Colorado / Lutheran Medical Center

CMS certification 060009 · Wheat Ridge, CO · 2 entries in CMS's price-transparency list

Lutheran Medical Center: charges and Medicare payments

Lutheran Medical Center reported 860 Medicare inpatient stays across 31 DRGs in 2024. Across them it charged 7.16 times what it was paid — among the higher ratios in Colorado, number 12 of 37 hospitals with at least 100 stays (state median 6.33×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 189 stays at an average charge of $111,334, 23% above the national average. It also billed 1,491 outpatient services, charging 11.41 times what Medicare paid.

1Medicare inpatient stays 860
2Charge ÷ paid, inpatient 7.16×
3Rank in CO (highest ratio = 1) 12 of 37
4CMS price-transparency actions 2

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

Inpatient stays

For the 31 DRGs that can be compared with the national average, Lutheran Medical Center charged more than the national average in 30 (97%). 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	189	$111,334	+23%	$15,865
291 Heart Failure and Shock with MCC	73	$73,878	+31%	$9,995
193 Simple Pneumonia and Pleurisy with MCC	39	$66,541	+11%	$11,011
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	39	$59,018	+20%	$7,992
177 Respiratory Infections and Inflammations with MCC	34	$90,539	+28%	$13,369
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	33	$104,396	+5%	$15,620
698 Other Kidney and Urinary Tract Diagnoses with MCC	32	$75,766	+3%	$12,375
481 Hip and Femur Procedures except Major Joint with CC	31	$140,658	+40%	$15,300
853 Infectious and Parasitic Diseases with O.R. Procedures with...	29	$274,082	+20%	$46,095
189 Pulmonary Edema and Respiratory Failure	28	$78,199	+36%	$11,112
190 Chronic Obstructive Pulmonary Disease with MCC	26	$79,292	+57%	$8,441
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	25	$64,866	+16%	$7,688
378 Gastrointestinal Hemorrhage with CC	23	$63,903	+32%	$8,708
274 Percutaneous and Other Intracardiac Procedures without MCC	21	$228,060	+45%	$23,505
377 Gastrointestinal Hemorrhage with MCC	20	$96,577	+13%	$12,911
689 Kidney and Urinary Tract Infections with MCC	18	$52,149	+2%	$9,515
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	17	$107,344	+5%	$16,767
690 Kidney and Urinary Tract Infections without MCC	17	$49,990	+32%	$6,326
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	15	$70,263	+8%	$10,451
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	15	$78,197	+30%	$10,939
683 Renal Failure with CC	15	$69,865	+72%	$8,003
023 Craniotomy with Major Device Implant or Acute Complex Cns...	14	$278,765	-1%	$39,081
280 Acute Myocardial Infarction, Discharged Alive with MCC	14	$94,305	+24%	$11,805
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	13	$238,248	+10%	$36,803
025 Craniotomy and Endovascular Intracranial Procedures with MCC	12	$251,837	+9%	$32,888
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	12	$50,552	+26%	$6,271
603 Cellulitis without MCC	12	$51,273	+38%	$6,928
184 Major Chest Trauma with CC	11	$63,850	+15%	$7,929
322 Percutaneous Cardiovascular Procedures with Intraluminal...	11	$131,115	+14%	$13,718
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	11	$43,804	+18%	$6,260
896 Alcohol, Drug Abuse or Dependence without Rehabilitation...	11	$85,089	+9%	$12,729

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	536	$34,631	$2,583
Level 2 Upper GI Procedures	104	$18,542	$1,797
Level 2 Excision/ Biopsy/ Incision and Drainage	89	$13,344	$1,526
Level 1 Endovascular Procedures	66	$29,015	$3,039
Level 3 Electrophysiologic Procedures	57	$243,787	$22,550
Level 5 Urology and Related Services	54	$38,684	$4,853
Level 3 Vascular Procedures	48	$23,551	$2,993
Level 1 Laparoscopy and Related Services	45	$42,546	$5,395
Level 3 Excision/ Biopsy/ Incision and Drainage	42	$30,291	$2,705
Level 3 Endovascular Procedures	42	$95,813	$10,048
Level 5 Musculoskeletal Procedures	34	$80,734	$12,510
Level 2 Laparoscopy and Related Services	34	$77,480	$9,557
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	29	$20,128	$3,294
Level 3 Pacemaker and Similar Procedures	27	$71,578	$9,841
Level 1 Breast/Lymphatic Surgery and Related Procedures	25	$28,371	$3,513
Level 4 Musculoskeletal Procedures	24	$69,588	$6,810
Level 4 Airway Endoscopy	21	$16,123	$3,565
Level 2 Vascular Procedures	21	$5,039	$1,525
Level 3 Lower GI Procedures	21	$23,842	$2,570
Level 3 Urology and Related Services	20	$23,374	$1,939
Level 2 Endovascular Procedures	18	$37,546	$5,200
Level 6 Musculoskeletal Procedures	17	$101,076	$17,701
Level 2 Musculoskeletal Procedures	16	$11,550	$1,530
Level 2 Breast/Lymphatic Surgery and Related Procedures	15	$47,950	$6,208
Level 4 Urology and Related Services	15	$28,723	$3,319

Against the Colorado average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lutheran Medical Center charged $111,334 on average, 2% less than the Colorado average of $113,091, and was paid $15,865 against a state average of $16,848. For Heart Failure and Shock with MCC (DRG 291), Lutheran Medical Center charged $73,878 on average, 4% more than the Colorado average of $71,240, and was paid $9,995 against a state average of $11,134. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Lutheran Medical Center charged $66,541 on average, 3% less than the Colorado average of $68,465, and was paid $11,011 against a state average of $11,488. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Lutheran Medical Center charged $59,018 on average, 8% less than the Colorado average of $64,370, and was paid $7,992 against a state average of $9,284. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $34,631 was 2% above the state average of $34,074. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $18,542 was 26% above the state average of $14,762. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $13,344 was 4% below the state average of $13,898. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $29,015 was 11% below the state average of $32,669.

Price-transparency record

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

Warning Notice — 2025-04-07 (CMS case 3522)
Closure Notice — 2025-07-09 (CMS case 3522)

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.