Kentucky / Saint Joseph Hospital
CMS certification 180010 · Lexington, KY · 2 entries in CMS's price-transparency list
Saint Joseph Hospital: charges and Medicare payments
Saint Joseph Hospital reported 2,032 Medicare inpatient stays across 67 DRGs in 2024. Across them it charged 3.68 times what it was paid — mid-range in Kentucky, number 31 of 51 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: 389 stays at an average charge of $70,136, 22% below the national average. It also billed 1,628 outpatient services, charging 4.56 times what Medicare paid.
- 1Medicare inpatient stays 2,032
- 2Charge ÷ paid, inpatient 3.68×
- 3Rank in KY (highest ratio = 1) 31 of 51
- 4CMS price-transparency actions 2
Inpatient stays
For the 67 DRGs that can be compared with the national average, Saint Joseph 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 | 389 | $70,136 | -22% | $15,549 |
| 291 Heart Failure and Shock with MCC | 101 | $39,800 | -29% | $9,124 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 101 | $150,579 | -34% | $41,354 |
| 193 Simple Pneumonia and Pleurisy with MCC | 68 | $38,000 | -36% | $9,516 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 47 | $30,366 | -50% | $9,630 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 43 | $30,434 | -38% | $8,006 |
| 177 Respiratory Infections and Inflammations with MCC | 42 | $44,120 | -37% | $11,481 |
| 682 Renal Failure with MCC | 42 | $39,915 | -39% | $10,852 |
| 377 Gastrointestinal Hemorrhage with MCC | 40 | $52,228 | -39% | $13,492 |
| 330 Major Small and Large Bowel Procedures with CC | 39 | $63,204 | -47% | $17,419 |
| 378 Gastrointestinal Hemorrhage with CC | 39 | $29,331 | -40% | $6,923 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 37 | $53,531 | -29% | $12,986 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 36 | $18,518 | -49% | $5,598 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 35 | $54,469 | -45% | $13,733 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 32 | $90,322 | -42% | $21,569 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 32 | $35,276 | -52% | $11,790 |
| 252 Other Vascular Procedures with MCC | 31 | $80,703 | -53% | $24,483 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 30 | $25,745 | -54% | $7,374 |
| 270 Other Major Cardiovascular Procedures with MCC | 29 | $111,789 | -57% | $35,426 |
| 683 Renal Failure with CC | 29 | $23,094 | -43% | $6,651 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 29 | $248,456 | -23% | $57,078 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 28 | $111,657 | -50% | $32,430 |
| 689 Kidney and Urinary Tract Infections with MCC | 27 | $32,585 | -37% | $8,236 |
| 101 Seizures without MCC | 26 | $31,245 | -36% | $6,776 |
| 189 Pulmonary Edema and Respiratory Failure | 26 | $40,289 | -30% | $8,638 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 26 | $88,330 | -68% | $44,510 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $31,007 | -45% | $8,456 |
| 314 Other Circulatory System Diagnoses with MCC | 24 | $58,234 | -39% | $15,605 |
| 235 Coronary Bypass without Cardiac Catheterization with MCC | 23 | $132,087 | -55% | $44,271 |
| 253 Other Vascular Procedures with CC | 22 | $71,111 | -46% | $17,488 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 21 | $31,113 | -38% | $6,947 |
| 329 Major Small and Large Bowel Procedures with MCC | 21 | $104,798 | -51% | $31,924 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 21 | $79,189 | -61% | $35,252 |
| 299 Peripheral Vascular Disorders with MCC | 19 | $32,206 | -57% | $10,952 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $17,988 | -51% | $6,013 |
| 811 Red Blood Cell Disorders with MCC | 19 | $36,421 | -47% | $9,819 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 18 | $104,679 | -50% | $31,382 |
| 271 Other Major Cardiovascular Procedures with CC | 18 | $74,521 | -57% | $24,640 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 18 | $57,137 | -50% | $13,039 |
| 460 Spinal Fusion except Cervical without MCC | 18 | $80,623 | -53% | $23,473 |
| 481 Hip and Femur Procedures except Major Joint with CC | 18 | $47,724 | -53% | $14,120 |
| 069 Transient Ischemia without Thrombolytic | 17 | $24,128 | -52% | $5,692 |
| 239 Amputation for Circulatory System Disorders except Upper... | 15 | $109,828 | -49% | $37,272 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 15 | $102,985 | -8% | $23,771 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 15 | $17,694 | -38% | $4,661 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 14 | $108,324 | -53% | $29,886 |
| 312 Syncope and Collapse | 14 | $26,010 | -43% | $6,184 |
| 305 Hypertension without MCC | 13 | $23,605 | -41% | $6,334 |
| 472 Cervical Spinal Fusion with CC | 13 | $76,110 | -47% | $21,540 |
| 812 Red Blood Cell Disorders without MCC | 13 | $35,400 | -20% | $6,867 |
| 163 Major Chest Procedures with MCC | 12 | $135,975 | -35% | $37,052 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 12 | $47,323 | -45% | $13,811 |
| 432 Cirrhosis and Alcoholic Hepatitis with MCC | 12 | $57,019 | -40% | $15,063 |
| 444 Disorders of The Biliary Tract with MCC | 12 | $43,235 | -48% | $12,288 |
| 453 Combined Anterior and Posterior Spinal Fusion with MCC | 12 | $123,202 | -73% | $59,331 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 12 | $97,426 | -30% | $21,006 |
| 603 Cellulitis without MCC | 12 | $28,209 | -24% | $6,781 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 12 | $116,198 | -46% | $31,016 |
| 039 Extracranial Procedures without CC/MCC | 11 | $39,728 | -38% | $8,509 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 11 | $25,602 | -61% | $9,631 |
Showing the 60 most frequent of 67 DRGs.
Outpatient services
Against the Kentucky average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Saint Joseph Hospital charged $70,136 on average, 11% more than the Kentucky average of $63,454, and was paid $15,549 against a state average of $14,765. For Heart Failure and Shock with MCC (DRG 291), Saint Joseph Hospital charged $39,800 on average, 2% less than the Kentucky average of $40,730, and was paid $9,124 against a state average of $9,552. For Infectious and Parasitic Diseases with O.R. Procedures with MCC (DRG 853), Saint Joseph Hospital charged $150,579 on average, 8% less than the Kentucky average of $164,235, and was paid $41,354 against a state average of $38,113. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Saint Joseph Hospital charged $38,000 on average, 13% less than the Kentucky average of $43,745, and was paid $9,516 against a state average of $9,962. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $10,078 was 47% below the state average of $19,184. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $33,341 was 62% below the state average of $87,601. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $15,807 was 46% below the state average of $29,393. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $46,722 was 46% below the state average of $87,042.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Saint Joseph Hospital in Lexington, KY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-06-04 (CMS case 4888)
- Met Requirements — 2025-06-11 (CMS case 5037)
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.