Massachusetts / Marlborough Hospital
CMS certification 220049 · Marlborough, MA
Marlborough Hospital: charges and Medicare payments
Marlborough Hospital reported 853 Medicare inpatient stays across 28 DRGs in 2024. Across them it charged 2.71 times what it was paid — among the higher ratios in Massachusetts, number 11 of 52 hospitals with at least 100 stays (state median 2×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 124 stays at an average charge of $26,696, 53% below the national average. It also billed 698 outpatient services, charging 6.33 times what Medicare paid.
- 1Medicare inpatient stays 853
- 2Charge ÷ paid, inpatient 2.71×
- 3Rank in MA (highest ratio = 1) 11 of 52
- 4CMS price-transparency actions 0
Inpatient stays
For the 28 DRGs that can be compared with the national average, Marlborough Hospital charged more than the national average in 1 (4%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 124 | $26,696 | -53% | $10,601 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 109 | $37,525 | -58% | $15,641 |
| 177 Respiratory Infections and Inflammations with MCC | 82 | $36,402 | -48% | $13,309 |
| 193 Simple Pneumonia and Pleurisy with MCC | 70 | $26,335 | -56% | $11,349 |
| 885 Psychoses | 55 | $65,435 | +49% | $18,221 |
| 689 Kidney and Urinary Tract Infections with MCC | 47 | $26,590 | -48% | $9,454 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 26 | $19,746 | -61% | $8,904 |
| 690 Kidney and Urinary Tract Infections without MCC | 26 | $18,525 | -51% | $7,059 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 25 | $55,283 | -25% | $15,486 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 22 | $30,542 | -60% | $12,645 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 22 | $25,742 | -57% | $10,319 |
| 683 Renal Failure with CC | 19 | $18,591 | -54% | $7,338 |
| 312 Syncope and Collapse | 18 | $22,584 | -50% | $7,417 |
| 603 Cellulitis without MCC | 18 | $19,629 | -47% | $7,628 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $30,048 | -25% | $7,083 |
| 682 Renal Failure with MCC | 16 | $22,077 | -67% | $11,728 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $35,520 | -42% | $10,834 |
| 813 Coagulation Disorders | 15 | $28,566 | -64% | $13,138 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $34,540 | -40% | $10,525 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $28,037 | -50% | $10,411 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $18,590 | -50% | $6,774 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 14 | $20,956 | -57% | $8,458 |
| 194 Simple Pneumonia and Pleurisy with CC | 13 | $13,101 | -66% | $6,607 |
| 069 Transient Ischemia without Thrombolytic | 12 | $22,874 | -55% | $6,896 |
| 202 Bronchitis and Asthma with CC/MCC | 12 | $19,596 | -58% | $8,285 |
| 481 Hip and Femur Procedures except Major Joint with CC | 12 | $56,627 | -44% | $17,744 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 11 | $22,997 | -59% | $10,963 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 11 | $31,508 | -52% | $11,015 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 278 | $18,158 | $2,908 |
| Level 5 Musculoskeletal Procedures | 70 | $67,367 | $13,932 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 65 | $9,785 | $1,741 |
| Level 3 Musculoskeletal Procedures | 52 | $14,482 | $3,356 |
| Level 1 Intraocular Procedures | 48 | $15,291 | $2,503 |
| Level 4 Musculoskeletal Procedures | 41 | $36,838 | $7,308 |
| Level 1 Laparoscopy and Related Services | 25 | $24,610 | $5,999 |
| Level 2 Upper GI Procedures | 24 | $14,879 | $2,043 |
| Level 4 Urology and Related Services | 22 | $14,639 | $3,744 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 17 | $14,091 | $2,766 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 16 | $15,010 | $3,716 |
| Level 5 Urology and Related Services | 15 | $24,250 | $5,557 |
| Level 2 Musculoskeletal Procedures | 13 | $7,116 | $1,726 |
| Level 6 Musculoskeletal Procedures | 12 | $99,437 | $18,438 |
Against the Massachusetts average
For Heart Failure and Shock with MCC (DRG 291), Marlborough Hospital charged $26,696 on average, 12% less than the Massachusetts average of $30,373, and was paid $10,601 against a state average of $12,996. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Marlborough Hospital charged $37,525 on average, 17% less than the Massachusetts average of $45,229, and was paid $15,641 against a state average of $19,536. For Respiratory Infections and Inflammations with MCC (DRG 177), Marlborough Hospital charged $36,402 on average, 2% less than the Massachusetts average of $37,072, and was paid $13,309 against a state average of $15,861. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Marlborough Hospital charged $26,335 on average, 6% less than the Massachusetts average of $28,077, and was paid $11,349 against a state average of $12,627. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $18,158 was 30% above the state average of $14,010. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $67,367 was 90% above the state average of $35,549. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,785 was 48% above the state average of $6,596. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $14,482 was 10% above the state average of $13,150.
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.