Intraluminal...	24	$109,428	-4%	$18,824
330 Major Small and Large Bowel Procedures with CC	24	$99,200	-17%	$19,998
194 Simple Pneumonia and Pleurisy with CC	21	$32,671	-15%	$7,984
638 Diabetes with CC	20	$42,295	+1%	$9,136
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	19	$43,340	-12%	$10,333
280 Acute Myocardial Infarction, Discharged Alive with MCC	18	$49,796	-34%	$12,760
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	18	$52,317	-22%	$12,163
602 Cellulitis with MCC	16	$61,464	+2%	$13,310
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	15	$47,609	-22%	$12,113
637 Diabetes with MCC	15	$54,991	-17%	$12,300
853 Infectious and Parasitic Diseases with O.R. Procedures with...	14	$255,055	+11%	$51,265
100 Seizures with MCC	13	$59,305	-37%	$18,063
101 Seizures without MCC	13	$26,842	-45%	$8,901
243 Permanent Cardiac Pacemaker Implant with CC	13	$145,906	+31%	$19,674
321 Percutaneous Cardiovascular Procedures with Intraluminal...	13	$146,849	-10%	$22,516
377 Gastrointestinal Hemorrhage with MCC	13	$88,417	+4%	$20,517
617 Amputation of Lower Limb for Endocrine, Nutritional and...	13	$68,389	-21%	$15,536
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	12	$141,664	+42%	$24,164
069 Transient Ischemia without Thrombolytic	12	$39,242	-22%	$8,090
070 Other Cerebrovascular Disorders with MCC	12	$52,004	-32%	$15,638
389 Gastrointestinal Obstruction with CC	12	$28,485	-27%	$8,275
698 Other Kidney and Urinary Tract Diagnoses with MCC	12	$61,056	-17%	$14,910
812 Red Blood Cell Disorders without MCC	12	$38,502	-13%	$9,741
208 Respiratory System Diagnosis with Ventilator Support <=96...	11	$155,587	+15%	$28,624
267 Endovascular Cardiac Valve Replacement and Supplement...	11	$220,690	0%	$38,291
281 Acute Myocardial Infarction, Discharged Alive with CC	11	$40,181	-20%	$8,992
329 Major Small and Large Bowel Procedures with MCC	11	$180,468	-16%	$33,817
394 Other Digestive System Diagnoses with CC	11	$44,090	-6%	$9,413
482 Hip and Femur Procedures except Major Joint without CC/MCC	11	$73,279	-6%	$18,622

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	407	$23,556	$2,452
Level 2 Upper GI Procedures	213	$16,098	$1,721
Level 1 Endovascular Procedures	151	$23,704	$2,933
Level 2 Excision/ Biopsy/ Incision and Drainage	120	$9,119	$1,446
Level 5 Musculoskeletal Procedures	110	$71,885	$11,607
Level 3 Vascular Procedures	82	$19,579	$2,850
Level 4 Urology and Related Services	65	$23,263	$3,139
Level 3 Excision/ Biopsy/ Incision and Drainage	57	$11,384	$2,591
Level 5 Urology and Related Services	50	$27,088	$4,492
Level 4 Endovascular Procedures	45	$115,268	$14,218
Level 4 Musculoskeletal Procedures	44	$34,608	$6,286
Level 2 Vascular Procedures	44	$12,223	$1,384
Level 3 Endovascular Procedures	40	$74,016	$9,609
Level 1 Laparoscopy and Related Services	34	$41,625	$5,261
Level 3 Musculoskeletal Procedures	32	$24,116	$2,951
Level 3 Electrophysiologic Procedures	31	$123,595	$21,598
Level 6 Musculoskeletal Procedures	28	$82,716	$16,955
Level 2 Laparoscopy and Related Services	26	$70,331	$9,380
Level 3 Pacemaker and Similar Procedures	25	$68,192	$9,405
Level 2 Endovascular Procedures	23	$33,200	$5,031
Level 6 Urology and Related Services	21	$50,041	$8,075
Level 2 Musculoskeletal Procedures	17	$12,609	$1,465
Level 4 Vascular Procedures	17	$21,642	$5,010
Level 2 Breast/Lymphatic Surgery and Related Procedures	15	$37,321	$5,945
Level 2 ICD and Similar Procedures	15	$169,534	$29,906

Against the Georgia average

For Heart Failure and Shock with MCC (DRG 291), Hamilton Medical Center charged $54,370 on average, 3% more than the Georgia average of $52,781, and was paid $12,131 against a state average of $12,005. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Hamilton Medical Center charged $53,912 on average, 4% less than the Georgia average of $56,349, and was paid $12,212 against a state average of $12,110. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Hamilton Medical Center charged $90,070 on average, 5% more than the Georgia average of $85,396, and was paid $17,754 against a state average of $17,147. For Respiratory Infections and Inflammations with MCC (DRG 177), Hamilton Medical Center charged $53,195 on average, 19% less than the Georgia average of $66,006, and was paid $14,123 against a state average of $14,774. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,556 was 13% above the state average of $20,900. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $16,098 was 8% above the state average of $14,925. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $23,704 was 12% below the state average of $26,927. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,119 was 30% below the state average of $12,974.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Hamilton Medical Center in Dalton, GA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2023-07-12 (CMS case 260)

A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.

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.