South Dakota / Sioux Falls Specialty Hospital Llp

CMS certification 430090 · Sioux Falls, SD · 1 entry in CMS's price-transparency list

Sioux Falls Specialty Hospital Llp: charges and Medicare payments

Sioux Falls Specialty Hospital Llp reported 185 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 4.04 times what it was paid — mid-range in South Dakota, number 5 of 12 hospitals with at least 100 stays (state median 3.53×, national 4.15×). Its most frequent stay was DRG 468, Revision of Hip or Knee Replacement without CC/MCC: 41 stays at an average charge of $69,210, 44% below the national average. It also billed 3,435 outpatient services, charging 5.23 times what Medicare paid.

1Medicare inpatient stays 185
2Charge ÷ paid, inpatient 4.04×
3Rank in SD (highest ratio = 1) 5 of 12
4CMS price-transparency actions 1

Average charge per stay at Sioux Falls Specialty Hospital Llp, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 7 DRGs that can be compared with the national average, Sioux Falls Specialty Hospital Llp charged more than the national average in 1 (14%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
468 Revision of Hip or Knee Replacement without CC/MCC	41	$69,210	-44%	$18,336
467 Revision of Hip or Knee Replacement with CC	35	$65,696	-58%	$23,256
483 Major Joint or Limb Reattachment Procedures of Upper...	35	$55,339	-56%	$17,319
470 Major Hip and Knee Joint Replacement or Reattachment of...	30	$56,376	-40%	$13,015
460 Spinal Fusion except Cervical without MCC	17	$215,158	+26%	$28,105
488 Knee Procedures without Principal Diagnosis of Infection...	14	$40,820	-58%	$13,953
489 Knee Procedures without Principal Diagnosis of Infection...	13	$40,231	-34%	$8,556

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	1,213	$45,509	$12,287
Level 4 Musculoskeletal Procedures	401	$43,367	$6,636
Level 1 Nerve Procedures	393	$12,375	$1,807
Level 3 Musculoskeletal Procedures	335	$21,492	$3,014
Level 6 Musculoskeletal Procedures	277	$70,519	$17,356
Level 2 Musculoskeletal Procedures	132	$10,309	$1,498
Level 2 Intraocular Procedures	122	$11,923	$3,812
Level 2 Laparoscopy and Related Services	76	$40,571	$9,644
Level 4 Urology and Related Services	72	$16,096	$3,268
Level 5 Urology and Related Services	70	$19,188	$4,851
Level 5 Neurostimulator and Related Procedures	54	$148,479	$29,027
Level 5 Airway Endoscopy	35	$82,251	$6,271
Level 3 Excision/ Biopsy/ Incision and Drainage	34	$10,542	$2,664
Level 3 Urology and Related Services	33	$8,095	$1,910
Level 2 Neurostimulator and Related Procedures	33	$58,888	$6,412
Level 5 ENT Procedures	25	$40,830	$5,490
Level 4 ENT Procedures	22	$25,657	$2,922
Level 2 Excision/ Biopsy/ Incision and Drainage	21	$9,134	$1,520
Level 3 Airway Endoscopy	21	$5,174	$1,591
Level 1 Laparoscopy and Related Services	21	$27,831	$5,410
Level 4 Airway Endoscopy	17	$17,455	$3,511
Level 6 Urology and Related Services	17	$34,739	$8,634
Level 2 Breast/Lymphatic Surgery and Related Procedures	11	$32,683	$6,114

Against the South Dakota average

For Revision of Hip or Knee Replacement without CC/MCC (DRG 468), Sioux Falls Specialty Hospital Llp charged $69,210 on average, 19% less than the South Dakota average of $85,029, and was paid $18,336 against a state average of $19,804. For Revision of Hip or Knee Replacement with CC (DRG 467), Sioux Falls Specialty Hospital Llp charged $65,696 on average, 32% less than the South Dakota average of $97,214, and was paid $23,256 against a state average of $25,802. For Major Joint or Limb Reattachment Procedures of Upper Extremities (DRG 483), Sioux Falls Specialty Hospital Llp charged $55,339 on average, 5% less than the South Dakota average of $58,334, and was paid $17,319 against a state average of $17,988. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Sioux Falls Specialty Hospital Llp charged $56,376 on average, 8% more than the South Dakota average of $52,397, and was paid $13,015 against a state average of $13,781. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $45,509 was 6% below the state average of $48,584. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $43,367 was 33% above the state average of $32,535. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $12,375 was 23% above the state average of $10,045. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $21,492 was 34% above the state average of $16,040.

Price-transparency record

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

Warning Notice — 2026-07-22 (CMS case 8306)

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.