Mississippi / Merit Health Biloxi
CMS certification 250007 · Biloxi, MS · 3 entries in CMS's price-transparency list
Merit Health Biloxi: charges and Medicare payments
Merit Health Biloxi reported 161 Medicare inpatient stays across 8 DRGs in 2024. Across them it charged 10.44 times what it was paid — among the higher ratios in Mississippi, number 4 of 37 hospitals with at least 100 stays (state median 3.49×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 52 stays at an average charge of $142,192, 57% above the national average. It also billed 218 outpatient services, charging 26.99 times what Medicare paid.
- 1Medicare inpatient stays 161
- 2Charge ÷ paid, inpatient 10.44×
- 3Rank in MS (highest ratio = 1) 4 of 37
- 4CMS price-transparency actions 3
Inpatient stays
For the 8 DRGs that can be compared with the national average, Merit Health Biloxi charged more than the national average in 8 (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 | 52 | $142,192 | +57% | $14,035 |
| 291 Heart Failure and Shock with MCC | 25 | $122,774 | +118% | $10,417 |
| 193 Simple Pneumonia and Pleurisy with MCC | 19 | $111,248 | +86% | $10,245 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 15 | $108,308 | +43% | $10,761 |
| 689 Kidney and Urinary Tract Infections with MCC | 14 | $111,002 | +116% | $9,678 |
| 177 Respiratory Infections and Inflammations with MCC | 13 | $142,881 | +102% | $13,147 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $50,957 | +38% | $7,199 |
| 603 Cellulitis without MCC | 11 | $76,962 | +106% | $7,919 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Intraocular Procedures | 73 | $77,499 | $3,320 |
| Comprehensive Observation Services | 40 | $53,372 | $2,235 |
| Level 4 Musculoskeletal Procedures | 23 | $112,582 | $5,842 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 21 | $14,833 | $1,283 |
| Level 5 Musculoskeletal Procedures | 13 | $169,282 | $10,229 |
| Level 1 Laparoscopy and Related Services | 13 | $122,365 | $4,712 |
| Level 1 Endovascular Procedures | 12 | $81,043 | $2,665 |
| Level 2 Upper GI Procedures | 12 | $48,396 | $1,554 |
| Level 3 Intraocular Procedures | 11 | $82,771 | $4,268 |
Against the Mississippi average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Merit Health Biloxi charged $142,192 on average, 121% more than the Mississippi average of $64,437, and was paid $14,035 against a state average of $14,187. For Heart Failure and Shock with MCC (DRG 291), Merit Health Biloxi charged $122,774 on average, 181% more than the Mississippi average of $43,650, and was paid $10,417 against a state average of $9,475. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Merit Health Biloxi charged $111,248 on average, 133% more than the Mississippi average of $47,785, and was paid $10,245 against a state average of $9,796. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Merit Health Biloxi charged $108,308 on average, 104% more than the Mississippi average of $53,089, and was paid $10,761 against a state average of $11,307. For Level 2 Intraocular Procedures (outpatient APC 5492), its average charge of $77,499 was 154% above the state average of $30,472. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $53,372 was 232% above the state average of $16,069. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $112,582 was 182% above the state average of $39,926. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $14,833 was 56% above the state average of $9,506.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Merit Health Biloxi in Biloxi, MS, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- CAP Request — 2025-04-04 (CMS case 3535)
- CAP Request — 2025-07-17 (CMS case 3535)
- Closure Notice — 2025-08-05 (CMS case 3535)
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.