Overlake Hospital Medical Center: charges and Medicare payments

Overlake Hospital Medical Center reported 1,799 Medicare inpatient stays across 65 DRGs in 2024. Across them it charged 5.37 times what it was paid — among the higher ratios in Washington, number 6 of 43 hospitals with at least 100 stays (state median 4.37×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 158 stays at an average charge of $71,368, 21% below the national average. It also billed 3,232 outpatient services, charging 7.27 times what Medicare paid.

1Medicare inpatient stays 1,799
2Charge ÷ paid, inpatient 5.37×
3Rank in WA (highest ratio = 1) 6 of 43
4CMS price-transparency actions 0

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

Inpatient stays

For the 65 DRGs that can be compared with the national average, Overlake Hospital Medical Center charged more than the national average in 26 (40%). 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	158	$71,368	-21%	$17,151
291 Heart Failure and Shock with MCC	139	$54,923	-3%	$10,604
177 Respiratory Infections and Inflammations with MCC	76	$54,376	-23%	$13,156
274 Percutaneous and Other Intracardiac Procedures without MCC	67	$140,637	-10%	$25,754
193 Simple Pneumonia and Pleurisy with MCC	59	$51,484	-14%	$10,659
690 Kidney and Urinary Tract Infections without MCC	54	$47,427	+25%	$9,469
189 Pulmonary Edema and Respiratory Failure	52	$51,902	-10%	$10,232
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	47	$65,830	+18%	$8,574
267 Endovascular Cardiac Valve Replacement and Supplement...	47	$183,195	-17%	$39,288
481 Hip and Femur Procedures except Major Joint with CC	45	$104,932	+4%	$16,678
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	40	$33,469	-32%	$8,615
378 Gastrointestinal Hemorrhage with CC	39	$45,996	-5%	$8,359
682 Renal Failure with MCC	37	$56,016	-15%	$12,108
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	35	$137,950	+35%	$18,127
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	34	$88,653	-11%	$19,608
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	34	$38,194	+3%	$6,533
683 Renal Failure with CC	34	$42,617	+5%	$7,725
552 Medical Back Problems without MCC	28	$38,735	-21%	$7,922
689 Kidney and Urinary Tract Infections with MCC	27	$60,120	+17%	$11,222
698 Other Kidney and Urinary Tract Diagnoses with MCC	27	$66,710	-9%	$14,067
377 Gastrointestinal Hemorrhage with MCC	26	$84,360	-1%	$14,894
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	25	$33,693	-16%	$7,046
468 Revision of Hip or Knee Replacement without CC/MCC	25	$154,834	+25%	$21,076
853 Infectious and Parasitic Diseases with O.R. Procedures with...	25	$185,156	-19%	$39,449
470 Major Hip and Knee Joint Replacement or Reattachment of...	23	$129,908	+39%	$15,766
480 Hip and Femur Procedures except Major Joint with MCC	22	$131,884	-5%	$22,676
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	22	$61,248	+2%	$11,405
280 Acute Myocardial Infarction, Discharged Alive with MCC	20	$63,275	-17%	$12,848
603 Cellulitis without MCC	20	$33,082	-11%	$7,204
243 Permanent Cardiac Pacemaker Implant with CC	19	$72,533	-35%	$17,767
266 Endovascular Cardiac Valve Replacement and Supplement...	19	$240,338	-16%	$50,896
309 Cardiac Arrhythmia and Conduction Disorders with CC	19	$36,894	+2%	$6,275
329 Major Small and Large Bowel Procedures with MCC	19	$274,169	+28%	$46,120
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	19	$231,196	+14%	$37,501
194 Simple Pneumonia and Pleurisy with CC	18	$36,798	-4%	$6,882
330 Major Small and Large Bowel Procedures with CC	18	$182,996	+54%	$20,852
057 Degenerative Nervous System Disorders without MCC	17	$123,875	+119%	$22,090
308 Cardiac Arrhythmia and Conduction Disorders with MCC	17	$44,484	-21%	$9,776
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	17	$32,244	+12%	$4,819
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	17	$40,021	-34%	$10,912
467 Revision of Hip or Knee Replacement with CC	16	$161,140	+2%	$28,260
178 Respiratory Infections and Inflammations with CC	15	$37,416	-17%	$8,547
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	14	$249,333	-10%	$41,590
286 Circulatory Disorders except AMI, with Cardiac...	14	$97,416	-13%	$18,301
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	14	$40,761	-4%	$7,449
025 Craniotomy and Endovascular Intracranial Procedures with MCC	13	$219,611	-5%	$40,547
208 Respiratory System Diagnosis with Ventilator Support <=96...	13	$116,853	-14%	$21,276
236 Coronary Bypass without Cardiac Catheterization without MCC	13	$232,403	+10%	$36,645
253 Other Vascular Procedures with CC	13	$165,078	+25%	$24,632
254 Other Vascular Procedures without CC/MCC	13	$113,194	+24%	$13,983
389 Gastrointestinal Obstruction with CC	13	$38,942	0%	$7,444
482 Hip and Femur Procedures except Major Joint without CC/MCC	13	$103,153	+32%	$12,868
699 Other Kidney and Urinary Tract Diagnoses with CC	13	$34,651	-27%	$8,096
322 Percutaneous Cardiovascular Procedures with Intraluminal...	12	$87,161	-24%	$16,598
393 Other Digestive System Diagnoses with MCC	12	$53,072	-31%	$13,102
394 Other Digestive System Diagnoses with CC	12	$34,832	-26%	$8,337
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	12	$155,512	+15%	$24,243
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	11	$35,985	-45%	$10,840
312 Syncope and Collapse	11	$49,847	+9%	$7,190
331 Major Small and Large Bowel Procedures without CC/MCC	11	$163,247	+90%	$19,500

Showing the 60 most frequent of 65 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	644	$20,728	$2,765
Level 5 Musculoskeletal Procedures	459	$89,240	$13,290
Level 3 Electrophysiologic Procedures	324	$126,750	$24,120
Level 1 Intraocular Procedures	184	$10,923	$2,370
Level 2 Excision/ Biopsy/ Incision and Drainage	147	$10,910	$1,634
Level 1 Endovascular Procedures	140	$22,600	$3,299
Level 1 Laparoscopy and Related Services	118	$52,694	$5,853
Level 4 Musculoskeletal Procedures	80	$63,463	$7,233
Level 3 Vascular Procedures	75	$20,129	$3,221
Level 5 Urology and Related Services	68	$40,927	$5,284
Level 6 Musculoskeletal Procedures	67	$110,218	$18,728
Level 2 Upper GI Procedures	60	$11,477	$1,921
Level 3 Endovascular Procedures	56	$70,486	$11,222
Level 4 Urology and Related Services	54	$30,413	$3,560
Level 2 Laparoscopy and Related Services	53	$111,345	$10,003
Level 3 Extraocular, Repair, and Plastic Eye Procedures	52	$22,765	$2,277
Level 3 Pacemaker and Similar Procedures	50	$36,357	$10,708
Level 4 Endovascular Procedures	44	$93,972	$17,462
Level 3 Excision/ Biopsy/ Incision and Drainage	43	$19,974	$2,848
Level 2 Musculoskeletal Procedures	37	$13,214	$1,606
Level 1 Breast/Lymphatic Surgery and Related Procedures	35	$30,958	$3,804
Level 4 Airway Endoscopy	35	$31,867	$3,737
Level 2 Breast/Lymphatic Surgery and Related Procedures	34	$56,871	$6,660
Level 4 Vascular Procedures	34	$56,075	$5,486
Level 2 Endovascular Procedures	34	$38,045	$5,837

Against the Washington average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Overlake Hospital Medical Center charged $71,368 on average, 9% less than the Washington average of $78,715, and was paid $17,151 against a state average of $18,304. For Heart Failure and Shock with MCC (DRG 291), Overlake Hospital Medical Center charged $54,923 on average, 3% more than the Washington average of $53,424, and was paid $10,604 against a state average of $12,124. For Respiratory Infections and Inflammations with MCC (DRG 177), Overlake Hospital Medical Center charged $54,376 on average, 18% less than the Washington average of $65,942, and was paid $13,156 against a state average of $15,782. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Overlake Hospital Medical Center charged $140,637 on average, 6% more than the Washington average of $132,875, and was paid $25,754 against a state average of $29,468. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $20,728 was 8% below the state average of $22,427. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $89,240 was 28% above the state average of $69,838. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $126,750 was 4% above the state average of $122,380. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,923 was 6% above the state average of $10,318.

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.