Prisma Health Oconee Memorial Hospital: charges and Medicare payments

Prisma Health Oconee Memorial Hospital reported 1,453 Medicare inpatient stays across 46 DRGs in 2024. Across them it charged 3.38 times what it was paid — among the lower ratios in South Carolina, number 38 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: 289 stays at an average charge of $60,552, 33% below the national average. It also billed 1,256 outpatient services, charging 8.14 times what Medicare paid.

1Medicare inpatient stays 1,453
2Charge ÷ paid, inpatient 3.38×
3Rank in SC (highest ratio = 1) 38 of 45
4CMS price-transparency actions 0

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

Inpatient stays

For the 46 DRGs that can be compared with the national average, Prisma Health Oconee Memorial Hospital charged more than the national average in 1 (2%). 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	289	$60,552	-33%	$17,149
291 Heart Failure and Shock with MCC	144	$37,339	-34%	$11,593
690 Kidney and Urinary Tract Infections without MCC	52	$25,332	-33%	$7,029
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	51	$33,006	-33%	$9,386
177 Respiratory Infections and Inflammations with MCC	46	$44,608	-37%	$13,645
193 Simple Pneumonia and Pleurisy with MCC	36	$37,324	-38%	$11,491
683 Renal Failure with CC	36	$25,132	-38%	$7,691
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	35	$86,691	-15%	$19,530
689 Kidney and Urinary Tract Infections with MCC	35	$29,675	-42%	$10,190
682 Renal Failure with MCC	31	$35,737	-46%	$12,754
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	30	$32,145	-42%	$8,901
189 Pulmonary Edema and Respiratory Failure	30	$38,641	-33%	$10,392
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	30	$31,243	-48%	$11,305
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	29	$24,205	-40%	$6,525
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	29	$24,059	-35%	$6,942
853 Infectious and Parasitic Diseases with O.R. Procedures with...	29	$93,687	-59%	$40,295
481 Hip and Femur Procedures except Major Joint with CC	28	$77,347	-23%	$18,708
308 Cardiac Arrhythmia and Conduction Disorders with MCC	27	$33,588	-41%	$10,485
280 Acute Myocardial Infarction, Discharged Alive with MCC	26	$29,779	-61%	$13,058
378 Gastrointestinal Hemorrhage with CC	26	$27,296	-44%	$8,318
603 Cellulitis without MCC	25	$20,942	-44%	$7,675
312 Syncope and Collapse	24	$26,160	-43%	$7,351
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	21	$48,992	-51%	$16,791
470 Major Hip and Knee Joint Replacement or Reattachment of...	21	$91,630	-2%	$15,660
638 Diabetes with CC	21	$20,678	-50%	$7,863
389 Gastrointestinal Obstruction with CC	20	$22,070	-43%	$6,972
178 Respiratory Infections and Inflammations with CC	19	$32,453	-28%	$9,190
194 Simple Pneumonia and Pleurisy with CC	19	$25,992	-32%	$7,106
281 Acute Myocardial Infarction, Discharged Alive with CC	19	$21,859	-57%	$7,637
698 Other Kidney and Urinary Tract Diagnoses with MCC	19	$42,326	-42%	$14,102
309 Cardiac Arrhythmia and Conduction Disorders with CC	18	$25,443	-30%	$6,599
377 Gastrointestinal Hemorrhage with MCC	17	$41,309	-52%	$17,944
552 Medical Back Problems without MCC	15	$26,044	-47%	$8,250
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	14	$20,698	-28%	$5,037
314 Other Circulatory System Diagnoses with MCC	14	$52,030	-45%	$18,120
467 Revision of Hip or Knee Replacement with CC	14	$176,746	+12%	$38,446
190 Chronic Obstructive Pulmonary Disease with MCC	13	$38,349	-24%	$8,971
812 Red Blood Cell Disorders without MCC	13	$27,353	-38%	$7,729
057 Degenerative Nervous System Disorders without MCC	11	$26,924	-52%	$11,232
069 Transient Ischemia without Thrombolytic	11	$30,165	-40%	$6,898
101 Seizures without MCC	11	$23,989	-51%	$7,865
329 Major Small and Large Bowel Procedures with MCC	11	$147,840	-31%	$45,654
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	11	$26,611	-56%	$10,760
480 Hip and Femur Procedures except Major Joint with MCC	11	$102,822	-26%	$24,759
637 Diabetes with MCC	11	$25,066	-62%	$12,217
699 Other Kidney and Urinary Tract Diagnoses with CC	11	$18,966	-60%	$8,726

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	368	$17,932	$2,503
Level 5 Musculoskeletal Procedures	225	$77,804	$11,979
Level 1 Laparoscopy and Related Services	89	$40,566	$5,227
Level 2 Upper GI Procedures	62	$12,480	$1,754
Level 6 Musculoskeletal Procedures	55	$106,708	$17,146
Level 2 Excision/ Biopsy/ Incision and Drainage	53	$10,085	$1,450
Level 5 Urology and Related Services	52	$30,297	$4,771
Level 4 Musculoskeletal Procedures	51	$48,111	$6,390
Level 3 Vascular Procedures	50	$18,316	$2,892
Level 4 Urology and Related Services	39	$24,229	$3,149
Level 2 Musculoskeletal Procedures	37	$11,793	$1,482
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	32	$18,579	$3,111
Level 3 Musculoskeletal Procedures	25	$27,322	$2,889
Level 1 Nerve Procedures	23	$11,313	$1,780
Level 1 Endovascular Procedures	18	$26,274	$3,009
Level 3 Excision/ Biopsy/ Incision and Drainage	15	$23,405	$2,620
Level 3 Lower GI Procedures	13	$16,018	$2,588
Level 3 Urology and Related Services	13	$19,372	$1,878
Level 4 Vascular Procedures	12	$32,915	$5,067
Level 2 Laparoscopy and Related Services	12	$71,623	$9,485
Level 4 Gynecologic Procedures	12	$21,022	$2,883

Against the South Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Prisma Health Oconee Memorial Hospital charged $60,552 on average, 21% less than the South Carolina average of $76,532, and was paid $17,149 against a state average of $16,014. For Heart Failure and Shock with MCC (DRG 291), Prisma Health Oconee Memorial Hospital charged $37,339 on average, 18% less than the South Carolina average of $45,682, and was paid $11,593 against a state average of $10,696. For Kidney and Urinary Tract Infections without MCC (DRG 690), Prisma Health Oconee Memorial Hospital charged $25,332 on average, 23% less than the South Carolina average of $32,811, and was paid $7,029 against a state average of $7,345. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Prisma Health Oconee Memorial Hospital charged $33,006 on average, 26% less than the South Carolina average of $44,459, and was paid $9,386 against a state average of $9,001. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,932 was 14% below the state average of $20,764. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $77,804 was 3% below the state average of $80,461. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $40,566 was 12% below the state average of $46,306. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,480 was 11% 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.