Pelham Medical Center: charges and Medicare payments

Pelham Medical Center reported 429 Medicare inpatient stays across 20 DRGs in 2024. Across them it charged 4.98 times what it was paid — mid-range in South Carolina, number 17 of 45 hospitals with at least 100 stays (state median 4.13×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 40 stays at an average charge of $59,714, 34% below the national average. It also billed 1,183 outpatient services, charging 7.22 times what Medicare paid.

1Medicare inpatient stays 429
2Charge ÷ paid, inpatient 4.98×
3Rank in SC (highest ratio = 1) 17 of 45
4CMS price-transparency actions 0

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

Inpatient stays

For the 20 DRGs that can be compared with the national average, Pelham Medical Center 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	40	$59,714	-34%	$13,878
291 Heart Failure and Shock with MCC	39	$37,802	-33%	$7,167
690 Kidney and Urinary Tract Infections without MCC	37	$24,933	-34%	$5,056
460 Spinal Fusion except Cervical without MCC	34	$131,183	-23%	$27,589
194 Simple Pneumonia and Pleurisy with CC	29	$31,623	-18%	$4,973
193 Simple Pneumonia and Pleurisy with MCC	28	$43,005	-28%	$7,949
683 Renal Failure with CC	22	$30,658	-25%	$5,277
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	20	$32,664	-19%	$5,016
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	19	$179,851	-11%	$32,248
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	19	$28,859	-22%	$4,909
177 Respiratory Infections and Inflammations with MCC	17	$41,219	-42%	$8,643
189 Pulmonary Edema and Respiratory Failure	16	$45,625	-21%	$7,925
603 Cellulitis without MCC	16	$25,069	-33%	$5,905
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	15	$36,628	-39%	$8,192
178 Respiratory Infections and Inflammations with CC	14	$41,626	-8%	$6,076
454 Combined Anterior and Posterior Spinal Fusion with CC	14	$214,572	-23%	$54,045
481 Hip and Femur Procedures except Major Joint with CC	14	$67,881	-33%	$12,662
378 Gastrointestinal Hemorrhage with CC	13	$34,781	-28%	$5,977
552 Medical Back Problems without MCC	12	$28,121	-42%	$5,875
472 Cervical Spinal Fusion with CC	11	$101,186	-29%	$18,762

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	421	$19,513	$2,352
Level 5 Musculoskeletal Procedures	142	$57,092	$11,292
Level 4 Musculoskeletal Procedures	123	$37,439	$6,060
Level 2 Upper GI Procedures	78	$12,121	$1,638
Level 1 Laparoscopy and Related Services	72	$31,106	$4,684
Level 2 Excision/ Biopsy/ Incision and Drainage	52	$7,546	$1,410
Level 5 Neurostimulator and Related Procedures	45	$98,965	$26,924
Level 1 Nerve Procedures	36	$16,024	$1,605
Level 3 Vascular Procedures	35	$25,919	$2,772
Level 5 Urology and Related Services	33	$41,862	$4,499
Level 2 Endovascular Procedures	22	$23,663	$4,793
Level 2 Breast/Lymphatic Surgery and Related Procedures	20	$40,845	$5,670
Level 6 Musculoskeletal Procedures	17	$108,260	$15,316
Level 1 Breast/Lymphatic Surgery and Related Procedures	16	$25,713	$3,314
Level 2 Musculoskeletal Procedures	16	$13,544	$1,328
Level 2 Vascular Procedures	16	$19,172	$1,393
Level 3 Upper GI Procedures	14	$20,641	$3,142
Level 3 Musculoskeletal Procedures	13	$25,612	$2,815
Level 4 Vascular Procedures	12	$48,440	$4,778

Against the South Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Pelham Medical Center charged $59,714 on average, 22% less than the South Carolina average of $76,532, and was paid $13,878 against a state average of $16,014. For Heart Failure and Shock with MCC (DRG 291), Pelham Medical Center charged $37,802 on average, 17% less than the South Carolina average of $45,682, and was paid $7,167 against a state average of $10,696. For Kidney and Urinary Tract Infections without MCC (DRG 690), Pelham Medical Center charged $24,933 on average, 24% less than the South Carolina average of $32,811, and was paid $5,056 against a state average of $7,345. For Spinal Fusion except Cervical without MCC (DRG 460), Pelham Medical Center charged $131,183 on average, 30% less than the South Carolina average of $187,031, and was paid $27,589 against a state average of $30,705. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,513 was 6% below the state average of $20,764. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $57,092 was 29% below the state average of $80,461. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $37,439 was 27% below the state average of $51,243. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,121 was 14% below the state average of $14,055.

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.