Georgia / Northside Hospital Forsyth

CMS certification 110005 · Cumming, GA · 4 entries in CMS's price-transparency list

Northside Hospital Forsyth: charges and Medicare payments

Northside Hospital Forsyth reported 3,736 Medicare inpatient stays across 115 DRGs in 2024. Across them it charged 6.92 times what it was paid — among the higher ratios in Georgia, number 5 of 74 hospitals with at least 100 stays (state median 4.44×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 281 stays at an average charge of $114,884, 27% above the national average. It also billed 4,569 outpatient services, charging 8.89 times what Medicare paid.

1Medicare inpatient stays 3,736
2Charge ÷ paid, inpatient 6.92×
3Rank in GA (highest ratio = 1) 5 of 74
4CMS price-transparency actions 4

Average charge per stay at Northside Hospital Forsyth, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 115 DRGs that can be compared with the national average, Northside Hospital Forsyth charged more than the national average in 93 (81%). 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	281	$114,884	+27%	$17,091
291 Heart Failure and Shock with MCC	202	$65,921	+17%	$10,738
177 Respiratory Infections and Inflammations with MCC	138	$87,511	+24%	$12,426
193 Simple Pneumonia and Pleurisy with MCC	129	$68,705	+15%	$10,191
682 Renal Failure with MCC	98	$74,925	+14%	$11,698
683 Renal Failure with CC	90	$49,823	+22%	$7,958
689 Kidney and Urinary Tract Infections with MCC	89	$61,141	+19%	$9,049
189 Pulmonary Edema and Respiratory Failure	87	$72,005	+25%	$12,132
690 Kidney and Urinary Tract Infections without MCC	76	$43,023	+14%	$6,792
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	67	$51,569	+28%	$6,762
698 Other Kidney and Urinary Tract Diagnoses with MCC	64	$95,249	+30%	$12,724
309 Cardiac Arrhythmia and Conduction Disorders with CC	58	$51,125	+42%	$6,480
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	57	$60,843	+24%	$8,941
378 Gastrointestinal Hemorrhage with CC	55	$71,615	+48%	$8,125
280 Acute Myocardial Infarction, Discharged Alive with MCC	49	$114,575	+51%	$12,729
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	48	$64,077	+6%	$9,763
603 Cellulitis without MCC	47	$46,482	+25%	$6,938
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	46	$116,275	+16%	$14,764
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	46	$60,599	+9%	$7,990
312 Syncope and Collapse	45	$49,171	+8%	$7,505
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	45	$47,031	+27%	$6,296
467 Revision of Hip or Knee Replacement with CC	44	$213,657	+35%	$29,039
286 Circulatory Disorders except AMI, with Cardiac...	43	$117,638	+5%	$16,884
377 Gastrointestinal Hemorrhage with MCC	43	$105,431	+23%	$13,884
330 Major Small and Large Bowel Procedures with CC	42	$100,546	-16%	$17,529
468 Revision of Hip or Knee Replacement without CC/MCC	42	$153,843	+24%	$20,827
481 Hip and Femur Procedures except Major Joint with CC	40	$106,645	+6%	$14,995
308 Cardiac Arrhythmia and Conduction Disorders with MCC	38	$75,196	+33%	$10,245
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	36	$120,171	+17%	$15,153
552 Medical Back Problems without MCC	36	$50,753	+4%	$7,726
329 Major Small and Large Bowel Procedures with MCC	35	$193,921	-10%	$34,673
470 Major Hip and Knee Joint Replacement or Reattachment of...	35	$139,977	+50%	$17,779
194 Simple Pneumonia and Pleurisy with CC	34	$47,349	+23%	$6,623
853 Infectious and Parasitic Diseases with O.R. Procedures with...	34	$215,281	-6%	$35,384
069 Transient Ischemia without Thrombolytic	33	$60,020	+19%	$7,517
178 Respiratory Infections and Inflammations with CC	33	$56,338	+24%	$8,048
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	33	$68,951	+13%	$9,867
190 Chronic Obstructive Pulmonary Disease with MCC	32	$52,954	+5%	$8,637
287 Circulatory Disorders except AMI, with Cardiac...	32	$105,452	+65%	$12,560
389 Gastrointestinal Obstruction with CC	31	$47,213	+21%	$7,064
460 Spinal Fusion except Cervical without MCC	29	$177,153	+4%	$26,319
305 Hypertension without MCC	27	$48,004	+20%	$6,263
638 Diabetes with CC	27	$44,183	+6%	$8,421
243 Permanent Cardiac Pacemaker Implant with CC	26	$158,771	+43%	$22,980
372 Major Gastrointestinal Disorders and Peritoneal Infections...	26	$58,911	+24%	$8,165
811 Red Blood Cell Disorders with MCC	26	$84,831	+24%	$11,005
202 Bronchitis and Asthma with CC/MCC	24	$60,980	+32%	$9,652
699 Other Kidney and Urinary Tract Diagnoses with CC	24	$66,594	+40%	$8,472
057 Degenerative Nervous System Disorders without MCC	23	$51,830	-8%	$9,891
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	23	$35,435	+23%	$6,775
516 Other Musculoskeletal System and Connective Tissue O.R....	23	$107,583	+6%	$14,284
812 Red Blood Cell Disorders without MCC	23	$72,353	+63%	$8,717
092 Other Disorders of Nervous System with CC	22	$43,259	-16%	$8,203
101 Seizures without MCC	22	$44,896	-8%	$7,606
432 Cirrhosis and Alcoholic Hepatitis with MCC	22	$102,483	+7%	$14,076
039 Extracranial Procedures without CC/MCC	19	$62,546	-2%	$8,873
056 Degenerative Nervous System Disorders with MCC	19	$111,803	+16%	$17,106
418 Laparoscopic Cholecystectomy without C.D.E. with CC	19	$86,697	-7%	$14,176
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	19	$232,105	+14%	$33,587
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	19	$41,850	-2%	$7,885

Showing the 60 most frequent of 115 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Intraocular Procedures	585	$10,786	$2,157
Level 5 Musculoskeletal Procedures	349	$89,998	$12,082
Level 2 Excision/ Biopsy/ Incision and Drainage	296	$12,525	$1,477
Level 3 Urology and Related Services	248	$16,840	$1,890
Level 1 Endovascular Procedures	239	$32,524	$3,011
Level 4 Musculoskeletal Procedures	200	$47,712	$6,517
Level 3 Excision/ Biopsy/ Incision and Drainage	198	$36,815	$2,584
Level 5 Urology and Related Services	193	$31,660	$4,668
Level 3 Vascular Procedures	182	$19,616	$2,920
Level 1 Laparoscopy and Related Services	151	$40,516	$5,185
Comprehensive Observation Services	137	$25,953	$2,481
Level 2 Laparoscopy and Related Services	115	$70,535	$9,547
Level 4 Urology and Related Services	106	$27,221	$3,187
Level 1 Nerve Procedures	100	$17,230	$1,763
Level 3 Endovascular Procedures	93	$101,715	$10,201
Level 3 Airway Endoscopy	91	$15,558	$1,539
Level 3 Musculoskeletal Procedures	85	$26,812	$3,004
Level 3 Extraocular, Repair, and Plastic Eye Procedures	82	$18,873	$2,169
Level 3 Pacemaker and Similar Procedures	79	$86,174	$9,902
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	79	$30,252	$3,178
Level 2 Upper GI Procedures	74	$13,529	$1,766
Level 2 Vascular Procedures	71	$8,561	$1,470
Level 6 Musculoskeletal Procedures	66	$117,202	$17,257
Level 5 Airway Endoscopy	55	$43,123	$6,352
Level 2 Endovascular Procedures	55	$37,901	$5,235

Against the Georgia average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northside Hospital Forsyth charged $114,884 on average, 35% more than the Georgia average of $85,396, and was paid $17,091 against a state average of $17,147. For Heart Failure and Shock with MCC (DRG 291), Northside Hospital Forsyth charged $65,921 on average, 25% more than the Georgia average of $52,781, and was paid $10,738 against a state average of $12,005. For Respiratory Infections and Inflammations with MCC (DRG 177), Northside Hospital Forsyth charged $87,511 on average, 33% more than the Georgia average of $66,006, and was paid $12,426 against a state average of $14,774. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northside Hospital Forsyth charged $68,705 on average, 22% more than the Georgia average of $56,349, and was paid $10,191 against a state average of $12,110. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,786 was 40% below the state average of $18,060. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $89,998 was 10% above the state average of $81,545. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,525 was 3% below the state average of $12,974. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $16,840 was 5% below the state average of $17,644.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Northside Hospital Forsyth in Cumming, GA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2022-03-09 (CMS case 336)
Closure Notice — 2022-08-01 (CMS case 336)
Warning Notice — 2023-12-12 (CMS case 2069)
Closure Notice — 2024-03-28 (CMS case 2069)

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.