Ohio / Kettering Health Troy
CMS certification 360368 · Troy, OH
Kettering Health Troy: charges and Medicare payments
Kettering Health Troy reported 228 Medicare inpatient stays across 10 DRGs in 2024. Across them it charged 4.73 times what it was paid — among the higher ratios in Ohio, number 26 of 104 hospitals with at least 100 stays (state median 4.01×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 63 stays at an average charge of $45,730, 19% below the national average. It also billed 337 outpatient services, charging 9.42 times what Medicare paid.
- 1Medicare inpatient stays 228
- 2Charge ÷ paid, inpatient 4.73×
- 3Rank in OH (highest ratio = 1) 26 of 104
- 4CMS price-transparency actions 0
Inpatient stays
For the 10 DRGs that can be compared with the national average, Kettering Health Troy 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 |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 63 | $45,730 | -19% | $9,040 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 39 | $54,830 | -39% | $12,510 |
| 189 Pulmonary Edema and Respiratory Failure | 25 | $42,260 | -27% | $9,816 |
| 193 Simple Pneumonia and Pleurisy with MCC | 23 | $41,706 | -30% | $9,249 |
| 177 Respiratory Infections and Inflammations with MCC | 19 | $51,635 | -27% | $10,844 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $35,962 | -5% | $5,877 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 12 | $50,262 | -32% | $12,385 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 12 | $36,684 | -25% | $7,996 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 11 | $45,222 | -19% | $7,205 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $27,063 | -27% | $5,585 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 110 | $21,406 | $2,324 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 61 | $11,261 | $1,357 |
| Level 1 Nerve Procedures | 42 | $18,674 | $1,651 |
| Level 4 Urology and Related Services | 36 | $26,670 | $2,981 |
| Level 3 Urology and Related Services | 25 | $21,984 | $1,742 |
| Level 1 Laparoscopy and Related Services | 20 | $71,944 | $4,738 |
| Level 5 Urology and Related Services | 17 | $29,453 | $4,425 |
| Level 5 Neurostimulator and Related Procedures | 14 | $96,850 | $26,480 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $26,334 | $2,430 |
Against the Ohio average
For Heart Failure and Shock with MCC (DRG 291), Kettering Health Troy charged $45,730 on average, 6% more than the Ohio average of $42,986, and was paid $9,040 against a state average of $10,652. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Kettering Health Troy charged $54,830 on average, 15% less than the Ohio average of $64,290, and was paid $12,510 against a state average of $15,664. For Pulmonary Edema and Respiratory Failure (DRG 189), Kettering Health Troy charged $42,260 on average, 4% less than the Ohio average of $44,002, and was paid $9,816 against a state average of $10,477. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Kettering Health Troy charged $41,706 on average, 0% less than the Ohio average of $41,598, and was paid $9,249 against a state average of $10,716. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $21,406 was 26% above the state average of $17,044. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,261 was 11% above the state average of $10,162. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $18,674 was 77% above the state average of $10,568. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $26,670 was 42% above the state average of $18,813.
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.