Maine / Northern Light Maine Coast Hospital
CMS certification 200050 · Ellsworth, ME
Northern Light Maine Coast Hospital: charges and Medicare payments
Northern Light Maine Coast Hospital reported 185 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 2.38 times what it was paid — among the lower ratios in Maine, number 13 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: 52 stays at an average charge of $43,967, 51% below the national average. It also billed 670 outpatient services, charging 6.41 times what Medicare paid.
- 1Medicare inpatient stays 185
- 2Charge ÷ paid, inpatient 2.38×
- 3Rank in ME (highest ratio = 1) 13 of 13
- 4CMS price-transparency actions 0
Inpatient stays
For the 9 DRGs that can be compared with the national average, Northern Light Maine Coast 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 | 52 | $43,967 | -51% | $20,896 |
| 291 Heart Failure and Shock with MCC | 32 | $32,705 | -42% | $13,427 |
| 177 Respiratory Infections and Inflammations with MCC | 22 | $50,362 | -29% | $19,387 |
| 193 Simple Pneumonia and Pleurisy with MCC | 15 | $35,360 | -41% | $13,998 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $28,140 | -43% | $10,898 |
| 378 Gastrointestinal Hemorrhage with CC | 14 | $27,982 | -42% | $10,368 |
| 603 Cellulitis without MCC | 13 | $20,537 | -45% | $9,331 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $22,004 | -45% | $7,696 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $56,765 | -44% | $21,904 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Urology and Related Services | 211 | $1,769 | $649 |
| Comprehensive Observation Services | 118 | $15,036 | $2,587 |
| Level 3 Urology and Related Services | 56 | $11,939 | $1,938 |
| Level 5 Urology and Related Services | 52 | $22,488 | $4,924 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 46 | $10,064 | $1,516 |
| Level 4 Urology and Related Services | 45 | $14,568 | $3,317 |
| Level 5 Musculoskeletal Procedures | 26 | $62,996 | $12,505 |
| Level 3 Musculoskeletal Procedures | 22 | $16,443 | $2,641 |
| Level 2 Musculoskeletal Procedures | 19 | $4,887 | $975 |
| Level 3 Vascular Procedures | 18 | $16,311 | $3,033 |
| Level 4 Airway Endoscopy | 15 | $23,610 | $3,374 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 15 | $23,237 | $3,292 |
| Level 1 Laparoscopy and Related Services | 15 | $27,391 | $5,490 |
| Level 4 Gynecologic Procedures | 12 | $17,635 | $2,975 |
Against the Maine average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northern Light Maine Coast Hospital charged $43,967 on average, 24% less than the Maine average of $57,965, and was paid $20,896 against a state average of $19,002. For Heart Failure and Shock with MCC (DRG 291), Northern Light Maine Coast Hospital charged $32,705 on average, 19% less than the Maine average of $40,287, and was paid $13,427 against a state average of $11,946. For Respiratory Infections and Inflammations with MCC (DRG 177), Northern Light Maine Coast Hospital charged $50,362 on average, 5% less than the Maine average of $53,088, and was paid $19,387 against a state average of $15,399. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northern Light Maine Coast Hospital charged $35,360 on average, 12% less than the Maine average of $40,166, and was paid $13,998 against a state average of $12,049. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,769 was 26% above the state average of $1,404. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,036 was 13% above the state average of $13,250. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $11,939 was 76% above the state average of $6,802. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $22,488 was 3% above the state average of $21,768.
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.