Texas / Nacogdoches Medical Center
CMS certification 450656 · Nacogdoches, TX · 3 entries in CMS's price-transparency list
Nacogdoches Medical Center: charges and Medicare payments
Nacogdoches Medical Center reported 742 Medicare inpatient stays across 29 DRGs in 2024. Across them it charged 12.55 times what it was paid — among the higher ratios in Texas, number 10 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 158 stays at an average charge of $168,345, 86% above the national average. It also billed 316 outpatient services, charging 19.03 times what Medicare paid.
- 1Medicare inpatient stays 742
- 2Charge ÷ paid, inpatient 12.55×
- 3Rank in TX (highest ratio = 1) 10 of 190
- 4CMS price-transparency actions 3
Inpatient stays
For the 29 DRGs that can be compared with the national average, Nacogdoches Medical Center charged more than the national average in 29 (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 | 158 | $168,345 | +86% | $13,081 |
| 177 Respiratory Infections and Inflammations with MCC | 49 | $132,433 | +88% | $11,445 |
| 193 Simple Pneumonia and Pleurisy with MCC | 41 | $118,785 | +99% | $9,190 |
| 291 Heart Failure and Shock with MCC | 39 | $100,112 | +78% | $8,754 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 37 | $102,975 | +110% | $7,524 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 32 | $389,590 | +70% | $31,816 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 29 | $168,043 | +80% | $13,887 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 27 | $118,857 | +57% | $10,686 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $98,158 | +91% | $8,135 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 20 | $148,892 | +49% | $13,141 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 20 | $97,791 | +75% | $7,234 |
| 603 Cellulitis without MCC | 20 | $84,342 | +126% | $6,504 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 20 | $99,068 | +64% | $9,077 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 20 | $72,857 | +97% | $5,758 |
| 690 Kidney and Urinary Tract Infections without MCC | 20 | $79,562 | +110% | $5,939 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $99,689 | +160% | $5,959 |
| 481 Hip and Femur Procedures except Major Joint with CC | 17 | $232,469 | +131% | $14,489 |
| 378 Gastrointestinal Hemorrhage with CC | 16 | $75,051 | +55% | $6,946 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $71,449 | +78% | $5,815 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 14 | $103,639 | +105% | $6,484 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 14 | $147,786 | +101% | $10,940 |
| 377 Gastrointestinal Hemorrhage with MCC | 13 | $160,115 | +88% | $12,026 |
| 683 Renal Failure with CC | 13 | $84,666 | +108% | $6,543 |
| 812 Red Blood Cell Disorders without MCC | 13 | $74,868 | +69% | $6,569 |
| 552 Medical Back Problems without MCC | 12 | $70,811 | +45% | $6,852 |
| 682 Renal Failure with MCC | 12 | $94,271 | +43% | $10,490 |
| 312 Syncope and Collapse | 11 | $83,503 | +83% | $6,319 |
| 327 Stomach, Esophageal and Duodenal Procedures with CC | 11 | $163,620 | +29% | $14,774 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 11 | $214,152 | +109% | $14,366 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 80 | $44,781 | $2,328 |
| Level 5 Musculoskeletal Procedures | 59 | $155,752 | $10,909 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 45 | $18,699 | $1,404 |
| Level 2 Upper GI Procedures | 38 | $20,414 | $1,616 |
| Level 1 Laparoscopy and Related Services | 19 | $93,196 | $5,006 |
| Level 5 Urology and Related Services | 17 | $64,366 | $4,490 |
| Level 2 Vascular Procedures | 13 | $11,620 | $1,390 |
| Level 4 Musculoskeletal Procedures | 12 | $115,365 | $6,208 |
| Level 3 Vascular Procedures | 11 | $50,528 | $2,585 |
| Level 1 Endovascular Procedures | 11 | $49,668 | $2,832 |
| Level 3 Endovascular Procedures | 11 | $154,812 | $9,539 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Nacogdoches Medical Center charged $168,345 on average, 51% more than the Texas average of $111,133, and was paid $13,081 against a state average of $16,694. For Respiratory Infections and Inflammations with MCC (DRG 177), Nacogdoches Medical Center charged $132,433 on average, 62% more than the Texas average of $81,715, and was paid $11,445 against a state average of $13,815. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Nacogdoches Medical Center charged $118,785 on average, 61% more than the Texas average of $73,756, and was paid $9,190 against a state average of $11,597. For Heart Failure and Shock with MCC (DRG 291), Nacogdoches Medical Center charged $100,112 on average, 47% more than the Texas average of $67,944, and was paid $8,754 against a state average of $11,820. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $44,781 was 60% above the state average of $27,955. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $155,752 was 58% above the state average of $98,771. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $18,699 was 33% above the state average of $14,089. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $20,414 was 26% above the state average of $16,236.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Nacogdoches Medical Center in Nacogdoches, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-07-10 (CMS case 1239)
- Warning Notice — 2025-07-15 (CMS case 5761)
- Closure Notice — 2025-10-30 (CMS case 5761)
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.