Virginia / Lonesome Pine Hospital
CMS certification 490114 · Big Stone Gap, VA
Lonesome Pine Hospital: charges and Medicare payments
Lonesome Pine Hospital reported 389 Medicare inpatient stays across 15 DRGs in 2024. Across them it charged 2.1 times what it was paid — among the lower ratios in Virginia, number 65 of 66 hospitals with at least 100 stays (state median 3.6×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 136 stays at an average charge of $43,906, 51% below the national average. It also billed 285 outpatient services, charging 7.55 times what Medicare paid.
- 1Medicare inpatient stays 389
- 2Charge ÷ paid, inpatient 2.1×
- 3Rank in VA (highest ratio = 1) 65 of 66
- 4CMS price-transparency actions 0
Inpatient stays
For the 15 DRGs that can be compared with the national average, Lonesome Pine 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 | 136 | $43,906 | -51% | $20,826 |
| 291 Heart Failure and Shock with MCC | 36 | $29,036 | -48% | $13,991 |
| 193 Simple Pneumonia and Pleurisy with MCC | 33 | $36,375 | -39% | $13,904 |
| 689 Kidney and Urinary Tract Infections with MCC | 22 | $26,136 | -49% | $12,735 |
| 177 Respiratory Infections and Inflammations with MCC | 20 | $33,034 | -53% | $16,797 |
| 690 Kidney and Urinary Tract Infections without MCC | 20 | $22,223 | -41% | $10,536 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 19 | $26,126 | -47% | $12,902 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $17,170 | -54% | $9,227 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 14 | $28,275 | -44% | $12,487 |
| 683 Renal Failure with CC | 14 | $19,351 | -52% | $10,713 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 14 | $34,093 | -54% | $18,106 |
| 194 Simple Pneumonia and Pleurisy with CC | 11 | $21,399 | -44% | $10,412 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 11 | $28,836 | -62% | $16,981 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $38,860 | -36% | $15,396 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 11 | $86,598 | -62% | $44,868 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Nerve Procedures | 123 | $7,836 | $1,746 |
| Comprehensive Observation Services | 106 | $15,504 | $2,493 |
| Level 3 Vascular Procedures | 17 | $23,489 | $2,939 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 14 | $22,831 | $3,190 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 13 | $12,527 | $1,418 |
| Level 2 Musculoskeletal Procedures | 12 | $13,347 | $1,482 |
Against the Virginia average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lonesome Pine Hospital charged $43,906 on average, 33% less than the Virginia average of $65,235, and was paid $20,826 against a state average of $16,367. For Heart Failure and Shock with MCC (DRG 291), Lonesome Pine Hospital charged $29,036 on average, 29% less than the Virginia average of $40,795, and was paid $13,991 against a state average of $11,030. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Lonesome Pine Hospital charged $36,375 on average, 19% less than the Virginia average of $44,717, and was paid $13,904 against a state average of $11,065. For Kidney and Urinary Tract Infections with MCC (DRG 689), Lonesome Pine Hospital charged $26,136 on average, 27% less than the Virginia average of $35,683, and was paid $12,735 against a state average of $9,652. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $7,836 was 36% below the state average of $12,264. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,504 was 21% below the state average of $19,506. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $23,489 was 21% above the state average of $19,434. For Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (outpatient APC 5341), its average charge of $22,831 was 19% below the state average of $28,082.
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.