Michigan / Promedica Charles and Virginia Hickman Hospital
CMS certification 230005 · Adrian, MI
Promedica Charles and Virginia Hickman Hospital: charges and Medicare payments
Promedica Charles and Virginia Hickman Hospital reported 462 Medicare inpatient stays across 14 DRGs in 2024. Across them it charged 3.5 times what it was paid — among the higher ratios in Michigan, number 22 of 76 hospitals with at least 100 stays (state median 3.09×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 124 stays at an average charge of $55,880, 38% below the national average. It also billed 948 outpatient services, charging 8.65 times what Medicare paid.
- 1Medicare inpatient stays 462
- 2Charge ÷ paid, inpatient 3.5×
- 3Rank in MI (highest ratio = 1) 22 of 76
- 4CMS price-transparency actions 0
Inpatient stays
For the 14 DRGs that can be compared with the national average, Promedica Charles and Virginia Hickman 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 | 124 | $55,880 | -38% | $16,268 |
| 291 Heart Failure and Shock with MCC | 89 | $32,510 | -42% | $11,016 |
| 189 Pulmonary Edema and Respiratory Failure | 47 | $39,889 | -31% | $10,547 |
| 193 Simple Pneumonia and Pleurisy with MCC | 45 | $45,838 | -23% | $11,126 |
| 177 Respiratory Infections and Inflammations with MCC | 32 | $46,305 | -34% | $13,835 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 18 | $32,325 | -57% | $12,513 |
| 481 Hip and Femur Procedures except Major Joint with CC | 17 | $73,494 | -27% | $16,924 |
| 682 Renal Failure with MCC | 15 | $39,115 | -41% | $12,305 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $33,405 | -32% | $8,770 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 13 | $29,264 | -48% | $9,990 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 12 | $41,569 | -25% | $8,308 |
| 683 Renal Failure with CC | 12 | $31,498 | -23% | $7,472 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $29,584 | -22% | $6,640 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $29,498 | -20% | $6,818 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 301 | $14,096 | $2,147 |
| Comprehensive Observation Services | 179 | $24,001 | $2,465 |
| Level 5 Musculoskeletal Procedures | 90 | $72,441 | $11,923 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 48 | $10,009 | $1,475 |
| Level 1 Nerve Procedures | 46 | $10,438 | $1,786 |
| Level 4 Musculoskeletal Procedures | 34 | $41,000 | $5,934 |
| Level 3 Vascular Procedures | 32 | $27,066 | $2,783 |
| Level 1 Laparoscopy and Related Services | 32 | $48,124 | $5,075 |
| Level 3 Urology and Related Services | 31 | $20,086 | $1,742 |
| Level 3 Musculoskeletal Procedures | 29 | $25,799 | $2,912 |
| Level 4 Urology and Related Services | 29 | $29,110 | $3,138 |
| Level 5 Urology and Related Services | 28 | $38,935 | $4,786 |
| Level 2 Musculoskeletal Procedures | 21 | $8,737 | $1,487 |
| Level 6 Musculoskeletal Procedures | 13 | $66,617 | $17,200 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $17,369 | $2,454 |
| Level 2 Intraocular Procedures | 12 | $22,576 | $3,761 |
| Level 3 Intraocular Procedures | 11 | $22,362 | $4,834 |
Against the Michigan average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Promedica Charles and Virginia Hickman Hospital charged $55,880 on average, 3% more than the Michigan average of $54,260, and was paid $16,268 against a state average of $17,096. For Heart Failure and Shock with MCC (DRG 291), Promedica Charles and Virginia Hickman Hospital charged $32,510 on average, 9% less than the Michigan average of $35,827, and was paid $11,016 against a state average of $11,565. For Pulmonary Edema and Respiratory Failure (DRG 189), Promedica Charles and Virginia Hickman Hospital charged $39,889 on average, 6% more than the Michigan average of $37,617, and was paid $10,547 against a state average of $11,581. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Promedica Charles and Virginia Hickman Hospital charged $45,838 on average, 28% more than the Michigan average of $35,850, and was paid $11,126 against a state average of $11,562. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $14,096 was 18% above the state average of $11,973. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,001 was 56% above the state average of $15,355. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $72,441 was 50% above the state average of $48,446. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,009 was 36% above the state average of $7,344.
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.