Texas / Medical City Decatur
CMS certification 450271 · Decatur, TX · 1 entry in CMS's price-transparency list
Medical City Decatur: charges and Medicare payments
Medical City Decatur reported 182 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 11.05 times what it was paid — among the higher ratios in Texas, number 26 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 53 stays at an average charge of $141,433, 57% above the national average. It also billed 234 outpatient services, charging 21.98 times what Medicare paid.
- 1Medicare inpatient stays 182
- 2Charge ÷ paid, inpatient 11.05×
- 3Rank in TX (highest ratio = 1) 26 of 190
- 4CMS price-transparency actions 1
Inpatient stays
For the 7 DRGs that can be compared with the national average, Medical City Decatur charged more than the national average in 7 (100%). 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 | 53 | $141,433 | +57% | $14,319 |
| 291 Heart Failure and Shock with MCC | 39 | $95,144 | +69% | $7,999 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $102,041 | +71% | $8,819 |
| 189 Pulmonary Edema and Respiratory Failure | 19 | $102,373 | +78% | $8,595 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $118,853 | +68% | $10,150 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 16 | $77,192 | +114% | $4,832 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $74,973 | +46% | $7,599 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 75 | $51,031 | $2,445 |
| Level 1 Endovascular Procedures | 33 | $60,320 | $2,883 |
| Level 3 Vascular Procedures | 23 | $32,733 | $2,878 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 19 | $19,807 | $1,464 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 19 | $38,278 | $2,566 |
| Level 3 Musculoskeletal Procedures | 15 | $37,804 | $2,922 |
| Level 2 Upper GI Procedures | 14 | $25,822 | $1,718 |
| Level 1 Laparoscopy and Related Services | 14 | $79,451 | $4,913 |
| Level 3 Endovascular Procedures | 11 | $183,703 | $9,924 |
| Level 4 Urology and Related Services | 11 | $33,012 | $2,919 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Medical City Decatur charged $141,433 on average, 27% more than the Texas average of $111,133, and was paid $14,319 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), Medical City Decatur charged $95,144 on average, 40% more than the Texas average of $67,944, and was paid $7,999 against a state average of $11,820. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Medical City Decatur charged $102,041 on average, 38% more than the Texas average of $73,756, and was paid $8,819 against a state average of $11,597. For Pulmonary Edema and Respiratory Failure (DRG 189), Medical City Decatur charged $102,373 on average, 55% more than the Texas average of $65,957, and was paid $8,595 against a state average of $11,822. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $51,031 was 83% above the state average of $27,955. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $60,320 was 67% above the state average of $36,220. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $32,733 was 16% above the state average of $28,214. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $19,807 was 41% above the state average of $14,089.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Medical City Decatur in Decatur, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-05-01 (CMS case 4235)
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.