Texas / North Texas Medical Center
CMS certification 450090 · Gainesville, TX · 1 entry in CMS's price-transparency list
North Texas Medical Center: charges and Medicare payments
North Texas Medical Center reported 317 Medicare inpatient stays across 13 DRGs in 2024. Across them it charged 2.78 times what it was paid — among the lower ratios in Texas, number 177 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: 72 stays at an average charge of $45,144, 50% below the national average. It also billed 446 outpatient services, charging 5.09 times what Medicare paid.
- 1Medicare inpatient stays 317
- 2Charge ÷ paid, inpatient 2.78×
- 3Rank in TX (highest ratio = 1) 177 of 190
- 4CMS price-transparency actions 1
Inpatient stays
For the 13 DRGs that can be compared with the national average, North Texas Medical Center 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 | 72 | $45,144 | -50% | $16,988 |
| 189 Pulmonary Edema and Respiratory Failure | 50 | $33,247 | -42% | $11,611 |
| 193 Simple Pneumonia and Pleurisy with MCC | 32 | $37,642 | -37% | $12,214 |
| 690 Kidney and Urinary Tract Infections without MCC | 25 | $21,734 | -43% | $8,374 |
| 291 Heart Failure and Shock with MCC | 23 | $32,970 | -42% | $11,967 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 23 | $25,308 | -48% | $10,097 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $39,647 | -44% | $14,877 |
| 071 Other Cerebrovascular Disorders with CC | 14 | $24,048 | -52% | $10,179 |
| 194 Simple Pneumonia and Pleurisy with CC | 14 | $23,940 | -38% | $8,423 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 13 | $67,293 | -28% | $16,472 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $22,965 | -38% | $8,093 |
| 689 Kidney and Urinary Tract Infections with MCC | 12 | $28,978 | -44% | $11,169 |
| 070 Other Cerebrovascular Disorders with MCC | 11 | $33,556 | -56% | $15,487 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 244 | $7,800 | $2,231 |
| Comprehensive Observation Services | 96 | $13,380 | $2,616 |
| Level 2 Upper GI Procedures | 24 | $7,224 | $1,834 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 17 | $6,622 | $1,563 |
| Level 1 Laparoscopy and Related Services | 16 | $15,518 | $5,561 |
| Level 3 Musculoskeletal Procedures | 13 | $13,200 | $3,120 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 13 | $13,689 | $3,334 |
| Level 3 Vascular Procedures | 12 | $17,077 | $3,072 |
| Level 4 Musculoskeletal Procedures | 11 | $35,261 | $6,895 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), North Texas Medical Center charged $45,144 on average, 59% less than the Texas average of $111,133, and was paid $16,988 against a state average of $16,694. For Pulmonary Edema and Respiratory Failure (DRG 189), North Texas Medical Center charged $33,247 on average, 50% less than the Texas average of $65,957, and was paid $11,611 against a state average of $11,822. For Simple Pneumonia and Pleurisy with MCC (DRG 193), North Texas Medical Center charged $37,642 on average, 49% less than the Texas average of $73,756, and was paid $12,214 against a state average of $11,597. For Kidney and Urinary Tract Infections without MCC (DRG 690), North Texas Medical Center charged $21,734 on average, 49% less than the Texas average of $42,965, and was paid $8,374 against a state average of $8,372. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $7,800 was 53% below the state average of $16,442. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $13,380 was 52% below the state average of $27,955. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $7,224 was 56% below the state average of $16,236. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,622 was 53% below the state average of $14,089.
Price-transparency record
CMS's enforcement list records these actions for a hospital named North Texas Medical Center in Gainesville, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-07 (CMS case 3619)
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.