Maine / Northern Light A R Gould Hospital
CMS certification 200018 · Presque Isle, ME · 2 entries in CMS's price-transparency list
Northern Light A R Gould Hospital: charges and Medicare payments
Northern Light A R Gould Hospital reported 129 Medicare inpatient stays across 6 DRGs in 2024. Across them it charged 3.36 times what it was paid — mid-range in Maine, number 6 of 13 hospitals with at least 100 stays (state median 3.18×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 35 stays at an average charge of $57,123, 37% below the national average. It also billed 948 outpatient services, charging 6.53 times what Medicare paid.
- 1Medicare inpatient stays 129
- 2Charge ÷ paid, inpatient 3.36×
- 3Rank in ME (highest ratio = 1) 6 of 13
- 4CMS price-transparency actions 2
Inpatient stays
For the 6 DRGs that can be compared with the national average, Northern Light A R Gould 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 | $57,123 | -37% | $18,936 |
| 193 Simple Pneumonia and Pleurisy with MCC | 31 | $37,107 | -38% | $11,942 |
| 291 Heart Failure and Shock with MCC | 23 | $51,776 | -8% | $12,417 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $34,671 | -29% | $9,090 |
| 177 Respiratory Infections and Inflammations with MCC | 13 | $48,256 | -32% | $14,753 |
| 682 Renal Failure with MCC | 12 | $48,954 | -26% | $13,581 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 225 | $9,012 | $1,971 |
| Level 2 Urology and Related Services | 176 | $1,580 | $584 |
| Comprehensive Observation Services | 141 | $18,125 | $2,332 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 71 | $6,923 | $1,391 |
| Level 1 Nerve Procedures | 49 | $7,998 | $1,657 |
| Level 1 Endovascular Procedures | 44 | $14,822 | $2,801 |
| Level 4 Urology and Related Services | 39 | $17,159 | $2,991 |
| Level 3 Musculoskeletal Procedures | 38 | $21,440 | $2,724 |
| Level 3 Urology and Related Services | 38 | $7,195 | $1,748 |
| Level 5 Musculoskeletal Procedures | 32 | $61,641 | $11,280 |
| Level 3 Vascular Procedures | 28 | $22,697 | $2,735 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 26 | $21,642 | $2,344 |
| Level 4 Musculoskeletal Procedures | 15 | $46,090 | $6,139 |
| Level 2 ICD and Similar Procedures | 15 | $88,726 | $28,147 |
| Level 5 Urology and Related Services | 11 | $23,201 | $4,440 |
Against the Maine average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northern Light A R Gould Hospital charged $57,123 on average, 1% less than the Maine average of $57,965, and was paid $18,936 against a state average of $19,002. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northern Light A R Gould Hospital charged $37,107 on average, 8% less than the Maine average of $40,166, and was paid $11,942 against a state average of $12,049. For Heart Failure and Shock with MCC (DRG 291), Northern Light A R Gould Hospital charged $51,776 on average, 29% more than the Maine average of $40,287, and was paid $12,417 against a state average of $11,946. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Northern Light A R Gould Hospital charged $34,671 on average, 10% more than the Maine average of $31,445, and was paid $9,090 against a state average of $10,386. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,012 was 14% below the state average of $10,436. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,580 was 13% above the state average of $1,404. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $18,125 was 37% above the state average of $13,250. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,923 was 10% below the state average of $7,697.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Northern Light A R Gould Hospital in Presque Isle, ME, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-09 (CMS case 1168)
- Closure Notice — 2023-06-15 (CMS case 1168)
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.