Kentucky / Highlands Arh Regional Medical Center
CMS certification 180005 · Prestonsburg, KY · 3 entries in CMS's price-transparency list
Highlands Arh Regional Medical Center: charges and Medicare payments
Highlands Arh Regional Medical Center reported 188 Medicare inpatient stays across 8 DRGs in 2024. Across them it charged 5.62 times what it was paid — among the higher ratios in Kentucky, number 14 of 51 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: 78 stays at an average charge of $76,771, 15% below the national average. It also billed 235 outpatient services, charging 9.05 times what Medicare paid.
- 1Medicare inpatient stays 188
- 2Charge ÷ paid, inpatient 5.62×
- 3Rank in KY (highest ratio = 1) 14 of 51
- 4CMS price-transparency actions 3
Inpatient stays
For the 8 DRGs that can be compared with the national average, Highlands Arh Regional Medical Center charged more than the national average in 1 (13%). 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 | 78 | $76,771 | -15% | $12,806 |
| 193 Simple Pneumonia and Pleurisy with MCC | 25 | $48,023 | -20% | $8,642 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 18 | $52,406 | +4% | $7,247 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $40,913 | -42% | $10,657 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 14 | $48,474 | -36% | $9,821 |
| 291 Heart Failure and Shock with MCC | 14 | $40,345 | -28% | $8,438 |
| 683 Renal Failure with CC | 13 | $39,471 | -3% | $5,909 |
| 682 Renal Failure with MCC | 12 | $36,747 | -44% | $9,422 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 76 | $25,661 | $2,321 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 32 | $10,288 | $1,341 |
| Level 1 Endovascular Procedures | 23 | $28,058 | $2,595 |
| Level 4 Musculoskeletal Procedures | 19 | $28,865 | $5,813 |
| Level 3 Musculoskeletal Procedures | 16 | $19,323 | $2,745 |
| Level 5 Musculoskeletal Procedures | 15 | $44,064 | $9,880 |
| Level 1 Laparoscopy and Related Services | 15 | $23,244 | $4,893 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 14 | $15,825 | $2,410 |
| Level 3 Vascular Procedures | 14 | $13,816 | $2,703 |
| Level 1 Nerve Procedures | 11 | $12,260 | $1,519 |
Against the Kentucky average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Highlands Arh Regional Medical Center charged $76,771 on average, 21% more than the Kentucky average of $63,454, and was paid $12,806 against a state average of $14,765. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Highlands Arh Regional Medical Center charged $48,023 on average, 10% more than the Kentucky average of $43,745, and was paid $8,642 against a state average of $9,962. For Chronic Obstructive Pulmonary Disease with MCC (DRG 190), Highlands Arh Regional Medical Center charged $52,406 on average, 41% more than the Kentucky average of $37,165, and was paid $7,247 against a state average of $8,277. For Respiratory Infections and Inflammations with MCC (DRG 177), Highlands Arh Regional Medical Center charged $40,913 on average, 24% less than the Kentucky average of $53,742, and was paid $10,657 against a state average of $12,118. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $25,661 was 26% above the state average of $20,333. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,288 was 14% below the state average of $11,961. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $28,058 was 5% below the state average of $29,393. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $28,865 was 35% below the state average of $44,565.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Highlands Arh Regional Medical Center in Prestonsburg, KY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-03-21 (CMS case 337)
- CAP Request — 2024-06-27 (CMS case 337)
- Closure Notice — 2024-08-15 (CMS case 337)
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.