Illinois / Saint James Hospital
CMS certification 140161 · Pontiac, IL
Saint James Hospital: charges and Medicare payments
Saint James Hospital reported 271 Medicare inpatient stays across 11 DRGs in 2024. Across them it charged 2.57 times what it was paid — among the lower ratios in Illinois, number 95 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 85 stays at an average charge of $48,086, 47% below the national average. It also billed 157 outpatient services, charging 8.05 times what Medicare paid.
- 1Medicare inpatient stays 271
- 2Charge ÷ paid, inpatient 2.57×
- 3Rank in IL (highest ratio = 1) 95 of 106
- 4CMS price-transparency actions 0
Inpatient stays
For the 11 DRGs that can be compared with the national average, Saint James 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 | 85 | $48,086 | -47% | $20,130 |
| 291 Heart Failure and Shock with MCC | 46 | $35,103 | -38% | $13,836 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 22 | $34,015 | -31% | $10,504 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 20 | $34,221 | -32% | $11,339 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $31,370 | -48% | $13,487 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $50,102 | -29% | $17,094 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $25,026 | -32% | $9,004 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $41,659 | -28% | $12,524 |
| 682 Renal Failure with MCC | 13 | $33,511 | -49% | $15,273 |
| 689 Kidney and Urinary Tract Infections with MCC | 12 | $25,258 | -51% | $11,987 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 11 | $24,158 | -43% | $9,206 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 67 | $20,069 | $2,692 |
| Level 1 Intraocular Procedures | 32 | $9,653 | $2,230 |
| Level 2 Upper GI Procedures | 30 | $10,718 | $1,866 |
| Level 1 Nerve Procedures | 28 | $11,814 | $1,945 |
Against the Illinois average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Saint James Hospital charged $48,086 on average, 35% less than the Illinois average of $73,987, and was paid $20,130 against a state average of $17,651. For Heart Failure and Shock with MCC (DRG 291), Saint James Hospital charged $35,103 on average, 24% less than the Illinois average of $46,293, and was paid $13,836 against a state average of $11,813. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Saint James Hospital charged $34,015 on average, 17% less than the Illinois average of $41,000, and was paid $10,504 against a state average of $9,886. For Chronic Obstructive Pulmonary Disease with MCC (DRG 190), Saint James Hospital charged $34,221 on average, 22% less than the Illinois average of $44,134, and was paid $11,339 against a state average of $10,405. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $20,069 was 7% below the state average of $21,498. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,653 was 35% below the state average of $14,917. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $10,718 was 22% below the state average of $13,666. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $11,814 was 8% below the state average of $12,903.
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.