Indiana / Pinnacle Hospital
CMS certification 150166 · Crown Point, IN · 4 entries in CMS's price-transparency list
Pinnacle Hospital: charges and Medicare payments
Pinnacle Hospital reported 109 Medicare inpatient stays across 3 DRGs in 2024. Across them it charged 16.89 times what it was paid — among the higher ratios in Indiana, number 1 of 70 hospitals with at least 100 stays (state median 4.08×, national 4.15×). Its most frequent stay was DRG 455, Combined Anterior and Posterior Spinal Fusion without CC/MCC: 44 stays at an average charge of $764,736, 277% above the national average. It also billed 249 outpatient services, charging 19.31 times what Medicare paid.
- 1Medicare inpatient stays 109
- 2Charge ÷ paid, inpatient 16.89×
- 3Rank in IN (highest ratio = 1) 1 of 70
- 4CMS price-transparency actions 4
Inpatient stays
For the 3 DRGs that can be compared with the national average, Pinnacle Hospital charged more than the national average in 3 (100%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 44 | $764,736 | +277% | $46,097 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 42 | $150,721 | +62% | $13,043 |
| 473 Cervical Spinal Fusion without CC/MCC | 23 | $541,740 | +371% | $23,024 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Endovascular Procedures | 41 | $44,660 | $3,070 |
| Level 3 Musculoskeletal Procedures | 30 | $37,926 | $2,638 |
| Comprehensive Observation Services | 30 | $62,558 | $2,497 |
| Level 3 Endovascular Procedures | 23 | $150,803 | $10,337 |
| Level 4 Musculoskeletal Procedures | 21 | $138,576 | $6,728 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 19 | $20,736 | $1,284 |
| Level 5 Musculoskeletal Procedures | 19 | $183,799 | $11,795 |
| Level 3 Vascular Procedures | 18 | $48,650 | $2,998 |
| Level 4 Endovascular Procedures | 15 | $242,526 | $16,457 |
| Level 2 Upper GI Procedures | 11 | $31,251 | $1,790 |
| Level 1 Laparoscopy and Related Services | 11 | $51,575 | $5,427 |
| Level 1 Nerve Procedures | 11 | $30,821 | $1,816 |
Against the Indiana average
For Combined Anterior and Posterior Spinal Fusion without CC/MCC (DRG 455), Pinnacle Hospital charged $764,736 on average, 195% more than the Indiana average of $258,994, and was paid $46,097 against a state average of $37,967. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Pinnacle Hospital charged $150,721 on average, 72% more than the Indiana average of $87,743, and was paid $13,043 against a state average of $14,506. For Cervical Spinal Fusion without CC/MCC (DRG 473), Pinnacle Hospital charged $541,740 on average, 169% more than the Indiana average of $201,662, and was paid $23,024 against a state average of $19,517. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $44,660 was 39% above the state average of $32,147. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $37,926 was 57% above the state average of $24,205. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $62,558 was 240% above the state average of $18,399. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $150,803 was 80% above the state average of $83,626.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Pinnacle Hospital in Crown Point, IN, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- CAP Request — 2025-09-02 (CMS case 6425)
- CMP Notice — 2026-02-04 (CMS case 6425)
- CMP Notice — 2026-06-03 (CMS case 6425)
- Closure Notice — 2026-06-10 (CMS case 6425)
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.