Connecticut / Middlesex Hospital
CMS certification 070020 · Middletown, CT
Middlesex Hospital: charges and Medicare payments
Middlesex Hospital reported 1,923 Medicare inpatient stays across 49 DRGs in 2024. Across them it charged 3.74 times what it was paid — among the higher ratios in Connecticut, number 5 of 25 hospitals with at least 100 stays (state median 3.43×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 300 stays at an average charge of $61,570, 32% below the national average. It also billed 1,798 outpatient services, charging 5.39 times what Medicare paid.
- 1Medicare inpatient stays 1,923
- 2Charge ÷ paid, inpatient 3.74×
- 3Rank in CT (highest ratio = 1) 5 of 25
- 4CMS price-transparency actions 0
Inpatient stays
For the 49 DRGs that can be compared with the national average, Middlesex Hospital charged more than the national average in 3 (6%). 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 | 300 | $61,570 | -32% | $18,083 |
| 291 Heart Failure and Shock with MCC | 152 | $45,334 | -20% | $11,788 |
| 689 Kidney and Urinary Tract Infections with MCC | 82 | $38,445 | -25% | $10,472 |
| 690 Kidney and Urinary Tract Infections without MCC | 71 | $34,663 | -8% | $7,698 |
| 177 Respiratory Infections and Inflammations with MCC | 69 | $50,128 | -29% | $15,168 |
| 603 Cellulitis without MCC | 69 | $27,823 | -25% | $8,633 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 65 | $36,304 | -10% | $7,930 |
| 193 Simple Pneumonia and Pleurisy with MCC | 61 | $41,533 | -30% | $13,018 |
| 378 Gastrointestinal Hemorrhage with CC | 59 | $41,275 | -15% | $9,019 |
| 481 Hip and Femur Procedures except Major Joint with CC | 55 | $66,425 | -34% | $18,866 |
| 194 Simple Pneumonia and Pleurisy with CC | 54 | $33,007 | -14% | $8,587 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 51 | $35,450 | -28% | $10,438 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 46 | $41,093 | -19% | $10,323 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 45 | $41,918 | -43% | $15,939 |
| 312 Syncope and Collapse | 41 | $38,825 | -15% | $9,166 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 36 | $60,231 | -35% | $17,543 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 33 | $54,031 | -3% | $9,455 |
| 189 Pulmonary Edema and Respiratory Failure | 31 | $52,170 | -9% | $11,832 |
| 178 Respiratory Infections and Inflammations with CC | 27 | $35,805 | -21% | $9,288 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 27 | $27,548 | -26% | $7,794 |
| 682 Renal Failure with MCC | 27 | $71,270 | +8% | $16,210 |
| 330 Major Small and Large Bowel Procedures with CC | 26 | $92,361 | -22% | $21,331 |
| 683 Renal Failure with CC | 26 | $33,331 | -18% | $8,574 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $54,339 | -4% | $11,950 |
| 377 Gastrointestinal Hemorrhage with MCC | 24 | $64,609 | -24% | $16,848 |
| 389 Gastrointestinal Obstruction with CC | 23 | $34,452 | -11% | $7,372 |
| 638 Diabetes with CC | 23 | $32,263 | -23% | $8,443 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $45,796 | -24% | $12,075 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 22 | $31,454 | -21% | $8,229 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 22 | $34,164 | -5% | $8,616 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 21 | $80,703 | -21% | $19,830 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 21 | $30,245 | -36% | $9,819 |
| 329 Major Small and Large Bowel Procedures with MCC | 20 | $152,138 | -29% | $36,951 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 19 | $175,058 | -24% | $44,398 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 19 | $33,657 | -9% | $8,899 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 18 | $64,298 | +5% | $13,067 |
| 394 Other Digestive System Diagnoses with CC | 18 | $39,287 | -17% | $9,167 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 18 | $207,928 | -36% | $66,886 |
| 101 Seizures without MCC | 17 | $42,109 | -14% | $8,761 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 17 | $43,493 | -8% | $9,247 |
| 602 Cellulitis with MCC | 16 | $50,139 | -17% | $13,863 |
| 885 Psychoses | 16 | $48,570 | +10% | $14,021 |
| 812 Red Blood Cell Disorders without MCC | 15 | $36,836 | -17% | $10,055 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 14 | $82,865 | -40% | $25,268 |
| 069 Transient Ischemia without Thrombolytic | 13 | $39,222 | -22% | $7,787 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 12 | $98,673 | -1% | $18,844 |
| 552 Medical Back Problems without MCC | 12 | $35,922 | -26% | $8,861 |
| 390 Gastrointestinal Obstruction without CC/MCC | 11 | $28,018 | 0% | $5,670 |
| 482 Hip and Femur Procedures except Major Joint without CC/MCC | 11 | $51,574 | -34% | $14,896 |
Outpatient services
Against the Connecticut average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Middlesex Hospital charged $61,570 on average, 11% less than the Connecticut average of $69,366, and was paid $18,083 against a state average of $20,799. For Heart Failure and Shock with MCC (DRG 291), Middlesex Hospital charged $45,334 on average, 12% less than the Connecticut average of $51,456, and was paid $11,788 against a state average of $13,920. For Kidney and Urinary Tract Infections with MCC (DRG 689), Middlesex Hospital charged $38,445 on average, 11% less than the Connecticut average of $43,033, and was paid $10,472 against a state average of $12,589. For Kidney and Urinary Tract Infections without MCC (DRG 690), Middlesex Hospital charged $34,663 on average, 11% more than the Connecticut average of $31,345, and was paid $7,698 against a state average of $8,927. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $18,386 was 22% below the state average of $23,465. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,125 was 21% below the state average of $10,228. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $8,976 was 23% below the state average of $11,665. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $25,679 was 17% below the state average of $30,904.
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.