South Dakota / Monument Health Spearfish Hospital
CMS certification 430048 · Spearfish, SD · 2 entries in CMS's price-transparency list
Monument Health Spearfish Hospital: charges and Medicare payments
Monument Health Spearfish Hospital reported 98 Medicare inpatient stays across 6 DRGs in 2024. Across them it charged 2.44 times what it was paid. Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 35 stays at an average charge of $40,916, 55% below the national average. It also billed 934 outpatient services, charging 5.22 times what Medicare paid.
- 1Medicare inpatient stays 98
- 2Charge ÷ paid, inpatient 2.44×
- 3Rank in SD (highest ratio = 1) –
- 4CMS price-transparency actions 2
Inpatient stays
For the 6 DRGs that can be compared with the national average, Monument Health Spearfish Hospital charged more than the national average in 0 (0%). 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 | 35 | $40,916 | -55% | $20,847 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $37,072 | -36% | $13,070 |
| 193 Simple Pneumonia and Pleurisy with MCC | 13 | $29,405 | -51% | $13,674 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $19,887 | -46% | $8,069 |
| 291 Heart Failure and Shock with MCC | 12 | $40,454 | -28% | $12,740 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 11 | $71,796 | -30% | $21,749 |
Outpatient services
Against the South Dakota average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Monument Health Spearfish Hospital charged $40,916 on average, 39% less than the South Dakota average of $67,007, and was paid $20,847 against a state average of $17,025. For Pulmonary Edema and Respiratory Failure (DRG 189), Monument Health Spearfish Hospital charged $37,072 on average, 22% less than the South Dakota average of $47,652, and was paid $13,070 against a state average of $11,675. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Monument Health Spearfish Hospital charged $29,405 on average, 29% less than the South Dakota average of $41,232, and was paid $13,674 against a state average of $11,334. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC (DRG 641), Monument Health Spearfish Hospital charged $19,887 on average, 31% less than the South Dakota average of $28,666, and was paid $8,069 against a state average of $7,151. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $60,504 was 25% above the state average of $48,584. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $25,895 was 8% below the state average of $28,222. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,342 was 24% below the state average of $8,333. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,162 was 23% below the state average of $18,366.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Monument Health Spearfish Hospital in Spearfish, SD, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2026-03-06 (CMS case 7179)
- CAP Request — 2026-06-17 (CMS case 7179)
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.