Northwestern Medical Center Inc: charges and Medicare payments

Northwestern Medical Center Inc reported 501 Medicare inpatient stays across 21 DRGs in 2024. Across them it charged 1.39 times what it was paid — among the lower ratios in Vermont, number 6 of 6 hospitals with at least 100 stays (state median 3.83×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 71 stays at an average charge of $24,831, 73% below the national average. It also billed 814 outpatient services, charging 11.54 times what Medicare paid.

1Medicare inpatient stays 501
2Charge ÷ paid, inpatient 1.39×
3Rank in VT (highest ratio = 1) 6 of 6
4CMS price-transparency actions 0

Average charge per stay at Northwestern Medical Center Inc, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 21 DRGs that can be compared with the national average, Northwestern Medical Center Inc 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	71	$24,831	-73%	$22,714
291 Heart Failure and Shock with MCC	59	$21,090	-63%	$15,361
189 Pulmonary Edema and Respiratory Failure	37	$22,210	-61%	$14,905
193 Simple Pneumonia and Pleurisy with MCC	37	$21,862	-63%	$15,154
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	30	$17,790	-64%	$11,778
378 Gastrointestinal Hemorrhage with CC	25	$18,247	-62%	$11,605
177 Respiratory Infections and Inflammations with MCC	24	$20,390	-71%	$19,186
281 Acute Myocardial Infarction, Discharged Alive with CC	23	$10,585	-79%	$10,455
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	19	$22,117	-60%	$11,632
389 Gastrointestinal Obstruction with CC	18	$17,448	-55%	$9,132
683 Renal Failure with CC	18	$13,821	-66%	$10,270
481 Hip and Femur Procedures except Major Joint with CC	17	$38,681	-62%	$23,722
190 Chronic Obstructive Pulmonary Disease with MCC	15	$16,756	-67%	$12,049
280 Acute Myocardial Infarction, Discharged Alive with MCC	15	$17,922	-76%	$18,074
330 Major Small and Large Bowel Procedures with CC	15	$50,027	-58%	$27,252
690 Kidney and Urinary Tract Infections without MCC	15	$14,683	-61%	$9,243
194 Simple Pneumonia and Pleurisy with CC	14	$15,768	-59%	$9,422
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	14	$18,420	-54%	$9,003
308 Cardiac Arrhythmia and Conduction Disorders with MCC	13	$19,141	-66%	$13,900
309 Cardiac Arrhythmia and Conduction Disorders with CC	11	$13,862	-62%	$8,289
603 Cellulitis without MCC	11	$16,090	-57%	$10,140

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Intraocular Procedures	262	$7,348	$866
Level 5 Musculoskeletal Procedures	92	$41,290	$5,983
Level 2 Urology and Related Services	92	$429	$263
Level 4 Musculoskeletal Procedures	57	$23,796	$3,044
Level 3 Musculoskeletal Procedures	41	$12,200	$1,249
Level 1 Laparoscopy and Related Services	34	$14,856	$2,975
Level 2 Musculoskeletal Procedures	30	$4,124	$814
Level 3 Urology and Related Services	28	$4,056	$852
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	26	$10,738	$1,302
Level 2 Excision/ Biopsy/ Incision and Drainage	24	$3,794	$633
Level 3 Excision/ Biopsy/ Incision and Drainage	21	$7,601	$1,293
Level 2 Upper GI Procedures	21	$3,422	$866
Level 2 Intraocular Procedures	20	$8,523	$2,071
Level 4 Urology and Related Services	15	$9,346	$1,406
Level 4 Gynecologic Procedures	15	$8,012	$1,321
Level 4 ENT Procedures	14	$4,744	$1,524
Level 5 Urology and Related Services	11	$13,217	$2,111
Level 1 Nerve Procedures	11	$15,671	$447

Against the Vermont average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northwestern Medical Center Inc charged $24,831 on average, 48% less than the Vermont average of $47,528, and was paid $22,714 against a state average of $12,534. For Heart Failure and Shock with MCC (DRG 291), Northwestern Medical Center Inc charged $21,090 on average, 34% less than the Vermont average of $31,756, and was paid $15,361 against a state average of $8,624. For Pulmonary Edema and Respiratory Failure (DRG 189), Northwestern Medical Center Inc charged $22,210 on average, 35% less than the Vermont average of $34,049, and was paid $14,905 against a state average of $8,115. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northwestern Medical Center Inc charged $21,862 on average, 35% less than the Vermont average of $33,721, and was paid $15,154 against a state average of $9,426. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $7,348 was 4% above the state average of $7,070. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $41,290 was 3% above the state average of $40,026. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $429 was 67% below the state average of $1,308. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $23,796 was 6% below the state average of $25,332.

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.