Massachusetts / Metrowest Medical Center
CMS certification 220175 · Framingham, MA
Metrowest Medical Center: charges and Medicare payments
Metrowest Medical Center reported 1,343 Medicare inpatient stays across 42 DRGs in 2024. Across them it charged 4.88 times what it was paid — among the higher ratios in Massachusetts, number 1 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: 316 stays at an average charge of $83,991, 7% below the national average. It also billed 1,023 outpatient services, charging 10.82 times what Medicare paid.
- 1Medicare inpatient stays 1,343
- 2Charge ÷ paid, inpatient 4.88×
- 3Rank in MA (highest ratio = 1) 1 of 52
- 4CMS price-transparency actions 0
Inpatient stays
For the 42 DRGs that can be compared with the national average, Metrowest Medical Center charged more than the national average in 28 (67%). 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 | 316 | $83,991 | -7% | $18,634 |
| 291 Heart Failure and Shock with MCC | 112 | $61,323 | +9% | $12,331 |
| 177 Respiratory Infections and Inflammations with MCC | 74 | $73,738 | +4% | $15,658 |
| 193 Simple Pneumonia and Pleurisy with MCC | 62 | $57,063 | -5% | $12,781 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 51 | $74,918 | +2% | $15,950 |
| 189 Pulmonary Edema and Respiratory Failure | 40 | $51,158 | -11% | $12,205 |
| 312 Syncope and Collapse | 40 | $61,189 | +34% | $8,872 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 39 | $80,583 | +6% | $15,515 |
| 689 Kidney and Urinary Tract Infections with MCC | 32 | $53,300 | +4% | $11,126 |
| 683 Renal Failure with CC | 30 | $55,212 | +36% | $9,292 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $75,867 | +26% | $12,407 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 27 | $45,532 | +26% | $7,616 |
| 690 Kidney and Urinary Tract Infections without MCC | 26 | $47,027 | +24% | $8,049 |
| 682 Renal Failure with MCC | 25 | $61,159 | -7% | $13,580 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 25 | $55,355 | +13% | $10,098 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 24 | $68,830 | +24% | $9,951 |
| 377 Gastrointestinal Hemorrhage with MCC | 24 | $84,400 | -1% | $15,859 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $63,339 | +58% | $8,066 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $52,188 | -14% | $12,820 |
| 552 Medical Back Problems without MCC | 19 | $49,772 | +2% | $9,638 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $44,523 | +20% | $8,022 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 19 | $143,748 | -37% | $44,637 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 18 | $121,514 | +6% | $19,518 |
| 811 Red Blood Cell Disorders with MCC | 17 | $69,595 | +2% | $14,302 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 15 | $82,850 | -17% | $19,257 |
| 069 Transient Ischemia without Thrombolytic | 14 | $61,789 | +22% | $10,051 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $56,933 | +1% | $12,002 |
| 314 Other Circulatory System Diagnoses with MCC | 14 | $67,690 | -29% | $17,789 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 14 | $51,798 | +9% | $9,517 |
| 812 Red Blood Cell Disorders without MCC | 14 | $58,518 | +32% | $9,514 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 13 | $93,223 | +43% | $13,289 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 13 | $45,380 | -10% | $8,738 |
| 481 Hip and Femur Procedures except Major Joint with CC | 13 | $115,428 | +15% | $20,167 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 13 | $50,543 | +19% | $8,886 |
| 603 Cellulitis without MCC | 13 | $35,829 | -4% | $8,575 |
| 884 Organic Disturbances and Intellectual Disability | 13 | $57,873 | -7% | $15,509 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 13 | $98,305 | +31% | $15,557 |
| 315 Other Circulatory System Diagnoses with CC | 12 | $53,800 | +12% | $9,421 |
| 091 Other Disorders of Nervous System with MCC | 11 | $63,881 | -23% | $16,641 |
| 100 Seizures with MCC | 11 | $88,389 | -6% | $18,336 |
| 101 Seizures without MCC | 11 | $53,078 | +9% | $9,468 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 11 | $170,551 | +4% | $29,636 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 294 | $32,897 | $2,940 |
| Level 1 Intraocular Procedures | 130 | $22,597 | $2,489 |
| Level 2 Upper GI Procedures | 122 | $17,602 | $2,044 |
| Level 1 Endovascular Procedures | 100 | $24,419 | $3,480 |
| Level 4 Urology and Related Services | 62 | $43,068 | $3,744 |
| Level 5 Urology and Related Services | 62 | $44,431 | $5,426 |
| Level 1 Laparoscopy and Related Services | 43 | $60,266 | $6,197 |
| Level 3 Endovascular Procedures | 38 | $92,090 | $11,800 |
| Level 3 Pacemaker and Similar Procedures | 38 | $91,028 | $11,454 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 34 | $15,465 | $1,741 |
| Level 3 Electrophysiologic Procedures | 22 | $187,473 | $25,436 |
| Level 3 Urology and Related Services | 22 | $25,747 | $2,108 |
| Level 4 Musculoskeletal Procedures | 16 | $67,831 | $7,683 |
| Level 2 Endovascular Procedures | 15 | $31,185 | $6,138 |
| Level 3 Upper GI Procedures | 14 | $21,027 | $4,113 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 11 | $43,361 | $3,716 |
Against the Massachusetts average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Metrowest Medical Center charged $83,991 on average, 86% more than the Massachusetts average of $45,229, and was paid $18,634 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), Metrowest Medical Center charged $61,323 on average, 102% more than the Massachusetts average of $30,373, and was paid $12,331 against a state average of $12,996. For Respiratory Infections and Inflammations with MCC (DRG 177), Metrowest Medical Center charged $73,738 on average, 99% more than the Massachusetts average of $37,072, and was paid $15,658 against a state average of $15,861. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Metrowest Medical Center charged $57,063 on average, 103% more than the Massachusetts average of $28,077, and was paid $12,781 against a state average of $12,627. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $32,897 was 135% above the state average of $14,010. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $22,597 was 215% above the state average of $7,172. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $17,602 was 111% above the state average of $8,334. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $24,419 was 25% above the state average of $19,611.
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.