Georgia / Northeast Georgia Medical Center Lumpkin
CMS certification 110237 · Dahlonega, GA
Northeast Georgia Medical Center Lumpkin: charges and Medicare payments
Northeast Georgia Medical Center Lumpkin reported 147 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 3.79 times what it was paid — among the lower ratios in Georgia, number 53 of 74 hospitals with at least 100 stays (state median 4.44×, national 4.15×). Its most frequent stay was DRG 193, Simple Pneumonia and Pleurisy with MCC: 24 stays at an average charge of $40,394, 32% below the national average. It also billed 219 outpatient services, charging 13.37 times what Medicare paid.
- 1Medicare inpatient stays 147
- 2Charge ÷ paid, inpatient 3.79×
- 3Rank in GA (highest ratio = 1) 53 of 74
- 4CMS price-transparency actions 0
Inpatient stays
For the 9 DRGs that can be compared with the national average, Northeast Georgia Medical Center Lumpkin charged more than the national average in 3 (33%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $40,394 | -32% | $12,263 |
| 291 Heart Failure and Shock with MCC | 19 | $38,678 | -31% | $13,101 |
| 690 Kidney and Urinary Tract Infections without MCC | 19 | $39,881 | +5% | $8,172 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $46,898 | -34% | $13,259 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $36,738 | -36% | $11,304 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $43,578 | +8% | $9,362 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $45,721 | -11% | $10,800 |
| 194 Simple Pneumonia and Pleurisy with CC | 11 | $36,208 | -6% | $8,193 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $40,170 | +8% | $7,837 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 127 | $25,730 | $2,385 |
| Level 4 Musculoskeletal Procedures | 39 | $69,318 | $6,353 |
| Level 3 Musculoskeletal Procedures | 25 | $26,925 | $2,874 |
| Level 1 Nerve Procedures | 15 | $17,110 | $1,715 |
| Level 2 Musculoskeletal Procedures | 13 | $12,854 | $1,340 |
Against the Georgia average
For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northeast Georgia Medical Center Lumpkin charged $40,394 on average, 28% less than the Georgia average of $56,349, and was paid $12,263 against a state average of $12,110. For Heart Failure and Shock with MCC (DRG 291), Northeast Georgia Medical Center Lumpkin charged $38,678 on average, 27% less than the Georgia average of $52,781, and was paid $13,101 against a state average of $12,005. For Kidney and Urinary Tract Infections without MCC (DRG 690), Northeast Georgia Medical Center Lumpkin charged $39,881 on average, 21% more than the Georgia average of $32,908, and was paid $8,172 against a state average of $8,115. For Respiratory Infections and Inflammations with MCC (DRG 177), Northeast Georgia Medical Center Lumpkin charged $46,898 on average, 29% less than the Georgia average of $66,006, and was paid $13,259 against a state average of $14,774. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $25,730 was 23% above the state average of $20,900. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $69,318 was 26% above the state average of $54,962. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $26,925 was 7% below the state average of $28,907. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $17,110 was 3% above the state average of $16,665.
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.