Massachusetts / Massachusetts General Hospital

CMS certification 220071 · Boston, MA · 2 entries in CMS's price-transparency list

Massachusetts General Hospital: charges and Medicare payments

Massachusetts General Hospital reported 13,982 Medicare inpatient stays across 298 DRGs in 2024. Across them it charged 3.88 times what it was paid — among the higher ratios in Massachusetts, number 4 of 52 hospitals with at least 100 stays (state median 2×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 640 stays at an average charge of $107,566, 19% above the national average. It also billed 15,898 outpatient services, charging 5.92 times what Medicare paid.

1Medicare inpatient stays 13,982
2Charge ÷ paid, inpatient 3.88×
3Rank in MA (highest ratio = 1) 4 of 52
4CMS price-transparency actions 2

Average charge per stay at Massachusetts General Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 298 DRGs that can be compared with the national average, Massachusetts General Hospital charged more than the national average in 183 (61%). 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	640	$107,566	+19%	$26,691
291 Heart Failure and Shock with MCC	466	$78,997	+40%	$18,760
177 Respiratory Infections and Inflammations with MCC	329	$89,121	+26%	$22,336
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	263	$337,937	-15%	$95,850
274 Percutaneous and Other Intracardiac Procedures without MCC	256	$98,766	-37%	$36,196
286 Circulatory Disorders except AMI, with Cardiac...	200	$152,627	+36%	$32,104
266 Endovascular Cardiac Valve Replacement and Supplement...	196	$245,368	-14%	$74,300
025 Craniotomy and Endovascular Intracranial Procedures with MCC	192	$169,716	-27%	$48,963
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	181	$108,296	+8%	$28,513
267 Endovascular Cardiac Valve Replacement and Supplement...	179	$169,160	-24%	$54,662
698 Other Kidney and Urinary Tract Diagnoses with MCC	163	$101,771	+39%	$24,709
193 Simple Pneumonia and Pleurisy with MCC	149	$70,792	+18%	$17,882
330 Major Small and Large Bowel Procedures with CC	147	$110,176	-7%	$29,434
853 Infectious and Parasitic Diseases with O.R. Procedures with...	143	$283,332	+24%	$70,713
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	131	$52,115	+30%	$11,778
481 Hip and Femur Procedures except Major Joint with CC	131	$118,023	+17%	$27,050
164 Major Chest Procedures with CC	127	$96,764	-24%	$30,723
699 Other Kidney and Urinary Tract Diagnoses with CC	126	$53,545	+13%	$14,181
287 Circulatory Disorders except AMI, with Cardiac...	119	$83,545	+31%	$16,405
321 Percutaneous Cardiovascular Procedures with Intraluminal...	110	$171,861	+5%	$38,710
329 Major Small and Large Bowel Procedures with MCC	108	$196,810	-8%	$58,827
309 Cardiac Arrhythmia and Conduction Disorders with CC	107	$38,144	+6%	$10,249
322 Percutaneous Cardiovascular Procedures with Intraluminal...	107	$109,221	-5%	$23,939
460 Spinal Fusion except Cervical without MCC	106	$133,105	-22%	$43,655
682 Renal Failure with MCC	106	$81,669	+24%	$20,159
280 Acute Myocardial Infarction, Discharged Alive with MCC	102	$120,476	+59%	$24,695
314 Other Circulatory System Diagnoses with MCC	99	$103,129	+9%	$28,131
057 Degenerative Nervous System Disorders without MCC	97	$70,561	+25%	$18,822
470 Major Hip and Knee Joint Replacement or Reattachment of...	97	$82,926	-11%	$24,357
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	95	$95,743	+59%	$20,170
312 Syncope and Collapse	93	$66,947	+47%	$13,590
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	92	$66,559	+9%	$17,038
683 Renal Failure with CC	92	$49,977	+23%	$12,861
689 Kidney and Urinary Tract Infections with MCC	92	$69,204	+35%	$16,215
178 Respiratory Infections and Inflammations with CC	91	$61,942	+37%	$14,128
194 Simple Pneumonia and Pleurisy with CC	89	$43,603	+14%	$12,361
235 Coronary Bypass without Cardiac Catheterization with MCC	89	$265,221	-9%	$71,369
377 Gastrointestinal Hemorrhage with MCC	89	$106,674	+25%	$24,509
394 Other Digestive System Diagnoses with CC	89	$56,155	+19%	$13,424
813 Coagulation Disorders	88	$93,192	+16%	$23,706
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	88	$58,567	+19%	$14,257
393 Other Digestive System Diagnoses with MCC	86	$89,463	+17%	$24,050
378 Gastrointestinal Hemorrhage with CC	79	$48,312	0%	$13,557
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	79	$255,017	+18%	$67,027
690 Kidney and Urinary Tract Infections without MCC	78	$42,477	+12%	$10,908
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	77	$62,540	+12%	$14,645
190 Chronic Obstructive Pulmonary Disease with MCC	74	$62,036	+23%	$15,094
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	72	$53,741	+45%	$12,157
652 Kidney Transplant	71	$294,194	-13%	$44,154
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	71	$54,922	-19%	$16,480
919 Complications of Treatment with MCC	67	$91,711	+4%	$25,518
435 Malignancy of Hepatobiliary System or Pancreas with MCC	65	$85,378	-10%	$24,805
519 Back and Neck Procedures except Spinal Fusion with CC	65	$94,343	-10%	$24,361
056 Degenerative Nervous System Disorders with MCC	64	$128,797	+34%	$34,908
243 Permanent Cardiac Pacemaker Implant with CC	64	$80,438	-28%	$27,507
252 Other Vascular Procedures with MCC	64	$209,493	+23%	$48,358
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	63	$1,201,916	+14%	$288,440
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	63	$118,743	0%	$29,081
406 Pancreas, Liver and Shunt Procedures with CC	62	$135,211	-16%	$34,288
516 Other Musculoskeletal System and Connective Tissue O.R....	62	$120,991	+19%	$27,380

Showing the 60 most frequent of 298 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	2,507	$19,776	$2,927
Level 2 Excision/ Biopsy/ Incision and Drainage	1,339	$8,054	$1,725
Level 2 Upper GI Procedures	846	$8,210	$2,028
Level 3 Electrophysiologic Procedures	760	$108,829	$25,280
Level 4 Musculoskeletal Procedures	650	$43,344	$7,608
Level 3 Excision/ Biopsy/ Incision and Drainage	638	$14,608	$3,004
Level 5 Musculoskeletal Procedures	624	$50,594	$14,010
Level 1 Endovascular Procedures	502	$30,021	$3,476
Level 1 Laparoscopy and Related Services	473	$35,831	$6,134
Level 4 Urology and Related Services	465	$20,085	$3,712
Level 5 Urology and Related Services	450	$29,561	$5,508
Level 3 Urology and Related Services	441	$13,717	$2,154
Level 3 Musculoskeletal Procedures	406	$27,092	$3,430
Level 3 Vascular Procedures	399	$19,703	$3,383
Level 3 Endovascular Procedures	377	$77,593	$11,745
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	357	$22,664	$3,691
Level 4 Vascular Procedures	337	$19,124	$3,373
Level 2 Laparoscopy and Related Services	334	$59,535	$10,874
Level 1 Breast/Lymphatic Surgery and Related Procedures	333	$26,766	$4,074
Level 1 Nerve Procedures	309	$15,318	$2,068
Level 2 Endovascular Procedures	297	$36,045	$6,090
Level 2 Musculoskeletal Procedures	274	$12,237	$1,648
Level 4 Airway Endoscopy	271	$27,018	$3,975
Level 2 Breast/Lymphatic Surgery and Related Procedures	209	$44,959	$6,977
Complex GI Procedures	195	$20,916	$5,719

Against the Massachusetts average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Massachusetts General Hospital charged $107,566 on average, 138% more than the Massachusetts average of $45,229, and was paid $26,691 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), Massachusetts General Hospital charged $78,997 on average, 160% more than the Massachusetts average of $30,373, and was paid $18,760 against a state average of $12,996. For Respiratory Infections and Inflammations with MCC (DRG 177), Massachusetts General Hospital charged $89,121 on average, 140% more than the Massachusetts average of $37,072, and was paid $22,336 against a state average of $15,861. For Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization (DRG 219), Massachusetts General Hospital charged $337,937 on average, 21% more than the Massachusetts average of $278,140, and was paid $95,850 against a state average of $92,762. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,776 was 41% above the state average of $14,010. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,054 was 22% above the state average of $6,596. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $8,210 was 1% below the state average of $8,334. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $108,829 was 1% above the state average of $108,274.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Massachusetts General Hospital in Boston, MA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2024-01-30 (CMS case 1877)
Met Requirements — 2025-03-13 (CMS case 3266)

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.