Sentara Martha Jefferson Hospital: charges and Medicare payments

Sentara Martha Jefferson Hospital reported 2,092 Medicare inpatient stays across 61 DRGs in 2024. Across them it charged 3.09 times what it was paid — among the lower ratios in Virginia, number 46 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: 343 stays at an average charge of $35,875, 60% below the national average. It also billed 3,477 outpatient services, charging 5.33 times what Medicare paid.

1Medicare inpatient stays 2,092
2Charge ÷ paid, inpatient 3.09×
3Rank in VA (highest ratio = 1) 46 of 66
4CMS price-transparency actions 0

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

Inpatient stays

For the 61 DRGs that can be compared with the national average, Sentara Martha Jefferson 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	343	$35,875	-60%	$12,936
291 Heart Failure and Shock with MCC	153	$25,647	-55%	$8,761
280 Acute Myocardial Infarction, Discharged Alive with MCC	97	$32,380	-57%	$10,309
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	83	$24,715	-50%	$7,031
177 Respiratory Infections and Inflammations with MCC	77	$28,410	-60%	$10,356
193 Simple Pneumonia and Pleurisy with MCC	58	$23,923	-60%	$8,440
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	45	$27,077	-51%	$7,432
309 Cardiac Arrhythmia and Conduction Disorders with CC	43	$13,679	-62%	$5,104
281 Acute Myocardial Infarction, Discharged Alive with CC	42	$28,033	-44%	$5,950
308 Cardiac Arrhythmia and Conduction Disorders with MCC	42	$25,166	-56%	$8,887
378 Gastrointestinal Hemorrhage with CC	42	$25,325	-48%	$7,134
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	41	$18,590	-54%	$5,389
481 Hip and Femur Procedures except Major Joint with CC	39	$43,593	-57%	$13,603
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	37	$49,259	-52%	$13,529
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	36	$23,099	-62%	$8,125
190 Chronic Obstructive Pulmonary Disease with MCC	34	$22,091	-56%	$7,352
682 Renal Failure with MCC	34	$27,670	-58%	$9,778
853 Infectious and Parasitic Diseases with O.R. Procedures with...	34	$92,848	-59%	$31,545
689 Kidney and Urinary Tract Infections with MCC	33	$22,618	-56%	$7,302
698 Other Kidney and Urinary Tract Diagnoses with MCC	33	$18,255	-75%	$9,861
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	31	$36,502	-63%	$12,776
377 Gastrointestinal Hemorrhage with MCC	30	$38,651	-55%	$13,446
690 Kidney and Urinary Tract Infections without MCC	29	$15,937	-58%	$5,333
287 Circulatory Disorders except AMI, with Cardiac...	28	$32,277	-49%	$7,830
322 Percutaneous Cardiovascular Procedures with Intraluminal...	28	$58,904	-49%	$13,061
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	26	$30,784	-53%	$9,683
286 Circulatory Disorders except AMI, with Cardiac...	26	$43,877	-61%	$14,580
321 Percutaneous Cardiovascular Procedures with Intraluminal...	26	$72,499	-56%	$20,718
603 Cellulitis without MCC	25	$17,072	-54%	$5,556
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	25	$14,713	-60%	$5,218
189 Pulmonary Edema and Respiratory Failure	24	$29,622	-49%	$8,140
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	24	$11,632	-60%	$4,140
683 Renal Failure with CC	23	$17,101	-58%	$5,844
470 Major Hip and Knee Joint Replacement or Reattachment of...	22	$41,178	-56%	$13,484
025 Craniotomy and Endovascular Intracranial Procedures with MCC	21	$98,374	-58%	$29,794
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	21	$31,799	-48%	$8,829
312 Syncope and Collapse	17	$31,490	-31%	$6,591
330 Major Small and Large Bowel Procedures with CC	17	$75,279	-37%	$18,010
536 Fractures of Hip and Pelvis without MCC	17	$15,499	-59%	$5,025
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	16	$66,681	-67%	$29,459
811 Red Blood Cell Disorders with MCC	16	$20,678	-70%	$10,049
854 Infectious and Parasitic Diseases with O.R. Procedures with...	16	$43,126	-56%	$13,965
069 Transient Ischemia without Thrombolytic	15	$26,329	-48%	$5,835
331 Major Small and Large Bowel Procedures without CC/MCC	15	$62,688	-27%	$10,814
389 Gastrointestinal Obstruction with CC	15	$19,807	-49%	$5,290
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	15	$18,501	-57%	$5,661
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	14	$55,067	-59%	$20,597
091 Other Disorders of Nervous System with MCC	13	$28,231	-66%	$10,467
253 Other Vascular Procedures with CC	13	$57,953	-56%	$17,667
315 Other Circulatory System Diagnoses with CC	13	$20,468	-57%	$6,224
919 Complications of Treatment with MCC	13	$24,345	-72%	$11,368
480 Hip and Femur Procedures except Major Joint with MCC	12	$66,778	-52%	$18,725
643 Endocrine Disorders with MCC	12	$36,279	-51%	$10,599
039 Extracranial Procedures without CC/MCC	11	$30,033	-53%	$7,370
092 Other Disorders of Nervous System with CC	11	$23,739	-54%	$7,731
194 Simple Pneumonia and Pleurisy with CC	11	$28,563	-26%	$5,381
282 Acute Myocardial Infarction, Discharged Alive without CC/MCC	11	$24,393	-44%	$5,255
313 Chest Pain	11	$17,889	-55%	$4,724
454 Combined Anterior and Posterior Spinal Fusion with CC	11	$74,759	-73%	$39,111
467 Revision of Hip or Knee Replacement with CC	11	$72,875	-54%	$19,761

Showing the 60 most frequent of 61 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	680	$13,053	$2,332
Level 5 Musculoskeletal Procedures	372	$32,971	$11,196
Level 2 Excision/ Biopsy/ Incision and Drainage	260	$7,710	$1,384
Level 1 Endovascular Procedures	184	$23,817	$2,804
Level 2 Upper GI Procedures	169	$9,932	$1,654
Level 3 Vascular Procedures	124	$17,938	$2,736
Level 5 Urology and Related Services	123	$24,760	$4,471
Level 1 Laparoscopy and Related Services	115	$30,911	$4,879
Level 4 Urology and Related Services	112	$10,941	$2,988
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	104	$18,262	$2,993
Level 3 Electrophysiologic Procedures	91	$73,176	$20,389
Level 3 Endovascular Procedures	81	$52,204	$9,558
Level 4 Musculoskeletal Procedures	80	$29,852	$6,220
Level 2 Endovascular Procedures	76	$26,046	$4,917
Level 2 Intraocular Procedures	75	$16,056	$3,535
Level 3 Excision/ Biopsy/ Incision and Drainage	69	$18,375	$2,442
Level 3 Pacemaker and Similar Procedures	64	$42,800	$9,279
Level 2 Vascular Procedures	61	$9,088	$1,392
Level 3 Urology and Related Services	61	$9,692	$1,748
Level 3 Musculoskeletal Procedures	58	$17,192	$2,776
Level 1 Breast/Lymphatic Surgery and Related Procedures	56	$14,886	$3,173
Level 4 Airway Endoscopy	45	$17,432	$3,198
Level 3 Lower GI Procedures	39	$13,286	$2,410
Level 6 Musculoskeletal Procedures	38	$45,632	$15,787
Level 2 Musculoskeletal Procedures	33	$8,351	$1,365

Against the Virginia average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Sentara Martha Jefferson Hospital charged $35,875 on average, 45% less than the Virginia average of $65,235, and was paid $12,936 against a state average of $16,367. For Heart Failure and Shock with MCC (DRG 291), Sentara Martha Jefferson Hospital charged $25,647 on average, 37% less than the Virginia average of $40,795, and was paid $8,761 against a state average of $11,030. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Sentara Martha Jefferson Hospital charged $32,380 on average, 44% less than the Virginia average of $57,438, and was paid $10,309 against a state average of $13,197. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Sentara Martha Jefferson Hospital charged $24,715 on average, 33% less than the Virginia average of $37,022, and was paid $7,031 against a state average of $8,962. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $13,053 was 33% below the state average of $19,506. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $32,971 was 61% below the state average of $83,920. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,710 was 31% below the state average of $11,217. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $23,817 was 25% below the state average of $31,869.

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.