South Carolina / Prisma Health Hillcrest Hospital
CMS certification 420037 · Simpsonville, SC
Prisma Health Hillcrest Hospital: charges and Medicare payments
Prisma Health Hillcrest Hospital reported 375 Medicare inpatient stays across 16 DRGs in 2024. Across them it charged 4.1 times what it was paid — mid-range in South Carolina, number 25 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: 96 stays at an average charge of $42,728, 53% below the national average. It also billed 621 outpatient services, charging 9.58 times what Medicare paid.
- 1Medicare inpatient stays 375
- 2Charge ÷ paid, inpatient 4.1×
- 3Rank in SC (highest ratio = 1) 25 of 45
- 4CMS price-transparency actions 0
Inpatient stays
For the 16 DRGs that can be compared with the national average, Prisma Health Hillcrest 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 | 96 | $42,728 | -53% | $10,979 |
| 291 Heart Failure and Shock with MCC | 59 | $34,819 | -38% | $7,839 |
| 690 Kidney and Urinary Tract Infections without MCC | 26 | $24,922 | -34% | $6,025 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $23,478 | -42% | $5,294 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 21 | $28,962 | -41% | $6,770 |
| 177 Respiratory Infections and Inflammations with MCC | 20 | $40,309 | -43% | $8,967 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $30,087 | -50% | $9,242 |
| 689 Kidney and Urinary Tract Infections with MCC | 16 | $23,715 | -54% | $6,794 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $41,250 | -28% | $7,792 |
| 682 Renal Failure with MCC | 14 | $41,815 | -37% | $9,338 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 14 | $37,656 | -49% | $9,629 |
| 193 Simple Pneumonia and Pleurisy with MCC | 12 | $41,178 | -31% | $11,427 |
| 355 Hernia Procedures except Inguinal and Femoral without CC/MCC | 12 | $47,703 | -34% | $11,035 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 11 | $28,279 | -44% | $6,733 |
| 389 Gastrointestinal Obstruction with CC | 11 | $24,849 | -36% | $5,049 |
| 683 Renal Failure with CC | 11 | $22,634 | -44% | $6,315 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 194 | $17,883 | $2,303 |
| Level 1 Laparoscopy and Related Services | 98 | $39,260 | $4,977 |
| Level 2 Upper GI Procedures | 86 | $15,949 | $1,641 |
| Level 2 Laparoscopy and Related Services | 66 | $59,386 | $8,766 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 45 | $27,684 | $2,931 |
| Level 4 Musculoskeletal Procedures | 37 | $47,481 | $5,772 |
| Level 3 Musculoskeletal Procedures | 28 | $23,860 | $2,792 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 21 | $16,665 | $1,398 |
| Level 5 Musculoskeletal Procedures | 20 | $65,197 | $11,339 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 14 | $17,484 | $2,172 |
| Level 2 Musculoskeletal Procedures | 12 | $14,524 | $1,386 |
Against the South Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Prisma Health Hillcrest Hospital charged $42,728 on average, 44% less than the South Carolina average of $76,532, and was paid $10,979 against a state average of $16,014. For Heart Failure and Shock with MCC (DRG 291), Prisma Health Hillcrest Hospital charged $34,819 on average, 24% less than the South Carolina average of $45,682, and was paid $7,839 against a state average of $10,696. For Kidney and Urinary Tract Infections without MCC (DRG 690), Prisma Health Hillcrest Hospital charged $24,922 on average, 24% less than the South Carolina average of $32,811, and was paid $6,025 against a state average of $7,345. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Prisma Health Hillcrest Hospital charged $23,478 on average, 34% less than the South Carolina average of $35,320, and was paid $5,294 against a state average of $7,048. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,883 was 14% below the state average of $20,764. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $39,260 was 15% below the state average of $46,306. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $15,949 was 13% above the state average of $14,055. For Level 2 Laparoscopy and Related Services (outpatient APC 5362), its average charge of $59,386 was 25% below the state average of $79,603.
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.