Texas / Medical City Plano
CMS certification 450651 · Plano, TX · 2 entries in CMS's price-transparency list
Medical City Plano: charges and Medicare payments
Medical City Plano reported 5,131 Medicare inpatient stays across 165 DRGs in 2024. Across them it charged 13.92 times what it was paid — among the higher ratios in Texas, number 2 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: 419 stays at an average charge of $168,430, 87% above the national average. It also billed 1,655 outpatient services, charging 23.27 times what Medicare paid.
- 1Medicare inpatient stays 5,131
- 2Charge ÷ paid, inpatient 13.92×
- 3Rank in TX (highest ratio = 1) 2 of 190
- 4CMS price-transparency actions 2
Inpatient stays
For the 165 DRGs that can be compared with the national average, Medical City Plano charged more than the national average in 165 (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 | 419 | $168,430 | +87% | $14,790 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 147 | $175,062 | +75% | $15,027 |
| 291 Heart Failure and Shock with MCC | 124 | $116,862 | +107% | $10,052 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 111 | $1,035,135 | +270% | $73,104 |
| 467 Revision of Hip or Knee Replacement with CC | 109 | $885,464 | +461% | $48,145 |
| 193 Simple Pneumonia and Pleurisy with MCC | 96 | $106,392 | +78% | $11,935 |
| 552 Medical Back Problems without MCC | 91 | $85,522 | +75% | $7,743 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 82 | $570,532 | +149% | $36,022 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 79 | $65,114 | +62% | $7,010 |
| 177 Respiratory Infections and Inflammations with MCC | 77 | $106,907 | +51% | $12,501 |
| 682 Renal Failure with MCC | 76 | $117,718 | +79% | $11,720 |
| 377 Gastrointestinal Hemorrhage with MCC | 67 | $176,402 | +107% | $14,687 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 67 | $341,612 | +267% | $16,916 |
| 689 Kidney and Urinary Tract Infections with MCC | 67 | $90,112 | +76% | $9,211 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 60 | $173,307 | +136% | $12,449 |
| 472 Cervical Spinal Fusion with CC | 59 | $392,939 | +175% | $25,998 |
| 460 Spinal Fusion except Cervical without MCC | 58 | $573,462 | +237% | $31,184 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 58 | $600,082 | +384% | $39,358 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 57 | $103,562 | +86% | $9,967 |
| 481 Hip and Femur Procedures except Major Joint with CC | 56 | $239,120 | +137% | $15,431 |
| 690 Kidney and Urinary Tract Infections without MCC | 56 | $64,389 | +70% | $7,067 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 55 | $111,279 | +127% | $8,831 |
| 189 Pulmonary Edema and Respiratory Failure | 53 | $85,161 | +48% | $9,741 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 53 | $587,901 | +275% | $24,783 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 53 | $685,046 | +237% | $45,318 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 51 | $602,527 | +160% | $36,638 |
| 069 Transient Ischemia without Thrombolytic | 50 | $96,979 | +92% | $6,922 |
| 378 Gastrointestinal Hemorrhage with CC | 48 | $109,287 | +125% | $9,048 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 46 | $92,551 | +54% | $10,182 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 45 | $123,044 | +80% | $11,283 |
| 683 Renal Failure with CC | 45 | $79,303 | +95% | $7,704 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 44 | $230,499 | +70% | $20,051 |
| 312 Syncope and Collapse | 44 | $91,036 | +100% | $7,479 |
| 464 Wound Debridement and Skin Graft except Hand for... | 42 | $645,432 | +344% | $35,766 |
| 551 Medical Back Problems with MCC | 42 | $135,786 | +73% | $12,202 |
| 252 Other Vascular Procedures with MCC | 40 | $363,972 | +113% | $24,483 |
| 085 Traumatic Stupor and Coma <1 Hour with MCC | 39 | $179,770 | +66% | $15,827 |
| 091 Other Disorders of Nervous System with MCC | 39 | $134,099 | +62% | $12,776 |
| 884 Organic Disturbances and Intellectual Disability | 39 | $79,098 | +27% | $12,438 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 37 | $152,650 | +101% | $13,045 |
| 082 Traumatic Stupor and Coma >1 Hour with MCC | 36 | $219,668 | +91% | $18,836 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 36 | $283,039 | +177% | $16,524 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 34 | $685,120 | +144% | $38,942 |
| 811 Red Blood Cell Disorders with MCC | 33 | $113,589 | +67% | $13,131 |
| 466 Revision of Hip or Knee Replacement with MCC | 32 | $921,876 | +283% | $51,645 |
| 389 Gastrointestinal Obstruction with CC | 31 | $63,188 | +62% | $8,678 |
| 521 Hip Replacement with Principal Diagnosis of Hip Fracture... | 31 | $399,978 | +196% | $19,987 |
| 402 Single Level Combined Anterior and Posterior Spinal Fusion... | 30 | $686,365 | +265% | $37,478 |
| 457 Spinal Fusion except Cervical with Spinal Curvature,... | 29 | $813,597 | +181% | $52,022 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 29 | $365,636 | +164% | $22,791 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 29 | $290,028 | +144% | $23,631 |
| 329 Major Small and Large Bowel Procedures with MCC | 28 | $382,600 | +78% | $31,819 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 27 | $144,775 | +98% | $14,790 |
| 163 Major Chest Procedures with MCC | 27 | $432,132 | +105% | $32,402 |
| 394 Other Digestive System Diagnoses with CC | 27 | $101,494 | +116% | $7,752 |
| 305 Hypertension without MCC | 26 | $70,341 | +75% | $6,616 |
| 393 Other Digestive System Diagnoses with MCC | 26 | $113,508 | +48% | $12,578 |
| 427 Multiple Level Combined Anterior and Posterior Spinal Fusion... | 26 | $1,222,347 | +258% | $100,036 |
| 463 Wound Debridement and Skin Graft except Hand for... | 26 | $965,649 | +306% | $60,713 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $327,470 | +478% | $12,618 |
Showing the 60 most frequent of 165 DRGs.
Outpatient services
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Medical City Plano charged $168,430 on average, 52% more than the Texas average of $111,133, and was paid $14,790 against a state average of $16,694. For Intracranial Hemorrhage or Cerebral Infarction with MCC (DRG 064), Medical City Plano charged $175,062 on average, 44% more than the Texas average of $121,565, and was paid $15,027 against a state average of $16,871. For Heart Failure and Shock with MCC (DRG 291), Medical City Plano charged $116,862 on average, 72% more than the Texas average of $67,944, and was paid $10,052 against a state average of $11,820. For Combined Anterior and Posterior Spinal Fusion with CC (DRG 454), Medical City Plano charged $1,035,135 on average, 132% more than the Texas average of $446,825, and was paid $73,104 against a state average of $54,675. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $255,934 was 159% above the state average of $98,771. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $42,496 was 52% above the state average of $27,955. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $19,974 was 42% above the state average of $14,089. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $31,793 was 96% above the state average of $16,236.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Medical City Plano in Plano, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-20 (CMS case 1902)
- Met Requirements — 2025-05-07 (CMS case 4367)
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.