Georgia / Northside Hospital Gwinnett

CMS certification 110087 · Lawrenceville, GA · 3 entries in CMS's price-transparency list

Northside Hospital Gwinnett: charges and Medicare payments

Northside Hospital Gwinnett reported 3,791 Medicare inpatient stays across 110 DRGs in 2024. Across them it charged 5.17 times what it was paid — mid-range in Georgia, number 26 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: 410 stays at an average charge of $109,340, 21% above the national average. It also billed 3,244 outpatient services, charging 9.25 times what Medicare paid.

1Medicare inpatient stays 3,791
2Charge ÷ paid, inpatient 5.17×
3Rank in GA (highest ratio = 1) 26 of 74
4CMS price-transparency actions 3

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

Inpatient stays

For the 110 DRGs that can be compared with the national average, Northside Hospital Gwinnett charged more than the national average in 82 (75%). 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	410	$109,340	+21%	$19,402
274 Percutaneous and Other Intracardiac Procedures without MCC	252	$106,799	-32%	$26,926
291 Heart Failure and Shock with MCC	204	$72,108	+28%	$14,721
177 Respiratory Infections and Inflammations with MCC	108	$97,120	+38%	$20,119
193 Simple Pneumonia and Pleurisy with MCC	94	$77,880	+30%	$16,269
236 Coronary Bypass without Cardiac Catheterization without MCC	84	$180,476	-14%	$35,839
689 Kidney and Urinary Tract Infections with MCC	78	$71,634	+40%	$13,619
267 Endovascular Cardiac Valve Replacement and Supplement...	71	$161,616	-27%	$39,174
682 Renal Failure with MCC	69	$76,358	+16%	$16,392
853 Infectious and Parasitic Diseases with O.R. Procedures with...	65	$267,489	+17%	$53,030
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	64	$55,787	+14%	$11,730
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	61	$137,568	+38%	$20,092
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	60	$48,211	+20%	$10,134
690 Kidney and Urinary Tract Infections without MCC	58	$46,622	+23%	$9,255
481 Hip and Femur Procedures except Major Joint with CC	56	$112,767	+12%	$23,977
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	54	$68,948	+14%	$14,018
189 Pulmonary Edema and Respiratory Failure	52	$99,889	+74%	$13,762
698 Other Kidney and Urinary Tract Diagnoses with MCC	52	$77,686	+6%	$16,167
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	47	$67,888	+22%	$10,761
552 Medical Back Problems without MCC	45	$56,491	+16%	$11,204
190 Chronic Obstructive Pulmonary Disease with MCC	43	$67,842	+34%	$11,793
480 Hip and Femur Procedures except Major Joint with MCC	43	$144,609	+4%	$26,287
683 Renal Failure with CC	42	$49,306	+21%	$11,551
378 Gastrointestinal Hemorrhage with CC	39	$61,512	+27%	$11,671
280 Acute Myocardial Infarction, Discharged Alive with MCC	35	$91,625	+21%	$16,795
322 Percutaneous Cardiovascular Procedures with Intraluminal...	35	$139,797	+22%	$16,871
321 Percutaneous Cardiovascular Procedures with Intraluminal...	34	$192,494	+18%	$25,490
812 Red Blood Cell Disorders without MCC	34	$66,386	+50%	$10,629
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	33	$119,786	+17%	$21,280
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	32	$260,690	-6%	$45,169
377 Gastrointestinal Hemorrhage with MCC	32	$103,868	+22%	$17,910
637 Diabetes with MCC	31	$85,676	+29%	$14,986
312 Syncope and Collapse	30	$63,861	+40%	$11,959
603 Cellulitis without MCC	30	$44,482	+19%	$9,827
811 Red Blood Cell Disorders with MCC	30	$84,831	+24%	$14,665
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	27	$78,894	+21%	$20,358
234 Coronary Bypass with Cardiac Catheterization or Open...	27	$223,514	-17%	$50,243
194 Simple Pneumonia and Pleurisy with CC	26	$50,280	+31%	$9,756
252 Other Vascular Procedures with MCC	26	$175,836	+3%	$33,431
308 Cardiac Arrhythmia and Conduction Disorders with MCC	26	$57,966	+2%	$12,009
202 Bronchitis and Asthma with CC/MCC	25	$59,521	+29%	$10,867
235 Coronary Bypass without Cardiac Catheterization with MCC	25	$259,232	-11%	$50,611
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	25	$56,212	-8%	$12,579
070 Other Cerebrovascular Disorders with MCC	24	$97,043	+28%	$21,291
178 Respiratory Infections and Inflammations with CC	23	$46,365	+2%	$10,784
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	23	$408,417	+2%	$68,817
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	23	$50,892	+19%	$11,087
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	23	$48,415	+31%	$9,235
286 Circulatory Disorders except AMI, with Cardiac...	22	$100,454	-11%	$19,360
273 Percutaneous and Other Intracardiac Procedures with MCC	21	$157,591	-26%	$33,064
287 Circulatory Disorders except AMI, with Cardiac...	21	$66,153	+4%	$10,843
314 Other Circulatory System Diagnoses with MCC	21	$124,344	+31%	$23,972
330 Major Small and Large Bowel Procedures with CC	21	$105,670	-11%	$23,428
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	21	$174,257	+29%	$26,172
313 Chest Pain	20	$43,132	+8%	$8,695
331 Major Small and Large Bowel Procedures without CC/MCC	20	$87,197	+2%	$15,703
536 Fractures of Hip and Pelvis without MCC	20	$44,581	+18%	$9,406
638 Diabetes with CC	20	$52,020	+25%	$10,437
699 Other Kidney and Urinary Tract Diagnoses with CC	20	$53,701	+13%	$11,374
071 Other Cerebrovascular Disorders with CC	19	$49,867	-1%	$10,967

Showing the 60 most frequent of 110 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	507	$22,376	$2,508
Level 1 Endovascular Procedures	278	$29,651	$2,967
Level 3 Electrophysiologic Procedures	247	$160,763	$21,748
Level 1 Intraocular Procedures	162	$14,502	$2,099
Level 2 Excision/ Biopsy/ Incision and Drainage	155	$13,385	$1,469
Level 3 Endovascular Procedures	132	$92,166	$10,136
Level 3 Vascular Procedures	126	$24,808	$2,885
Level 2 Upper GI Procedures	115	$17,459	$1,742
Level 5 Musculoskeletal Procedures	102	$100,188	$11,990
Level 5 Urology and Related Services	99	$39,328	$4,763
Level 1 Laparoscopy and Related Services	97	$37,267	$5,355
Level 4 Endovascular Procedures	93	$111,505	$15,934
Level 4 Urology and Related Services	92	$32,064	$3,151
Level 3 Excision/ Biopsy/ Incision and Drainage	74	$24,957	$2,637
Level 3 Pacemaker and Similar Procedures	73	$83,760	$9,902
Level 3 Urology and Related Services	67	$21,152	$1,857
Level 2 Endovascular Procedures	64	$42,161	$5,238
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	58	$27,415	$3,211
Level 4 Musculoskeletal Procedures	57	$58,005	$6,639
Level 2 Vascular Procedures	50	$7,143	$1,486
Level 4 Airway Endoscopy	48	$41,210	$3,418
Level 5 Airway Endoscopy	45	$53,605	$6,239
Level 1 Nerve Procedures	42	$18,931	$1,792
Level 4 Vascular Procedures	40	$36,809	$4,972
Level 3 Lower GI Procedures	36	$22,745	$2,514

Against the Georgia average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northside Hospital Gwinnett charged $109,340 on average, 28% more than the Georgia average of $85,396, and was paid $19,402 against a state average of $17,147. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Northside Hospital Gwinnett charged $106,799 on average, 23% less than the Georgia average of $139,191, and was paid $26,926 against a state average of $26,112. For Heart Failure and Shock with MCC (DRG 291), Northside Hospital Gwinnett charged $72,108 on average, 37% more than the Georgia average of $52,781, and was paid $14,721 against a state average of $12,005. For Respiratory Infections and Inflammations with MCC (DRG 177), Northside Hospital Gwinnett charged $97,120 on average, 47% more than the Georgia average of $66,006, and was paid $20,119 against a state average of $14,774. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,376 was 7% above the state average of $20,900. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $29,651 was 10% above the state average of $26,927. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $160,763 was 20% above the state average of $134,007. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $14,502 was 20% below the state average of $18,060.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Northside Hospital Gwinnett in Lawrenceville, 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 646)
Closure Notice — 2022-08-01 (CMS case 646)
Met Requirements — 2025-04-17 (CMS case 3868)

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.