South Carolina / Prisma Health Tuomey Hospital
CMS certification 420070 · Sumter, SC
Prisma Health Tuomey Hospital: charges and Medicare payments
Prisma Health Tuomey Hospital reported 1,234 Medicare inpatient stays across 46 DRGs in 2024. Across them it charged 4.13 times what it was paid — mid-range in South Carolina, number 23 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: 171 stays at an average charge of $56,964, 37% below the national average. It also billed 1,430 outpatient services, charging 9.38 times what Medicare paid.
- 1Medicare inpatient stays 1,234
- 2Charge ÷ paid, inpatient 4.13×
- 3Rank in SC (highest ratio = 1) 23 of 45
- 4CMS price-transparency actions 0
Inpatient stays
For the 46 DRGs that can be compared with the national average, Prisma Health Tuomey 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 | 171 | $56,964 | -37% | $13,667 |
| 291 Heart Failure and Shock with MCC | 153 | $37,977 | -33% | $9,560 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 58 | $35,801 | -41% | $10,004 |
| 177 Respiratory Infections and Inflammations with MCC | 53 | $53,059 | -25% | $11,821 |
| 682 Renal Failure with MCC | 34 | $42,455 | -36% | $11,750 |
| 683 Renal Failure with CC | 34 | $23,947 | -41% | $7,333 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 33 | $33,981 | -39% | $7,758 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 31 | $25,978 | -30% | $6,267 |
| 189 Pulmonary Edema and Respiratory Failure | 30 | $31,909 | -45% | $9,065 |
| 193 Simple Pneumonia and Pleurisy with MCC | 30 | $49,973 | -16% | $10,283 |
| 312 Syncope and Collapse | 29 | $24,516 | -46% | $7,020 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 28 | $22,866 | -37% | $6,673 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 28 | $36,531 | -26% | $9,148 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 26 | $53,871 | -27% | $13,054 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 25 | $135,667 | -41% | $31,723 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $30,006 | -21% | $6,721 |
| 812 Red Blood Cell Disorders without MCC | 23 | $35,520 | -20% | $7,684 |
| 481 Hip and Femur Procedures except Major Joint with CC | 22 | $78,710 | -22% | $17,593 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 21 | $46,693 | -53% | $11,402 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 21 | $102,333 | 0% | $16,538 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 20 | $34,704 | -31% | $10,175 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 19 | $29,190 | -27% | $5,830 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 18 | $34,554 | -54% | $9,104 |
| 178 Respiratory Infections and Inflammations with CC | 17 | $41,338 | -9% | $7,678 |
| 314 Other Circulatory System Diagnoses with MCC | 16 | $54,266 | -43% | $14,394 |
| 638 Diabetes with CC | 16 | $20,570 | -51% | $7,297 |
| 069 Transient Ischemia without Thrombolytic | 15 | $30,512 | -40% | $6,509 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 15 | $38,274 | -32% | $9,136 |
| 603 Cellulitis without MCC | 15 | $17,316 | -54% | $7,125 |
| 057 Degenerative Nervous System Disorders without MCC | 14 | $47,952 | -15% | $11,127 |
| 378 Gastrointestinal Hemorrhage with CC | 14 | $28,258 | -42% | $7,430 |
| 552 Medical Back Problems without MCC | 14 | $23,276 | -52% | $8,790 |
| 101 Seizures without MCC | 13 | $29,007 | -41% | $6,872 |
| 300 Peripheral Vascular Disorders with CC | 13 | $39,200 | -21% | $7,881 |
| 389 Gastrointestinal Obstruction with CC | 13 | $26,485 | -32% | $5,939 |
| 394 Other Digestive System Diagnoses with CC | 13 | $33,863 | -28% | $7,897 |
| 637 Diabetes with MCC | 13 | $36,957 | -44% | $9,453 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $34,177 | -33% | $8,469 |
| 070 Other Cerebrovascular Disorders with MCC | 12 | $50,466 | -34% | $12,758 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 12 | $20,873 | -27% | $5,404 |
| 091 Other Disorders of Nervous System with MCC | 11 | $39,891 | -52% | $12,269 |
| 194 Simple Pneumonia and Pleurisy with CC | 11 | $36,155 | -6% | $6,864 |
| 305 Hypertension without MCC | 11 | $26,529 | -34% | $6,241 |
| 330 Major Small and Large Bowel Procedures with CC | 11 | $112,200 | -6% | $17,747 |
| 811 Red Blood Cell Disorders with MCC | 11 | $44,162 | -35% | $10,750 |
| 884 Organic Disturbances and Intellectual Disability | 11 | $31,005 | -50% | $12,830 |
Outpatient services
Against the South Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Prisma Health Tuomey Hospital charged $56,964 on average, 26% less than the South Carolina average of $76,532, and was paid $13,667 against a state average of $16,014. For Heart Failure and Shock with MCC (DRG 291), Prisma Health Tuomey Hospital charged $37,977 on average, 17% less than the South Carolina average of $45,682, and was paid $9,560 against a state average of $10,696. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC (DRG 640), Prisma Health Tuomey Hospital charged $35,801 on average, 22% less than the South Carolina average of $45,956, and was paid $10,004 against a state average of $10,975. For Respiratory Infections and Inflammations with MCC (DRG 177), Prisma Health Tuomey Hospital charged $53,059 on average, 15% less than the South Carolina average of $62,241, and was paid $11,821 against a state average of $13,455. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,779 was 29% below the state average of $20,764. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,715 was 17% below the state average of $11,718. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $79,986 was 1% below the state average of $80,461. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $31,450 was 19% below the state average of $38,828.
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.