Missouri / Progress West Hospital
CMS certification 260219 · O Fallon, MO · 2 entries in CMS's price-transparency list
Progress West Hospital: charges and Medicare payments
Progress West Hospital reported 430 Medicare inpatient stays across 17 DRGs in 2024. Across them it charged 4 times what it was paid — mid-range in Missouri, number 28 of 59 hospitals with at least 100 stays (state median 3.85×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 102 stays at an average charge of $46,207, 49% below the national average. It also billed 467 outpatient services, charging 4.74 times what Medicare paid.
- 1Medicare inpatient stays 430
- 2Charge ÷ paid, inpatient 4×
- 3Rank in MO (highest ratio = 1) 28 of 59
- 4CMS price-transparency actions 2
Inpatient stays
For the 17 DRGs that can be compared with the national average, Progress West 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 | 102 | $46,207 | -49% | $12,955 |
| 291 Heart Failure and Shock with MCC | 40 | $37,437 | -34% | $9,002 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 29 | $33,820 | -16% | $6,087 |
| 690 Kidney and Urinary Tract Infections without MCC | 28 | $27,910 | -26% | $6,220 |
| 177 Respiratory Infections and Inflammations with MCC | 27 | $42,737 | -39% | $12,282 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 27 | $31,107 | -37% | $8,502 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $42,804 | -28% | $10,050 |
| 481 Hip and Femur Procedures except Major Joint with CC | 22 | $69,823 | -31% | $15,419 |
| 378 Gastrointestinal Hemorrhage with CC | 21 | $32,849 | -32% | $7,144 |
| 689 Kidney and Urinary Tract Infections with MCC | 20 | $34,096 | -34% | $8,272 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 16 | $53,173 | -43% | $15,256 |
| 603 Cellulitis without MCC | 14 | $24,150 | -35% | $7,196 |
| 189 Pulmonary Edema and Respiratory Failure | 13 | $31,027 | -46% | $8,936 |
| 312 Syncope and Collapse | 12 | $32,797 | -28% | $6,660 |
| 389 Gastrointestinal Obstruction with CC | 12 | $34,020 | -13% | $6,483 |
| 682 Renal Failure with MCC | 12 | $54,837 | -17% | $11,788 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $28,372 | -23% | $6,114 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 140 | $40,348 | $11,554 |
| Level 2 Upper GI Procedures | 44 | $6,775 | $1,693 |
| Comprehensive Observation Services | 42 | $17,007 | $2,390 |
| Level 3 Musculoskeletal Procedures | 35 | $16,343 | $2,624 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 34 | $7,109 | $1,333 |
| Level 1 Nerve Procedures | 34 | $9,981 | $1,718 |
| Level 4 Musculoskeletal Procedures | 30 | $30,567 | $6,217 |
| Level 1 Endovascular Procedures | 30 | $11,066 | $2,905 |
| Level 2 Musculoskeletal Procedures | 25 | $8,631 | $1,430 |
| Level 6 Musculoskeletal Procedures | 23 | $58,844 | $16,551 |
| Level 1 Laparoscopy and Related Services | 19 | $20,819 | $4,920 |
| Level 4 Gynecologic Procedures | 11 | $13,995 | $2,581 |
Against the Missouri average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Progress West Hospital charged $46,207 on average, 37% less than the Missouri average of $72,886, and was paid $12,955 against a state average of $15,808. For Heart Failure and Shock with MCC (DRG 291), Progress West Hospital charged $37,437 on average, 19% less than the Missouri average of $46,468, and was paid $9,002 against a state average of $10,539. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Progress West Hospital charged $33,820 on average, 4% more than the Missouri average of $32,372, and was paid $6,087 against a state average of $6,937. For Kidney and Urinary Tract Infections without MCC (DRG 690), Progress West Hospital charged $27,910 on average, 8% less than the Missouri average of $30,270, and was paid $6,220 against a state average of $6,812. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $40,348 was 23% below the state average of $52,262. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $6,775 was 30% below the state average of $9,712. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,007 was 17% below the state average of $20,571. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $16,343 was 13% below the state average of $18,725.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Progress West Hospital in O Fallon, MO, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-06-15 (CMS case 326)
- Met Requirements — 2025-08-01 (CMS case 6097)
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.