Virginia / Reston Hospital Center

CMS certification 490107 · Reston, VA · 3 entries in CMS's price-transparency list

Reston Hospital Center: charges and Medicare payments

Reston Hospital Center reported 2,122 Medicare inpatient stays across 79 DRGs in 2024. Across them it charged 6.84 times what it was paid — among the higher ratios in Virginia, number 6 of 66 hospitals with at least 100 stays (state median 3.6×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 259 stays at an average charge of $95,353, 6% above the national average. It also billed 1,831 outpatient services, charging 10.9 times what Medicare paid.

1Medicare inpatient stays 2,122
2Charge ÷ paid, inpatient 6.84×
3Rank in VA (highest ratio = 1) 6 of 66
4CMS price-transparency actions 3

Average charge per stay at Reston Hospital Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 79 DRGs that can be compared with the national average, Reston Hospital Center charged more than the national average in 61 (77%). 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	259	$95,353	+6%	$15,424
291 Heart Failure and Shock with MCC	89	$59,655	+6%	$10,961
193 Simple Pneumonia and Pleurisy with MCC	66	$69,977	+17%	$10,196
454 Combined Anterior and Posterior Spinal Fusion with CC	65	$367,844	+31%	$53,823
177 Respiratory Infections and Inflammations with MCC	64	$70,434	0%	$12,113
552 Medical Back Problems without MCC	61	$55,538	+14%	$7,472
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	47	$294,277	+45%	$39,707
470 Major Hip and Knee Joint Replacement or Reattachment of...	47	$118,059	+27%	$15,125
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	46	$67,430	+37%	$8,114
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	45	$82,967	-17%	$14,505
689 Kidney and Urinary Tract Infections with MCC	42	$55,768	+9%	$8,999
481 Hip and Femur Procedures except Major Joint with CC	40	$126,008	+25%	$15,096
460 Spinal Fusion except Cervical without MCC	35	$203,824	+20%	$30,086
682 Renal Failure with MCC	35	$74,443	+13%	$11,088
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	34	$42,222	+5%	$6,354
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	33	$67,438	+21%	$8,621
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	33	$58,331	-3%	$10,110
472 Cervical Spinal Fusion with CC	32	$115,254	-19%	$23,863
853 Infectious and Parasitic Diseases with O.R. Procedures with...	32	$212,406	-7%	$32,643
312 Syncope and Collapse	31	$49,142	+8%	$7,273
280 Acute Myocardial Infarction, Discharged Alive with MCC	30	$87,656	+16%	$11,638
309 Cardiac Arrhythmia and Conduction Disorders with CC	29	$40,892	+13%	$6,270
378 Gastrointestinal Hemorrhage with CC	26	$45,605	-6%	$7,669
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	26	$121,271	+19%	$15,823
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	26	$48,236	+30%	$6,029
690 Kidney and Urinary Tract Infections without MCC	26	$41,533	+10%	$6,309
467 Revision of Hip or Knee Replacement with CC	23	$173,101	+10%	$24,855
603 Cellulitis without MCC	23	$44,178	+18%	$6,887
189 Pulmonary Edema and Respiratory Failure	22	$65,648	+14%	$9,682
305 Hypertension without MCC	22	$50,758	+27%	$6,012
468 Revision of Hip or Knee Replacement without CC/MCC	22	$144,158	+16%	$19,837
683 Renal Failure with CC	22	$50,514	+24%	$6,889
811 Red Blood Cell Disorders with MCC	21	$64,539	-5%	$10,706
101 Seizures without MCC	20	$69,850	+43%	$7,136
322 Percutaneous Cardiovascular Procedures with Intraluminal...	20	$133,521	+17%	$16,315
812 Red Blood Cell Disorders without MCC	20	$48,625	+10%	$7,480
149 Dysequilibrium	19	$64,690	+46%	$6,384
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	19	$26,556	-8%	$4,835
536 Fractures of Hip and Pelvis without MCC	19	$48,183	+28%	$6,010
884 Organic Disturbances and Intellectual Disability	19	$82,697	+33%	$13,114
164 Major Chest Procedures with CC	18	$173,519	+36%	$19,792
605 Trauma To The Skin, Subcutaneous Tissue and Breast without...	18	$55,898	+21%	$7,125
057 Degenerative Nervous System Disorders without MCC	17	$62,728	+11%	$9,540
086 Traumatic Stupor and Coma <1 Hour with CC	17	$61,932	-9%	$10,784
100 Seizures with MCC	17	$128,300	+36%	$14,234
194 Simple Pneumonia and Pleurisy with CC	17	$53,325	+39%	$6,277
281 Acute Myocardial Infarction, Discharged Alive with CC	17	$58,733	+16%	$7,064
389 Gastrointestinal Obstruction with CC	17	$41,435	+6%	$6,330
551 Medical Back Problems with MCC	17	$69,291	-12%	$11,617
482 Hip and Femur Procedures except Major Joint without CC/MCC	16	$85,288	+9%	$11,811
069 Transient Ischemia without Thrombolytic	15	$57,238	+13%	$6,503
208 Respiratory System Diagnosis with Ventilator Support <=96...	15	$137,127	+1%	$21,651
453 Combined Anterior and Posterior Spinal Fusion with MCC	15	$422,269	-7%	$65,365
308 Cardiac Arrhythmia and Conduction Disorders with MCC	14	$68,947	+22%	$10,913
330 Major Small and Large Bowel Procedures with CC	14	$144,713	+22%	$18,599
418 Laparoscopic Cholecystectomy without C.D.E. with CC	14	$143,231	+54%	$14,054
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	14	$49,470	+16%	$6,467
165 Major Chest Procedures without CC/MCC	13	$163,414	+58%	$14,011
402 Single Level Combined Anterior and Posterior Spinal Fusion...	13	$267,362	+42%	$45,418
427 Multiple Level Combined Anterior and Posterior Spinal Fusion...	13	$413,070	+21%	$57,032

Showing the 60 most frequent of 79 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	467	$100,110	$12,201
Comprehensive Observation Services	172	$28,246	$2,557
Level 4 Musculoskeletal Procedures	103	$63,608	$6,690
Level 1 Laparoscopy and Related Services	93	$62,145	$5,372
Level 2 Upper GI Procedures	88	$14,632	$1,803
Level 6 Musculoskeletal Procedures	74	$165,966	$17,432
Level 2 Excision/ Biopsy/ Incision and Drainage	71	$13,473	$1,536
Level 3 Urology and Related Services	67	$26,506	$1,907
Level 1 Endovascular Procedures	66	$43,158	$3,092
Level 3 Vascular Procedures	64	$27,012	$2,982
Level 5 Urology and Related Services	61	$40,220	$4,838
Level 2 Laparoscopy and Related Services	55	$107,573	$9,450
Level 3 Musculoskeletal Procedures	51	$30,114	$3,022
Level 4 Urology and Related Services	47	$29,781	$3,303
Level 3 Excision/ Biopsy/ Incision and Drainage	42	$18,711	$2,652
Level 2 Musculoskeletal Procedures	38	$16,622	$1,523
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	34	$30,690	$3,277
Level 1 Nerve Procedures	31	$20,117	$1,670
Level 2 Breast/Lymphatic Surgery and Related Procedures	27	$79,230	$5,995
Level 4 Airway Endoscopy	26	$24,632	$3,439
Level 6 Urology and Related Services	25	$85,350	$8,724
Level 3 Endovascular Procedures	24	$86,627	$10,098
Level 2 Vascular Procedures	21	$7,478	$1,517
Level 4 Vascular Procedures	21	$50,413	$5,008
Level 3 Airway Endoscopy	18	$18,819	$1,608

Against the Virginia average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Reston Hospital Center charged $95,353 on average, 46% more than the Virginia average of $65,235, and was paid $15,424 against a state average of $16,367. For Heart Failure and Shock with MCC (DRG 291), Reston Hospital Center charged $59,655 on average, 46% more than the Virginia average of $40,795, and was paid $10,961 against a state average of $11,030. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Reston Hospital Center charged $69,977 on average, 56% more than the Virginia average of $44,717, and was paid $10,196 against a state average of $11,065. For Combined Anterior and Posterior Spinal Fusion with CC (DRG 454), Reston Hospital Center charged $367,844 on average, 23% more than the Virginia average of $299,730, and was paid $53,823 against a state average of $56,567. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $100,110 was 19% above the state average of $83,920. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $28,246 was 45% above the state average of $19,506. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $63,608 was 19% above the state average of $53,311. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $62,145 was 38% above the state average of $45,021.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Reston Hospital Center in Reston, VA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2023-06-28 (CMS case 1322)
Closure Notice — 2023-10-17 (CMS case 1322)
Met Requirements — 2025-04-30 (CMS case 4208)

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.