Indiana / Major Hospital
CMS certification 150097 · Shelbyville, IN
Major Hospital: charges and Medicare payments
Major Hospital reported 275 Medicare inpatient stays across 10 DRGs in 2024. Across them it charged 2.84 times what it was paid — among the lower ratios in Indiana, number 58 of 70 hospitals with at least 100 stays (state median 4.08×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 73 stays at an average charge of $41,134, 54% below the national average. It also billed 734 outpatient services, charging 8.47 times what Medicare paid.
- 1Medicare inpatient stays 275
- 2Charge ÷ paid, inpatient 2.84×
- 3Rank in IN (highest ratio = 1) 58 of 70
- 4CMS price-transparency actions 0
Inpatient stays
For the 10 DRGs that can be compared with the national average, Major 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 | 73 | $41,134 | -54% | $15,532 |
| 193 Simple Pneumonia and Pleurisy with MCC | 44 | $34,982 | -41% | $12,451 |
| 291 Heart Failure and Shock with MCC | 32 | $33,923 | -40% | $11,094 |
| 177 Respiratory Infections and Inflammations with MCC | 24 | $40,171 | -43% | $13,459 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $26,852 | -48% | $9,704 |
| 189 Pulmonary Edema and Respiratory Failure | 19 | $35,852 | -38% | $10,981 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 19 | $38,906 | -47% | $12,836 |
| 682 Renal Failure with MCC | 16 | $33,798 | -49% | $12,172 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $21,663 | -43% | $7,450 |
| 683 Renal Failure with CC | 12 | $21,434 | -47% | $8,078 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 216 | $17,365 | $2,445 |
| Level 2 Urology and Related Services | 85 | $2,876 | $611 |
| Level 1 Nerve Procedures | 70 | $9,372 | $1,744 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 48 | $11,449 | $1,441 |
| Level 5 Musculoskeletal Procedures | 46 | $74,921 | $11,427 |
| Level 3 Urology and Related Services | 36 | $8,060 | $1,840 |
| Level 3 Musculoskeletal Procedures | 35 | $28,155 | $2,924 |
| Level 4 Musculoskeletal Procedures | 34 | $48,975 | $6,310 |
| Level 1 Laparoscopy and Related Services | 22 | $34,279 | $5,212 |
| Level 4 Urology and Related Services | 22 | $23,074 | $3,035 |
| Level 5 Urology and Related Services | 21 | $33,615 | $4,319 |
| Level 6 Musculoskeletal Procedures | 20 | $102,126 | $16,039 |
| Level 2 Musculoskeletal Procedures | 16 | $13,941 | $1,452 |
| Level 3 Vascular Procedures | 15 | $22,289 | $2,879 |
| Level 5 Airway Endoscopy | 13 | $36,703 | $6,182 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 13 | $29,234 | $2,933 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 11 | $17,452 | $2,567 |
| Level 2 Upper GI Procedures | 11 | $16,838 | $1,719 |
Against the Indiana average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Major Hospital charged $41,134 on average, 35% less than the Indiana average of $63,232, and was paid $15,532 against a state average of $15,368. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Major Hospital charged $34,982 on average, 20% less than the Indiana average of $43,683, and was paid $12,451 against a state average of $10,631. For Heart Failure and Shock with MCC (DRG 291), Major Hospital charged $33,923 on average, 17% less than the Indiana average of $40,842, and was paid $11,094 against a state average of $10,315. For Respiratory Infections and Inflammations with MCC (DRG 177), Major Hospital charged $40,171 on average, 22% less than the Indiana average of $51,549, and was paid $13,459 against a state average of $12,977. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,365 was 6% below the state average of $18,399. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,876 was 37% below the state average of $4,596. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $9,372 was 32% below the state average of $13,717. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,449 was 6% above the state average of $10,786.
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.