Maine / Northern Light Mercy Hospital
CMS certification 200008 · Portland, ME
Northern Light Mercy Hospital: charges and Medicare payments
Northern Light Mercy Hospital reported 377 Medicare inpatient stays across 18 DRGs in 2024. Across them it charged 3.85 times what it was paid — among the higher ratios in Maine, number 2 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: 68 stays at an average charge of $62,068, 31% below the national average. It also billed 1,437 outpatient services, charging 5.28 times what Medicare paid.
- 1Medicare inpatient stays 377
- 2Charge ÷ paid, inpatient 3.85×
- 3Rank in ME (highest ratio = 1) 2 of 13
- 4CMS price-transparency actions 0
Inpatient stays
For the 18 DRGs that can be compared with the national average, Northern Light Mercy Hospital charged more than the national average in 1 (6%). 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 | 68 | $62,068 | -31% | $17,508 |
| 291 Heart Failure and Shock with MCC | 54 | $48,147 | -15% | $11,028 |
| 177 Respiratory Infections and Inflammations with MCC | 27 | $52,162 | -26% | $13,987 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $49,141 | -18% | $12,638 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 23 | $31,979 | -35% | $9,054 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $37,575 | -35% | $10,233 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 17 | $37,669 | -26% | $8,520 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $27,606 | -31% | $7,054 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $23,488 | -37% | $7,297 |
| 378 Gastrointestinal Hemorrhage with CC | 16 | $36,753 | -24% | $8,414 |
| 481 Hip and Femur Procedures except Major Joint with CC | 15 | $63,630 | -37% | $15,433 |
| 603 Cellulitis without MCC | 14 | $31,601 | -15% | $8,900 |
| 330 Major Small and Large Bowel Procedures with CC | 12 | $91,151 | -23% | $25,979 |
| 683 Renal Failure with CC | 12 | $25,346 | -38% | $7,810 |
| 389 Gastrointestinal Obstruction with CC | 11 | $26,892 | -31% | $7,104 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 11 | $81,200 | -34% | $20,845 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 11 | $72,166 | -23% | $14,614 |
| 690 Kidney and Urinary Tract Infections without MCC | 11 | $38,078 | +1% | $8,377 |
Outpatient services
Against the Maine average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northern Light Mercy Hospital charged $62,068 on average, 7% more than the Maine average of $57,965, and was paid $17,508 against a state average of $19,002. For Heart Failure and Shock with MCC (DRG 291), Northern Light Mercy Hospital charged $48,147 on average, 20% more than the Maine average of $40,287, and was paid $11,028 against a state average of $11,946. For Respiratory Infections and Inflammations with MCC (DRG 177), Northern Light Mercy Hospital charged $52,162 on average, 2% less than the Maine average of $53,088, and was paid $13,987 against a state average of $15,399. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northern Light Mercy Hospital charged $49,141 on average, 22% more than the Maine average of $40,166, and was paid $12,638 against a state average of $12,049. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $47,688 was 10% below the state average of $52,811. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $27,429 was 12% below the state average of $31,031. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $19,956 was 8% below the state average of $21,768. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,821 was 15% above the state average of $7,697.
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.