Mainehealth Maine Medical Center: charges and Medicare payments

Mainehealth Maine Medical Center reported 6,472 Medicare inpatient stays across 182 DRGs in 2024. Across them it charged 3.54 times what it was paid — among the higher ratios in Maine, number 4 of 13 hospitals with at least 100 stays (state median 3.18×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 453 stays at an average charge of $65,763, 27% below the national average. It also billed 6,957 outpatient services, charging 5.96 times what Medicare paid.

1Medicare inpatient stays 6,472
2Charge ÷ paid, inpatient 3.54×
3Rank in ME (highest ratio = 1) 4 of 13
4CMS price-transparency actions 0

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

Inpatient stays

For the 182 DRGs that can be compared with the national average, Mainehealth Maine Medical Center charged more than the national average in 17 (9%). 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	453	$65,763	-27%	$19,319
291 Heart Failure and Shock with MCC	248	$41,364	-27%	$12,688
177 Respiratory Infections and Inflammations with MCC	163	$60,667	-14%	$16,135
322 Percutaneous Cardiovascular Procedures with Intraluminal...	115	$86,044	-25%	$18,543
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	114	$63,726	-36%	$19,849
280 Acute Myocardial Infarction, Discharged Alive with MCC	114	$61,146	-19%	$16,650
193 Simple Pneumonia and Pleurisy with MCC	111	$38,253	-36%	$13,248
189 Pulmonary Edema and Respiratory Failure	106	$63,860	+11%	$19,171
286 Circulatory Disorders except AMI, with Cardiac...	101	$81,582	-27%	$23,102
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	87	$39,018	-30%	$10,288
853 Infectious and Parasitic Diseases with O.R. Procedures with...	86	$216,308	-6%	$66,083
481 Hip and Femur Procedures except Major Joint with CC	81	$71,942	-29%	$18,956
698 Other Kidney and Urinary Tract Diagnoses with MCC	78	$49,836	-32%	$18,650
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	75	$46,647	-23%	$16,541
321 Percutaneous Cardiovascular Procedures with Intraluminal...	73	$138,595	-15%	$38,251
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	71	$34,827	-29%	$11,045
689 Kidney and Urinary Tract Infections with MCC	70	$49,492	-4%	$11,933
266 Endovascular Cardiac Valve Replacement and Supplement...	67	$281,162	-1%	$61,336
267 Endovascular Cardiac Valve Replacement and Supplement...	65	$256,022	+16%	$49,233
287 Circulatory Disorders except AMI, with Cardiac...	63	$43,072	-33%	$10,894
682 Renal Failure with MCC	63	$49,682	-25%	$17,413
378 Gastrointestinal Hemorrhage with CC	62	$32,491	-33%	$10,182
025 Craniotomy and Endovascular Intracranial Procedures with MCC	61	$119,195	-49%	$48,151
377 Gastrointestinal Hemorrhage with MCC	60	$55,980	-34%	$18,015
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	59	$25,516	-36%	$8,231
690 Kidney and Urinary Tract Infections without MCC	59	$27,618	-27%	$8,055
330 Major Small and Large Bowel Procedures with CC	58	$62,806	-47%	$22,007
057 Degenerative Nervous System Disorders without MCC	55	$46,581	-18%	$14,293
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	55	$28,713	-23%	$8,346
281 Acute Myocardial Infarction, Discharged Alive with CC	54	$34,892	-31%	$8,839
243 Permanent Cardiac Pacemaker Implant with CC	52	$85,591	-23%	$20,943
683 Renal Failure with CC	52	$27,817	-32%	$9,116
543 Pathological Fractures and Musculoskeletal and Connective...	51	$35,619	-27%	$10,516
552 Medical Back Problems without MCC	50	$33,162	-32%	$9,090
603 Cellulitis without MCC	49	$27,223	-27%	$9,082
312 Syncope and Collapse	47	$28,045	-38%	$9,080
309 Cardiac Arrhythmia and Conduction Disorders with CC	46	$19,848	-45%	$7,652
023 Craniotomy with Major Device Implant or Acute Complex Cns...	45	$211,169	-25%	$54,649
308 Cardiac Arrhythmia and Conduction Disorders with MCC	45	$46,894	-17%	$19,478
329 Major Small and Large Bowel Procedures with MCC	45	$164,124	-24%	$44,939
274 Percutaneous and Other Intracardiac Procedures without MCC	44	$132,497	-15%	$29,638
480 Hip and Femur Procedures except Major Joint with MCC	44	$89,957	-35%	$26,209
234 Coronary Bypass with Cardiac Catheterization or Open...	43	$169,206	-37%	$61,755
470 Major Hip and Knee Joint Replacement or Reattachment of...	43	$86,988	-7%	$18,640
884 Organic Disturbances and Intellectual Disability	43	$46,784	-25%	$15,574
917 Poisoning and Toxic Effects of Drugs with MCC	43	$54,736	-27%	$15,177
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	42	$71,298	-30%	$21,344
184 Major Chest Trauma with CC	40	$45,567	-18%	$10,893
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	40	$50,029	-18%	$13,496
242 Permanent Cardiac Pacemaker Implant with MCC	39	$128,588	-20%	$34,472
699 Other Kidney and Urinary Tract Diagnoses with CC	38	$34,031	-28%	$10,634
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	38	$175,207	-19%	$44,237
164 Major Chest Procedures with CC	37	$77,838	-39%	$23,243
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	37	$259,971	-35%	$83,023
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	37	$205,243	-26%	$72,405
393 Other Digestive System Diagnoses with MCC	36	$51,045	-34%	$14,949
811 Red Blood Cell Disorders with MCC	36	$48,305	-29%	$16,590
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	34	$40,256	-38%	$12,972
178 Respiratory Infections and Inflammations with CC	34	$56,805	+25%	$13,123
389 Gastrointestinal Obstruction with CC	34	$25,358	-35%	$7,891

Showing the 60 most frequent of 182 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	636	$1,000	$635
Comprehensive Observation Services	559	$12,994	$2,518
Level 5 Musculoskeletal Procedures	551	$57,351	$12,212
Level 3 Urology and Related Services	433	$4,953	$1,886
Level 2 Excision/ Biopsy/ Incision and Drainage	421	$7,632	$1,460
Level 1 Endovascular Procedures	370	$14,820	$3,047
Level 1 Nerve Procedures	338	$5,588	$1,801
Level 2 Upper GI Procedures	249	$7,981	$1,776
Level 1 Laparoscopy and Related Services	218	$24,905	$5,302
Level 3 Electrophysiologic Procedures	212	$140,017	$22,160
Level 4 Musculoskeletal Procedures	207	$30,610	$6,618
Level 4 Urology and Related Services	204	$13,668	$3,186
Level 5 Urology and Related Services	192	$23,714	$4,842
Level 2 Endovascular Procedures	174	$30,724	$5,273
Level 3 Vascular Procedures	164	$14,395	$2,909
Level 2 Laparoscopy and Related Services	162	$38,350	$9,516
Level 3 Endovascular Procedures	141	$64,769	$10,327
Level 3 Excision/ Biopsy/ Incision and Drainage	118	$13,198	$1,797
Level 3 Musculoskeletal Procedures	118	$13,802	$2,898
Level 5 ENT Procedures	110	$28,996	$5,383
Level 6 Musculoskeletal Procedures	105	$78,093	$17,471
Level 2 Breast/Lymphatic Surgery and Related Procedures	94	$29,890	$6,127
Level 2 Musculoskeletal Procedures	87	$6,689	$1,482
Level 3 Pacemaker and Similar Procedures	81	$49,119	$10,025
Level 1 Breast/Lymphatic Surgery and Related Procedures	71	$17,497	$3,461

Against the Maine average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mainehealth Maine Medical Center charged $65,763 on average, 13% more than the Maine average of $57,965, and was paid $19,319 against a state average of $19,002. For Heart Failure and Shock with MCC (DRG 291), Mainehealth Maine Medical Center charged $41,364 on average, 3% more than the Maine average of $40,287, and was paid $12,688 against a state average of $11,946. For Respiratory Infections and Inflammations with MCC (DRG 177), Mainehealth Maine Medical Center charged $60,667 on average, 14% more than the Maine average of $53,088, and was paid $16,135 against a state average of $15,399. For Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC (DRG 322), Mainehealth Maine Medical Center charged $86,044 on average, 2% more than the Maine average of $84,578, and was paid $18,543 against a state average of $17,811. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,000 was 29% below the state average of $1,404. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,994 was 2% below the state average of $13,250. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $57,351 was 9% above the state average of $52,811. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $4,953 was 27% below the state average of $6,802.

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.