Mercy Health System Corp: charges and Medicare payments

Mercy Health System Corp reported 872 Medicare inpatient stays across 35 DRGs in 2024. Across them it charged 5.09 times what it was paid — among the higher ratios in Wisconsin, number 1 of 55 hospitals with at least 100 stays (state median 3.47×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 81 stays at an average charge of $83,890, 7% below the national average. It also billed 2,173 outpatient services, charging 7.93 times what Medicare paid.

1Medicare inpatient stays 872
2Charge ÷ paid, inpatient 5.09×
3Rank in WI (highest ratio = 1) 1 of 55
4CMS price-transparency actions 0

Average charge per stay at Mercy Health System Corp, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 35 DRGs that can be compared with the national average, Mercy Health System Corp charged more than the national average in 12 (34%). 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	81	$83,890	-7%	$15,980
291 Heart Failure and Shock with MCC	77	$48,496	-14%	$10,359
189 Pulmonary Edema and Respiratory Failure	60	$50,313	-13%	$10,360
274 Percutaneous and Other Intracardiac Procedures without MCC	53	$125,479	-20%	$26,939
885 Psychoses	39	$28,246	-36%	$10,943
193 Simple Pneumonia and Pleurisy with MCC	33	$66,593	+11%	$13,609
177 Respiratory Infections and Inflammations with MCC	32	$54,204	-23%	$13,484
690 Kidney and Urinary Tract Infections without MCC	28	$45,161	+19%	$7,033
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	28	$52,829	+8%	$8,033
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	26	$39,180	-2%	$6,406
378 Gastrointestinal Hemorrhage with CC	25	$37,697	-22%	$8,265
552 Medical Back Problems without MCC	24	$44,915	-8%	$8,619
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	24	$36,399	-2%	$6,919
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	23	$63,220	+13%	$9,229
322 Percutaneous Cardiovascular Procedures with Intraluminal...	23	$128,338	+12%	$19,351
267 Endovascular Cardiac Valve Replacement and Supplement...	22	$179,379	-19%	$35,594
603 Cellulitis without MCC	22	$36,291	-3%	$7,150
190 Chronic Obstructive Pulmonary Disease with MCC	21	$38,680	-24%	$8,522
321 Percutaneous Cardiovascular Procedures with Intraluminal...	19	$157,280	-4%	$27,425
689 Kidney and Urinary Tract Infections with MCC	17	$59,811	+17%	$9,137
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	16	$49,643	-18%	$12,015
314 Other Circulatory System Diagnoses with MCC	15	$125,492	+32%	$19,687
481 Hip and Femur Procedures except Major Joint with CC	15	$82,589	-18%	$15,753
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	15	$26,619	-28%	$6,925
194 Simple Pneumonia and Pleurisy with CC	13	$34,840	-9%	$6,623
309 Cardiac Arrhythmia and Conduction Disorders with CC	13	$35,465	-2%	$6,019
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	13	$21,891	-24%	$7,631
377 Gastrointestinal Hemorrhage with MCC	13	$89,533	+5%	$13,623
308 Cardiac Arrhythmia and Conduction Disorders with MCC	12	$44,528	-21%	$9,517
312 Syncope and Collapse	12	$34,416	-24%	$6,856
330 Major Small and Large Bowel Procedures with CC	12	$120,982	+2%	$20,996
683 Renal Failure with CC	12	$48,782	+20%	$8,417
853 Infectious and Parasitic Diseases with O.R. Procedures with...	12	$233,412	+2%	$42,194
178 Respiratory Infections and Inflammations with CC	11	$56,243	+24%	$8,001
208 Respiratory System Diagnosis with Ventilator Support <=96...	11	$110,523	-19%	$30,920

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Intraocular Procedures	494	$14,588	$2,106
Comprehensive Observation Services	269	$24,526	$2,447
Level 2 Upper GI Procedures	173	$9,676	$1,716
Level 2 Excision/ Biopsy/ Incision and Drainage	157	$8,181	$1,445
Level 2 Urology and Related Services	99	$1,957	$613
Level 1 Endovascular Procedures	95	$30,946	$2,951
Level 3 Musculoskeletal Procedures	83	$15,723	$2,786
Level 3 Urology and Related Services	82	$4,347	$1,840
Level 3 Vascular Procedures	64	$21,575	$2,881
Level 2 Musculoskeletal Procedures	63	$5,661	$1,456
Level 3 Electrophysiologic Procedures	62	$133,175	$21,581
Level 3 Excision/ Biopsy/ Incision and Drainage	50	$13,638	$2,547
Level 5 Musculoskeletal Procedures	47	$81,624	$11,534
Level 1 Nerve Procedures	47	$7,923	$1,759
Level 4 Musculoskeletal Procedures	37	$38,561	$6,517
Level 5 Urology and Related Services	34	$27,580	$4,714
Level 1 Laparoscopy and Related Services	32	$40,271	$5,256
Level 3 Airway Endoscopy	30	$4,453	$1,505
Level 2 Intraocular Procedures	29	$19,185	$3,704
Level 2 Vascular Procedures	27	$5,488	$1,416
Level 2 Pacemaker and Similar Procedures	23	$32,224	$7,740
Level 4 Urology and Related Services	22	$31,511	$3,176
Level 3 Pacemaker and Similar Procedures	20	$61,330	$9,721
Level 4 Airway Endoscopy	18	$21,453	$3,317
Level 3 Endovascular Procedures	18	$92,173	$10,014

Against the Wisconsin average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mercy Health System Corp charged $83,890 on average, 41% more than the Wisconsin average of $59,481, and was paid $15,980 against a state average of $16,719. For Heart Failure and Shock with MCC (DRG 291), Mercy Health System Corp charged $48,496 on average, 23% more than the Wisconsin average of $39,564, and was paid $10,359 against a state average of $10,862. For Pulmonary Edema and Respiratory Failure (DRG 189), Mercy Health System Corp charged $50,313 on average, 24% more than the Wisconsin average of $40,535, and was paid $10,360 against a state average of $10,823. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Mercy Health System Corp charged $125,479 on average, 17% more than the Wisconsin average of $107,338, and was paid $26,939 against a state average of $25,143. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $14,588 was 27% above the state average of $11,485. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,526 was 38% above the state average of $17,717. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $9,676 was 17% below the state average of $11,645. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,181 was 8% below the state average of $8,908.

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.