Texas / South Texas Health System Behavioral
CMS certification 450119 · Edinburg, TX
South Texas Health System Behavioral: charges and Medicare payments
South Texas Health System Behavioral reported 1,762 Medicare inpatient stays across 55 DRGs in 2024. Across them it charged 12.96 times what it was paid — among the higher ratios in Texas, number 9 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 357 stays at an average charge of $267,798, 197% above the national average. It also billed 460 outpatient services, charging 30.27 times what Medicare paid.
- 1Medicare inpatient stays 1,762
- 2Charge ÷ paid, inpatient 12.96×
- 3Rank in TX (highest ratio = 1) 9 of 190
- 4CMS price-transparency actions 0
Inpatient stays
For the 55 DRGs that can be compared with the national average, South Texas Health System Behavioral charged more than the national average in 55 (100%). 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 | 357 | $267,798 | +197% | $17,703 |
| 291 Heart Failure and Shock with MCC | 99 | $150,469 | +167% | $12,449 |
| 885 Psychoses | 83 | $72,323 | +64% | $13,008 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 74 | $165,279 | +118% | $14,350 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 58 | $124,542 | +107% | $12,828 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 55 | $132,688 | +171% | $10,209 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 53 | $152,282 | +107% | $14,004 |
| 069 Transient Ischemia without Thrombolytic | 50 | $128,979 | +156% | $9,090 |
| 193 Simple Pneumonia and Pleurisy with MCC | 48 | $168,649 | +182% | $12,298 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 47 | $521,335 | +128% | $37,648 |
| 682 Renal Failure with MCC | 40 | $134,724 | +104% | $13,654 |
| 690 Kidney and Urinary Tract Infections without MCC | 38 | $108,556 | +187% | $8,946 |
| 177 Respiratory Infections and Inflammations with MCC | 35 | $164,337 | +133% | $14,483 |
| 689 Kidney and Urinary Tract Infections with MCC | 35 | $152,492 | +197% | $11,290 |
| 252 Other Vascular Procedures with MCC | 30 | $395,466 | +131% | $27,527 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 27 | $282,225 | +183% | $17,026 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 27 | $110,569 | +198% | $8,861 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 26 | $167,528 | +201% | $9,807 |
| 377 Gastrointestinal Hemorrhage with MCC | 24 | $199,643 | +134% | $16,031 |
| 481 Hip and Femur Procedures except Major Joint with CC | 24 | $330,208 | +228% | $18,145 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 24 | $111,070 | +134% | $10,477 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 23 | $105,091 | +191% | $8,741 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 23 | $713,915 | +121% | $45,587 |
| 432 Cirrhosis and Alcoholic Hepatitis with MCC | 21 | $163,529 | +71% | $17,142 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 20 | $118,405 | +134% | $9,984 |
| 683 Renal Failure with CC | 20 | $90,648 | +123% | $9,594 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 19 | $128,825 | +221% | $9,013 |
| 441 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic... | 19 | $171,390 | +99% | $15,923 |
| 638 Diabetes with CC | 19 | $132,521 | +218% | $10,013 |
| 378 Gastrointestinal Hemorrhage with CC | 18 | $123,281 | +154% | $10,332 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 17 | $338,055 | +53% | $38,375 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 17 | $116,749 | +106% | $11,934 |
| 637 Diabetes with MCC | 16 | $145,149 | +118% | $13,773 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 15 | $413,823 | +45% | $47,341 |
| 603 Cellulitis without MCC | 15 | $118,499 | +218% | $9,070 |
| 299 Peripheral Vascular Disorders with MCC | 14 | $171,621 | +128% | $14,629 |
| 394 Other Digestive System Diagnoses with CC | 14 | $130,111 | +176% | $9,937 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 14 | $301,244 | +207% | $16,496 |
| 100 Seizures with MCC | 13 | $146,231 | +55% | $17,349 |
| 189 Pulmonary Edema and Respiratory Failure | 13 | $104,491 | +82% | $12,150 |
| 305 Hypertension without MCC | 13 | $100,117 | +150% | $8,599 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 13 | $76,864 | +168% | $7,287 |
| 312 Syncope and Collapse | 13 | $116,510 | +156% | $9,536 |
| 314 Other Circulatory System Diagnoses with MCC | 13 | $177,821 | +88% | $17,556 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 13 | $375,594 | +74% | $36,788 |
| 242 Permanent Cardiac Pacemaker Implant with MCC | 12 | $328,913 | +105% | $26,814 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 12 | $279,426 | +144% | $16,588 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $202,699 | +232% | $12,338 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 11 | $224,821 | +245% | $13,199 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 11 | $333,413 | +146% | $23,197 |
| 233 Coronary Bypass with Cardiac Catheterization or Open... | 11 | $1,243,451 | +223% | $63,457 |
| 300 Peripheral Vascular Disorders with CC | 11 | $113,696 | +130% | $10,870 |
| 304 Hypertension with MCC | 11 | $127,115 | +122% | $11,721 |
| 313 Chest Pain | 11 | $93,620 | +134% | $8,430 |
| 329 Major Small and Large Bowel Procedures with MCC | 11 | $535,266 | +149% | $42,235 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 128 | $68,557 | $2,360 |
| Level 1 Endovascular Procedures | 64 | $133,794 | $2,760 |
| Level 3 Vascular Procedures | 41 | $71,048 | $2,766 |
| Level 4 Vascular Procedures | 38 | $161,936 | $4,768 |
| Level 1 Laparoscopy and Related Services | 31 | $175,938 | $5,007 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 24 | $43,210 | $1,407 |
| Level 3 Endovascular Procedures | 24 | $163,010 | $9,538 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 18 | $118,151 | $3,002 |
| Level 4 Endovascular Procedures | 17 | $193,010 | $15,186 |
| Level 2 Upper GI Procedures | 15 | $32,611 | $1,650 |
| Level 1 Nerve Procedures | 14 | $33,118 | $1,675 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $78,082 | $2,302 |
| Level 3 Pacemaker and Similar Procedures | 12 | $122,909 | $9,260 |
| Level 4 Musculoskeletal Procedures | 11 | $237,371 | $6,208 |
| Level 5 Neurostimulator and Related Procedures | 11 | $222,072 | $24,573 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), South Texas Health System Behavioral charged $267,798 on average, 141% more than the Texas average of $111,133, and was paid $17,703 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), South Texas Health System Behavioral charged $150,469 on average, 121% more than the Texas average of $67,944, and was paid $12,449 against a state average of $11,820. For Psychoses (DRG 885), South Texas Health System Behavioral charged $72,323 on average, 43% more than the Texas average of $50,568, and was paid $13,008 against a state average of $14,350. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), South Texas Health System Behavioral charged $165,279 on average, 78% more than the Texas average of $92,713, and was paid $14,350 against a state average of $13,694. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $68,557 was 145% above the state average of $27,955. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $133,794 was 269% above the state average of $36,220. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $71,048 was 152% above the state average of $28,214. For Level 4 Vascular Procedures (outpatient APC 5184), its average charge of $161,936 was 195% above the state average of $54,980.
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.