District of Columbia / Sibley Memorial Hospital

CMS certification 090005 · Washington, DC · 3 entries in CMS's price-transparency list

Sibley Memorial Hospital: charges and Medicare payments

Sibley Memorial Hospital reported 2,639 Medicare inpatient stays across 78 DRGs in 2024. Across them it charged 4.19 times what it was paid — among the higher ratios in District of Columbia, number 2 of 6 hospitals with at least 100 stays (state median 3.83×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 384 stays at an average charge of $67,471, 25% below the national average. It also billed 4,555 outpatient services, charging 5.21 times what Medicare paid.

1Medicare inpatient stays 2,639
2Charge ÷ paid, inpatient 4.19×
3Rank in DC (highest ratio = 1) 2 of 6
4CMS price-transparency actions 3

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

Inpatient stays

For the 78 DRGs that can be compared with the national average, Sibley Memorial Hospital charged more than the national average in 4 (5%). 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	384	$67,471	-25%	$15,885
291 Heart Failure and Shock with MCC	149	$47,798	-15%	$10,231
177 Respiratory Infections and Inflammations with MCC	104	$45,781	-35%	$12,550
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	86	$35,872	-27%	$8,398
193 Simple Pneumonia and Pleurisy with MCC	72	$47,749	-20%	$10,926
690 Kidney and Urinary Tract Infections without MCC	71	$28,433	-25%	$6,278
682 Renal Failure with MCC	61	$46,543	-29%	$11,503
698 Other Kidney and Urinary Tract Diagnoses with MCC	59	$43,802	-40%	$12,853
689 Kidney and Urinary Tract Infections with MCC	58	$37,421	-27%	$9,015
330 Major Small and Large Bowel Procedures with CC	52	$73,002	-39%	$19,016
470 Major Hip and Knee Joint Replacement or Reattachment of...	51	$66,616	-29%	$14,929
603 Cellulitis without MCC	50	$26,291	-29%	$7,197
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	48	$31,432	-22%	$6,466
683 Renal Failure with CC	48	$34,786	-15%	$7,109
378 Gastrointestinal Hemorrhage with CC	46	$34,056	-30%	$7,884
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	45	$49,195	-18%	$10,110
468 Revision of Hip or Knee Replacement without CC/MCC	44	$73,264	-41%	$21,143
853 Infectious and Parasitic Diseases with O.R. Procedures with...	41	$172,866	-24%	$47,326
552 Medical Back Problems without MCC	39	$39,048	-20%	$7,758
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	36	$83,596	-16%	$17,404
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	36	$30,900	-17%	$6,323
329 Major Small and Large Bowel Procedures with MCC	33	$115,742	-46%	$38,391
460 Spinal Fusion except Cervical without MCC	33	$100,020	-41%	$28,030
467 Revision of Hip or Knee Replacement with CC	32	$103,052	-35%	$25,623
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	31	$51,826	-7%	$7,976
309 Cardiac Arrhythmia and Conduction Disorders with CC	30	$34,902	-3%	$6,095
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$40,453	-34%	$10,660
389 Gastrointestinal Obstruction with CC	29	$35,449	-9%	$6,559
194 Simple Pneumonia and Pleurisy with CC	28	$35,371	-8%	$7,143
377 Gastrointestinal Hemorrhage with MCC	28	$65,512	-23%	$14,395
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	27	$70,361	-31%	$17,127
189 Pulmonary Edema and Respiratory Failure	26	$62,074	+8%	$10,440
178 Respiratory Infections and Inflammations with CC	25	$37,669	-17%	$8,082
331 Major Small and Large Bowel Procedures without CC/MCC	25	$50,647	-41%	$13,986
481 Hip and Femur Procedures except Major Joint with CC	23	$68,824	-32%	$15,785
699 Other Kidney and Urinary Tract Diagnoses with CC	23	$31,999	-33%	$8,615
811 Red Blood Cell Disorders with MCC	23	$51,039	-25%	$11,404
812 Red Blood Cell Disorders without MCC	22	$29,585	-33%	$7,193
066 Intracranial Hemorrhage or Cerebral Infarction without...	21	$41,704	-1%	$5,768
165 Major Chest Procedures without CC/MCC	21	$58,255	-44%	$15,512
280 Acute Myocardial Infarction, Discharged Alive with MCC	21	$54,419	-28%	$10,721
374 Digestive Malignancy with MCC	21	$66,333	-34%	$16,431
388 Gastrointestinal Obstruction with MCC	20	$58,480	-15%	$12,136
445 Disorders of The Biliary Tract with CC	20	$45,225	-22%	$8,927
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	18	$59,792	-8%	$10,785
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	18	$30,232	-55%	$10,681
071 Other Cerebrovascular Disorders with CC	17	$42,527	-16%	$8,235
190 Chronic Obstructive Pulmonary Disease with MCC	17	$30,073	-41%	$9,102
390 Gastrointestinal Obstruction without CC/MCC	17	$22,487	-20%	$4,539
393 Other Digestive System Diagnoses with MCC	16	$55,399	-28%	$13,212
948 Signs and Symptoms without MCC	16	$39,479	+4%	$6,279
070 Other Cerebrovascular Disorders with MCC	15	$66,361	-13%	$13,509
202 Bronchitis and Asthma with CC/MCC	15	$27,005	-41%	$8,189
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	15	$23,263	-19%	$5,179
312 Syncope and Collapse	15	$40,706	-11%	$6,732
180 Respiratory Neoplasms with MCC	14	$51,911	-41%	$13,397
314 Other Circulatory System Diagnoses with MCC	14	$56,824	-40%	$17,463
394 Other Digestive System Diagnoses with CC	14	$50,146	+7%	$7,454
435 Malignancy of Hepatobiliary System or Pancreas with MCC	14	$64,805	-31%	$13,830
442 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic...	14	$31,395	-34%	$7,354

Showing the 60 most frequent of 78 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	577	$3,190	$697
Comprehensive Observation Services	413	$19,003	$2,779
Level 5 Musculoskeletal Procedures	402	$43,170	$13,356
Level 2 Excision/ Biopsy/ Incision and Drainage	373	$10,925	$1,647
Level 1 Laparoscopy and Related Services	347	$22,035	$5,863
Level 2 Upper GI Procedures	309	$8,390	$1,942
Level 3 Urology and Related Services	227	$15,162	$2,069
Level 5 Urology and Related Services	220	$24,336	$5,256
Level 2 Laparoscopy and Related Services	153	$38,699	$10,349
Level 4 Urology and Related Services	145	$17,047	$3,547
Level 3 Excision/ Biopsy/ Incision and Drainage	120	$18,402	$2,888
Level 4 Airway Endoscopy	109	$19,643	$3,832
Level 1 Breast/Lymphatic Surgery and Related Procedures	99	$22,818	$3,900
Level 4 Musculoskeletal Procedures	99	$35,139	$7,261
Level 4 Gynecologic Procedures	96	$15,483	$3,172
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	93	$19,664	$3,509
Level 2 Breast/Lymphatic Surgery and Related Procedures	89	$37,847	$6,612
Level 3 Vascular Procedures	88	$19,630	$3,202
Level 5 Airway Endoscopy	69	$27,261	$6,922
Level 2 Vascular Procedures	66	$4,468	$1,639
Level 3 Upper GI Procedures	66	$13,354	$3,871
Level 3 Lower GI Procedures	55	$13,907	$2,827
Complex GI Procedures	53	$21,521	$5,524
Level 6 Musculoskeletal Procedures	51	$65,239	$19,023
Level 3 Airway Endoscopy	46	$10,339	$1,737

Against the District of Columbia average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Sibley Memorial Hospital charged $67,471 on average, 39% less than the District of Columbia average of $110,527, and was paid $15,885 against a state average of $23,955. For Heart Failure and Shock with MCC (DRG 291), Sibley Memorial Hospital charged $47,798 on average, 34% less than the District of Columbia average of $72,832, and was paid $10,231 against a state average of $15,583. For Respiratory Infections and Inflammations with MCC (DRG 177), Sibley Memorial Hospital charged $45,781 on average, 44% less than the District of Columbia average of $81,774, and was paid $12,550 against a state average of $18,038. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Sibley Memorial Hospital charged $35,872 on average, 35% less than the District of Columbia average of $55,261, and was paid $8,398 against a state average of $12,097. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $3,190 was 22% below the state average of $4,095. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,003 was 26% below the state average of $25,706. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $43,170 was 30% below the state average of $61,377. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,925 was 9% below the state average of $11,963.

Price-transparency record

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

Warning Notice — 2023-04-19 (CMS case 1056)
Closure Notice — 2023-08-09 (CMS case 1056)
Met Requirements — 2025-04-18 (CMS case 3962)

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.