Wisconsin / SSM Health St Agnes Hospital-Fond Du Lac
CMS certification 520088 · Fond Du Lac, WI · 4 entries in CMS's price-transparency list
SSM Health St Agnes Hospital-Fond Du Lac: charges and Medicare payments
SSM Health St Agnes Hospital-Fond Du Lac reported 588 Medicare inpatient stays across 27 DRGs in 2024. Across them it charged 3.47 times what it was paid — mid-range in Wisconsin, number 28 of 55 hospitals with at least 100 stays (state median 3.47×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 78 stays at an average charge of $48,866, 46% below the national average. It also billed 1,684 outpatient services, charging 5.07 times what Medicare paid.
- 1Medicare inpatient stays 588
- 2Charge ÷ paid, inpatient 3.47×
- 3Rank in WI (highest ratio = 1) 28 of 55
- 4CMS price-transparency actions 4
Inpatient stays
For the 27 DRGs that can be compared with the national average, SSM Health St Agnes Hospital-Fond Du Lac 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 | 78 | $48,866 | -46% | $14,985 |
| 291 Heart Failure and Shock with MCC | 57 | $33,216 | -41% | $9,944 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 42 | $102,630 | -35% | $24,333 |
| 885 Psychoses | 42 | $18,907 | -57% | $10,301 |
| 193 Simple Pneumonia and Pleurisy with MCC | 30 | $32,140 | -46% | $10,028 |
| 378 Gastrointestinal Hemorrhage with CC | 27 | $36,725 | -24% | $7,529 |
| 177 Respiratory Infections and Inflammations with MCC | 23 | $46,514 | -34% | $12,735 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 21 | $58,920 | -49% | $14,388 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 21 | $30,182 | -38% | $8,030 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 20 | $72,868 | -55% | $22,021 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 17 | $24,859 | -31% | $6,038 |
| 690 Kidney and Urinary Tract Infections without MCC | 17 | $20,061 | -47% | $6,152 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 15 | $60,309 | -46% | $16,357 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $23,286 | -37% | $5,983 |
| 689 Kidney and Urinary Tract Infections with MCC | 15 | $32,984 | -36% | $8,899 |
| 057 Degenerative Nervous System Disorders without MCC | 14 | $48,470 | -14% | $11,180 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $35,482 | -38% | $9,938 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 14 | $32,499 | -56% | $12,621 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 13 | $41,697 | -45% | $12,256 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 13 | $95,133 | -58% | $37,560 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 12 | $36,722 | -34% | $7,704 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $22,980 | -43% | $6,042 |
| 683 Renal Failure with CC | 12 | $20,884 | -49% | $6,781 |
| 178 Respiratory Infections and Inflammations with CC | 11 | $24,244 | -46% | $7,586 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $45,865 | -54% | $15,812 |
| 603 Cellulitis without MCC | 11 | $26,586 | -29% | $6,733 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 11 | $43,221 | -36% | $10,218 |
Outpatient services
Against the Wisconsin average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), SSM Health St Agnes Hospital-Fond Du Lac charged $48,866 on average, 18% less than the Wisconsin average of $59,481, and was paid $14,985 against a state average of $16,719. For Heart Failure and Shock with MCC (DRG 291), SSM Health St Agnes Hospital-Fond Du Lac charged $33,216 on average, 16% less than the Wisconsin average of $39,564, and was paid $9,944 against a state average of $10,862. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), SSM Health St Agnes Hospital-Fond Du Lac charged $102,630 on average, 4% less than the Wisconsin average of $107,338, and was paid $24,333 against a state average of $25,143. For Psychoses (DRG 885), SSM Health St Agnes Hospital-Fond Du Lac charged $18,907 on average, 32% less than the Wisconsin average of $27,914, and was paid $10,301 against a state average of $12,682. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,152 was 20% below the state average of $11,485. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,136 was 49% below the state average of $2,237. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $7,789 was 33% below the state average of $11,645. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $5,719 was 34% below the state average of $8,646.
Price-transparency record
CMS's enforcement list records these actions for a hospital named SSM Health St Agnes Hospital-Fond Du Lac in Fond Du Lac, WI, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-07-24 (CMS case 1163)
- Closure Notice — 2023-11-22 (CMS case 1163)
- Met Requirements — 2025-04-17 (CMS case 3907)
- Met Requirements — 2026-07-16 (CMS case 8287)
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.