New Mexico / Presbyterian Hospital

CMS certification 320021 · Albuquerque, NM · 4 entries in CMS's price-transparency list

Presbyterian Hospital: charges and Medicare payments

Presbyterian Hospital reported 5,581 Medicare inpatient stays across 139 DRGs in 2024. Across them it charged 3.2 times what it was paid — among the lower ratios in New Mexico, number 12 of 16 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: 870 stays at an average charge of $47,549, 47% below the national average. It also billed 4,185 outpatient services, charging 5.1 times what Medicare paid.

1Medicare inpatient stays 5,581
2Charge ÷ paid, inpatient 3.2×
3Rank in NM (highest ratio = 1) 12 of 16
4CMS price-transparency actions 4

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

Inpatient stays

For the 139 DRGs that can be compared with the national average, Presbyterian Hospital 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	870	$47,549	-47%	$14,943
291 Heart Failure and Shock with MCC	274	$35,968	-36%	$10,436
177 Respiratory Infections and Inflammations with MCC	197	$36,937	-48%	$12,383
193 Simple Pneumonia and Pleurisy with MCC	176	$27,248	-54%	$10,241
853 Infectious and Parasitic Diseases with O.R. Procedures with...	146	$116,343	-49%	$37,324
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	142	$27,434	-44%	$8,299
698 Other Kidney and Urinary Tract Diagnoses with MCC	115	$39,853	-46%	$13,611
189 Pulmonary Edema and Respiratory Failure	105	$30,137	-48%	$9,340
481 Hip and Femur Procedures except Major Joint with CC	90	$48,548	-52%	$15,224
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	86	$38,322	-62%	$14,787
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	81	$31,845	-47%	$10,292
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	71	$28,397	-49%	$7,817
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	69	$21,544	-46%	$6,247
377 Gastrointestinal Hemorrhage with MCC	68	$51,311	-40%	$13,831
683 Renal Failure with CC	66	$23,806	-42%	$7,397
378 Gastrointestinal Hemorrhage with CC	64	$28,794	-41%	$7,665
682 Renal Failure with MCC	64	$35,349	-46%	$11,244
689 Kidney and Urinary Tract Infections with MCC	58	$26,281	-49%	$8,954
280 Acute Myocardial Infarction, Discharged Alive with MCC	57	$36,561	-52%	$12,747
603 Cellulitis without MCC	57	$18,426	-51%	$7,034
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	53	$20,041	-46%	$6,414
266 Endovascular Cardiac Valve Replacement and Supplement...	51	$148,670	-48%	$45,740
690 Kidney and Urinary Tract Infections without MCC	51	$23,469	-38%	$6,456
314 Other Circulatory System Diagnoses with MCC	48	$48,210	-49%	$16,162
322 Percutaneous Cardiovascular Procedures with Intraluminal...	48	$58,943	-49%	$13,819
286 Circulatory Disorders except AMI, with Cardiac...	46	$51,691	-54%	$16,942
432 Cirrhosis and Alcoholic Hepatitis with MCC	46	$49,954	-48%	$17,477
309 Cardiac Arrhythmia and Conduction Disorders with CC	45	$19,925	-45%	$6,431
480 Hip and Femur Procedures except Major Joint with MCC	42	$73,146	-47%	$23,235
308 Cardiac Arrhythmia and Conduction Disorders with MCC	41	$34,255	-40%	$10,162
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	40	$32,216	-47%	$9,810
329 Major Small and Large Bowel Procedures with MCC	39	$113,656	-47%	$37,689
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	39	$61,449	-40%	$15,762
854 Infectious and Parasitic Diseases with O.R. Procedures with...	38	$50,822	-48%	$15,555
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	36	$29,323	-55%	$10,661
299 Peripheral Vascular Disorders with MCC	36	$36,833	-51%	$11,733
321 Percutaneous Cardiovascular Procedures with Intraluminal...	35	$66,367	-59%	$22,282
389 Gastrointestinal Obstruction with CC	35	$19,589	-50%	$6,602
070 Other Cerebrovascular Disorders with MCC	34	$42,233	-44%	$13,463
274 Percutaneous and Other Intracardiac Procedures without MCC	34	$70,486	-55%	$24,002
699 Other Kidney and Urinary Tract Diagnoses with CC	34	$25,951	-45%	$8,048
100 Seizures with MCC	33	$36,614	-61%	$14,435
312 Syncope and Collapse	32	$25,061	-45%	$7,266
393 Other Digestive System Diagnoses with MCC	32	$40,397	-47%	$11,816
091 Other Disorders of Nervous System with MCC	31	$58,502	-29%	$14,257
229 Other Cardiothoracic Procedures without MCC	31	$120,078	-27%	$31,556
637 Diabetes with MCC	31	$40,723	-39%	$11,992
025 Craniotomy and Endovascular Intracranial Procedures with MCC	30	$87,779	-62%	$39,794
194 Simple Pneumonia and Pleurisy with CC	30	$18,485	-52%	$6,517
235 Coronary Bypass without Cardiac Catheterization with MCC	30	$164,011	-44%	$45,052
896 Alcohol, Drug Abuse or Dependence without Rehabilitation...	30	$40,786	-48%	$14,869
460 Spinal Fusion except Cervical without MCC	29	$87,867	-48%	$31,225
281 Acute Myocardial Infarction, Discharged Alive with CC	28	$26,033	-48%	$7,149
330 Major Small and Large Bowel Procedures with CC	28	$53,922	-55%	$18,087
435 Malignancy of Hepatobiliary System or Pancreas with MCC	28	$47,810	-49%	$13,275
101 Seizures without MCC	27	$22,171	-55%	$7,197
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	27	$24,753	-33%	$7,506
069 Transient Ischemia without Thrombolytic	26	$26,702	-47%	$6,420
178 Respiratory Infections and Inflammations with CC	26	$26,363	-42%	$7,950
418 Laparoscopic Cholecystectomy without C.D.E. with CC	26	$56,106	-40%	$12,428

Showing the 60 most frequent of 139 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	644	$17,025	$2,399
Level 2 Urology and Related Services	583	$976	$582
Level 5 Musculoskeletal Procedures	430	$46,631	$11,327
Level 3 Urology and Related Services	217	$5,450	$1,737
Level 2 Upper GI Procedures	209	$7,051	$1,654
Level 1 Laparoscopy and Related Services	155	$24,996	$5,003
Level 5 Urology and Related Services	154	$22,345	$4,486
Level 2 Excision/ Biopsy/ Incision and Drainage	146	$6,483	$1,409
Level 1 Endovascular Procedures	146	$9,451	$2,750
Level 4 Urology and Related Services	145	$17,519	$3,036
Level 3 Vascular Procedures	130	$12,871	$2,804
Level 3 Electrophysiologic Procedures	120	$58,047	$20,214
Level 3 Excision/ Biopsy/ Incision and Drainage	89	$10,800	$2,470
Level 4 Musculoskeletal Procedures	81	$28,700	$6,028
Level 3 Lower GI Procedures	80	$8,986	$2,435
Level 2 Laparoscopy and Related Services	77	$35,479	$8,729
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	73	$10,855	$3,029
Level 6 Musculoskeletal Procedures	66	$55,653	$16,247
Level 2 Vascular Procedures	64	$5,318	$1,393
Level 2 Musculoskeletal Procedures	57	$5,201	$1,394
Level 3 Endovascular Procedures	46	$35,846	$9,378
Level 4 Endovascular Procedures	45	$69,713	$15,489
Level 2 Endovascular Procedures	43	$20,672	$4,965
Level 1 Breast/Lymphatic Surgery and Related Procedures	42	$18,887	$3,374
Level 3 Pacemaker and Similar Procedures	39	$32,542	$9,445

Against the New Mexico average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Presbyterian Hospital charged $47,549 on average, 28% less than the New Mexico average of $65,967, and was paid $14,943 against a state average of $17,240. For Heart Failure and Shock with MCC (DRG 291), Presbyterian Hospital charged $35,968 on average, 27% less than the New Mexico average of $49,310, and was paid $10,436 against a state average of $11,350. For Respiratory Infections and Inflammations with MCC (DRG 177), Presbyterian Hospital charged $36,937 on average, 33% less than the New Mexico average of $54,728, and was paid $12,383 against a state average of $14,774. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Presbyterian Hospital charged $27,248 on average, 42% less than the New Mexico average of $47,073, and was paid $10,241 against a state average of $12,080. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,025 was 21% below the state average of $21,444. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $976 was 46% below the state average of $1,809. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $46,631 was 37% below the state average of $73,720. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $5,450 was 37% below the state average of $8,698.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Presbyterian Hospital in Albuquerque, NM, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2023-04-28 (CMS case 987)
CAP Request — 2023-08-16 (CMS case 987)
Closure Notice — 2023-10-24 (CMS case 987)
Met Requirements — 2025-04-01 (CMS case 3497)

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.