Knox Community Hospital: charges and Medicare payments

Knox Community Hospital reported 344 Medicare inpatient stays across 16 DRGs in 2024. Across them it charged 3.29 times what it was paid — among the lower ratios in Ohio, number 72 of 104 hospitals with at least 100 stays (state median 4.01×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 48 stays at an average charge of $53,165, 41% below the national average. It also billed 1,548 outpatient services, charging 6.11 times what Medicare paid.

1Medicare inpatient stays 344
2Charge ÷ paid, inpatient 3.29×
3Rank in OH (highest ratio = 1) 72 of 104
4CMS price-transparency actions 0

Average charge per stay at Knox Community Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 16 DRGs that can be compared with the national average, Knox Community 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	48	$53,165	-41%	$16,063
189 Pulmonary Edema and Respiratory Failure	45	$31,743	-45%	$9,895
291 Heart Failure and Shock with MCC	33	$29,923	-47%	$10,290
193 Simple Pneumonia and Pleurisy with MCC	26	$37,861	-37%	$11,447
177 Respiratory Infections and Inflammations with MCC	23	$46,739	-34%	$13,342
690 Kidney and Urinary Tract Infections without MCC	23	$19,529	-48%	$6,822
190 Chronic Obstructive Pulmonary Disease with MCC	18	$26,389	-48%	$8,817
322 Percutaneous Cardiovascular Procedures with Intraluminal...	18	$77,206	-33%	$17,224
309 Cardiac Arrhythmia and Conduction Disorders with CC	17	$16,780	-54%	$5,928
481 Hip and Femur Procedures except Major Joint with CC	16	$47,836	-53%	$16,439
389 Gastrointestinal Obstruction with CC	15	$15,929	-59%	$6,346
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	15	$25,198	-49%	$8,254
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	13	$25,760	-36%	$6,231
689 Kidney and Urinary Tract Infections with MCC	12	$31,418	-39%	$9,347
321 Percutaneous Cardiovascular Procedures with Intraluminal...	11	$93,195	-43%	$25,335
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	11	$12,480	-66%	$6,769

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	317	$15,022	$2,512
Level 2 Urology and Related Services	256	$1,006	$633
Level 1 Intraocular Procedures	191	$11,963	$2,151
Level 1 Endovascular Procedures	120	$21,030	$3,025
Level 3 Urology and Related Services	81	$5,996	$1,888
Level 1 Nerve Procedures	70	$14,722	$1,790
Level 5 Musculoskeletal Procedures	58	$50,010	$12,182
Level 3 Endovascular Procedures	57	$52,047	$10,188
Level 4 Urology and Related Services	42	$13,478	$3,231
Level 2 Musculoskeletal Procedures	39	$8,319	$1,490
Level 2 Excision/ Biopsy/ Incision and Drainage	38	$8,528	$1,503
Level 2 Vascular Procedures	38	$12,141	$1,484
Level 3 Musculoskeletal Procedures	37	$13,942	$2,936
Level 4 Musculoskeletal Procedures	30	$27,110	$6,455
Level 3 Airway Endoscopy	27	$2,274	$1,573
Level 3 Vascular Procedures	25	$17,033	$2,954
Level 3 Pacemaker and Similar Procedures	24	$41,049	$9,890
Level 1 Laparoscopy and Related Services	21	$26,890	$5,349
Level 2 Endovascular Procedures	19	$28,694	$5,298
Level 4 Endovascular Procedures	16	$81,692	$16,220
Level 5 Urology and Related Services	16	$14,579	$4,796
Level 6 Musculoskeletal Procedures	15	$56,588	$17,236
Level 4 Vascular Procedures	11	$32,420	$5,094

Against the Ohio average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Knox Community Hospital charged $53,165 on average, 17% less than the Ohio average of $64,290, and was paid $16,063 against a state average of $15,664. For Pulmonary Edema and Respiratory Failure (DRG 189), Knox Community Hospital charged $31,743 on average, 28% less than the Ohio average of $44,002, and was paid $9,895 against a state average of $10,477. For Heart Failure and Shock with MCC (DRG 291), Knox Community Hospital charged $29,923 on average, 30% less than the Ohio average of $42,986, and was paid $10,290 against a state average of $10,652. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Knox Community Hospital charged $37,861 on average, 9% less than the Ohio average of $41,598, and was paid $11,447 against a state average of $10,716. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,022 was 12% below the state average of $17,044. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,006 was 67% below the state average of $3,065. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $11,963 was 13% above the state average of $10,597. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $21,030 was 10% below the state average of $23,255.

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.