Prisma Health Baptist: charges and Medicare payments

Prisma Health Baptist reported 871 Medicare inpatient stays across 39 DRGs in 2024. Across them it charged 3.89 times what it was paid — among the lower ratios in South Carolina, number 31 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: 118 stays at an average charge of $63,370, 30% below the national average. It also billed 1,867 outpatient services, charging 8.62 times what Medicare paid.

1Medicare inpatient stays 871
2Charge ÷ paid, inpatient 3.89×
3Rank in SC (highest ratio = 1) 31 of 45
4CMS price-transparency actions 0

Average charge per stay at Prisma Health Baptist, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 39 DRGs that can be compared with the national average, Prisma Health Baptist charged more than the national average in 2 (5%). 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	118	$63,370	-30%	$16,471
291 Heart Failure and Shock with MCC	49	$37,136	-34%	$10,536
378 Gastrointestinal Hemorrhage with CC	46	$24,035	-50%	$8,494
698 Other Kidney and Urinary Tract Diagnoses with MCC	35	$42,158	-43%	$13,048
812 Red Blood Cell Disorders without MCC	34	$25,716	-42%	$9,216
470 Major Hip and Knee Joint Replacement or Reattachment of...	33	$116,305	+25%	$17,847
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	31	$32,121	-47%	$10,357
682 Renal Failure with MCC	27	$34,637	-47%	$12,244
377 Gastrointestinal Hemorrhage with MCC	26	$43,367	-49%	$13,838
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	25	$44,162	-10%	$9,126
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	23	$42,671	-57%	$14,087
683 Renal Failure with CC	23	$35,271	-13%	$9,649
811 Red Blood Cell Disorders with MCC	23	$31,867	-53%	$11,384
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	22	$26,193	-35%	$7,277
699 Other Kidney and Urinary Tract Diagnoses with CC	22	$30,909	-35%	$8,597
467 Revision of Hip or Knee Replacement with CC	21	$150,536	-5%	$29,520
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	21	$25,438	-31%	$7,189
853 Infectious and Parasitic Diseases with O.R. Procedures with...	20	$102,551	-55%	$32,191
312 Syncope and Collapse	17	$29,521	-35%	$7,771
193 Simple Pneumonia and Pleurisy with MCC	16	$43,786	-27%	$10,970
468 Revision of Hip or Knee Replacement without CC/MCC	16	$120,427	-3%	$20,982
603 Cellulitis without MCC	16	$24,055	-35%	$7,931
389 Gastrointestinal Obstruction with CC	14	$34,351	-12%	$7,588
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	14	$47,138	-23%	$12,827
689 Kidney and Urinary Tract Infections with MCC	14	$27,349	-47%	$9,748
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	13	$28,796	-48%	$8,674
177 Respiratory Infections and Inflammations with MCC	13	$59,293	-16%	$14,640
466 Revision of Hip or Knee Replacement with MCC	13	$179,588	-25%	$35,256
070 Other Cerebrovascular Disorders with MCC	12	$45,990	-40%	$12,223
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	12	$49,679	-24%	$11,255
189 Pulmonary Edema and Respiratory Failure	12	$59,096	+3%	$10,976
314 Other Circulatory System Diagnoses with MCC	12	$91,132	-4%	$18,273
330 Major Small and Large Bowel Procedures with CC	12	$105,179	-12%	$18,969
056 Degenerative Nervous System Disorders with MCC	11	$35,601	-63%	$17,792
074 Cranial and Peripheral Nerve Disorders without MCC	11	$24,488	-54%	$8,774
372 Major Gastrointestinal Disorders and Peritoneal Infections...	11	$33,896	-29%	$9,032
552 Medical Back Problems without MCC	11	$32,947	-33%	$12,499
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	11	$53,388	-21%	$14,157
884 Organic Disturbances and Intellectual Disability	11	$28,537	-54%	$12,558

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	419	$82,844	$11,227
Level 2 Excision/ Biopsy/ Incision and Drainage	321	$8,812	$1,372
Level 5 Urology and Related Services	101	$35,916	$4,341
Level 1 Laparoscopy and Related Services	76	$42,072	$4,854
Comprehensive Observation Services	72	$16,808	$2,352
Level 3 Excision/ Biopsy/ Incision and Drainage	68	$15,411	$2,442
Level 2 Breast/Lymphatic Surgery and Related Procedures	63	$38,051	$5,462
Level 3 Vascular Procedures	63	$17,403	$2,739
Level 1 Breast/Lymphatic Surgery and Related Procedures	62	$25,964	$3,233
Level 6 Musculoskeletal Procedures	59	$86,921	$15,981
Level 4 Urology and Related Services	57	$26,552	$2,996
Level 4 Musculoskeletal Procedures	55	$48,843	$6,059
Level 3 Urology and Related Services	50	$17,483	$1,723
Level 2 Intraocular Procedures	49	$23,173	$3,396
Level 1 Nerve Procedures	48	$20,435	$1,659
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	47	$22,383	$2,891
Level 3 Musculoskeletal Procedures	39	$27,439	$2,781
Level 2 Laparoscopy and Related Services	38	$59,269	$8,652
Level 4 Airway Endoscopy	36	$16,985	$3,147
Level 2 Vascular Procedures	23	$7,704	$1,376
Level 4 Gynecologic Procedures	23	$23,841	$2,687
Level 2 Upper GI Procedures	21	$12,503	$1,635
Level 3 Endovascular Procedures	18	$65,430	$9,448
Level 2 Musculoskeletal Procedures	16	$13,747	$1,381
Level 4 Neurostimulator and Related Procedures	16	$86,839	$18,754

Against the South Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Prisma Health Baptist charged $63,370 on average, 17% less than the South Carolina average of $76,532, and was paid $16,471 against a state average of $16,014. For Heart Failure and Shock with MCC (DRG 291), Prisma Health Baptist charged $37,136 on average, 19% less than the South Carolina average of $45,682, and was paid $10,536 against a state average of $10,696. For Gastrointestinal Hemorrhage with CC (DRG 378), Prisma Health Baptist charged $24,035 on average, 42% less than the South Carolina average of $41,450, and was paid $8,494 against a state average of $8,590. For Other Kidney and Urinary Tract Diagnoses with MCC (DRG 698), Prisma Health Baptist charged $42,158 on average, 30% less than the South Carolina average of $60,345, and was paid $13,048 against a state average of $13,643. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $82,844 was 3% above the state average of $80,461. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,812 was 25% below the state average of $11,718. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $35,916 was 7% below the state average of $38,828. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $42,072 was 9% below the state average of $46,306.

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.