Missouri / SSM Health St Joseph Hospital-Lake Saint Louis
CMS certification 260200 · Lake Saint Louis, MO · 2 entries in CMS's price-transparency list
SSM Health St Joseph Hospital-Lake Saint Louis: charges and Medicare payments
SSM Health St Joseph Hospital-Lake Saint Louis reported 1,529 Medicare inpatient stays across 55 DRGs in 2024. Across them it charged 3.63 times what it was paid — mid-range in Missouri, number 37 of 59 hospitals with at least 100 stays (state median 3.85×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 151 stays at an average charge of $46,053, 49% below the national average. It also billed 1,453 outpatient services, charging 4.99 times what Medicare paid.
- 1Medicare inpatient stays 1,529
- 2Charge ÷ paid, inpatient 3.63×
- 3Rank in MO (highest ratio = 1) 37 of 59
- 4CMS price-transparency actions 2
Inpatient stays
For the 55 DRGs that can be compared with the national average, SSM Health St Joseph Hospital-Lake Saint Louis 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 | 151 | $46,053 | -49% | $13,149 |
| 291 Heart Failure and Shock with MCC | 147 | $34,689 | -38% | $8,744 |
| 177 Respiratory Infections and Inflammations with MCC | 60 | $31,407 | -56% | $10,898 |
| 193 Simple Pneumonia and Pleurisy with MCC | 57 | $39,267 | -34% | $9,253 |
| 683 Renal Failure with CC | 51 | $25,840 | -37% | $6,427 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 48 | $22,559 | -38% | $5,542 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 44 | $20,627 | -49% | $5,878 |
| 682 Renal Failure with MCC | 42 | $33,707 | -49% | $9,870 |
| 189 Pulmonary Edema and Respiratory Failure | 36 | $32,615 | -43% | $8,660 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 34 | $28,801 | -41% | $7,055 |
| 378 Gastrointestinal Hemorrhage with CC | 33 | $29,039 | -40% | $7,014 |
| 603 Cellulitis without MCC | 31 | $18,090 | -51% | $6,146 |
| 690 Kidney and Urinary Tract Infections without MCC | 31 | $20,036 | -47% | $5,606 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $28,249 | -53% | $8,779 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 28 | $42,862 | -43% | $11,100 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 28 | $61,632 | -45% | $14,503 |
| 552 Medical Back Problems without MCC | 28 | $22,604 | -54% | $6,843 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 28 | $97,084 | -58% | $30,092 |
| 312 Syncope and Collapse | 26 | $27,652 | -39% | $6,234 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 25 | $32,560 | -42% | $6,956 |
| 689 Kidney and Urinary Tract Infections with MCC | 25 | $25,556 | -50% | $7,969 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 25 | $38,928 | -47% | $10,781 |
| 305 Hypertension without MCC | 24 | $20,716 | -48% | $5,567 |
| 481 Hip and Femur Procedures except Major Joint with CC | 23 | $52,480 | -48% | $13,687 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 23 | $47,120 | -54% | $14,237 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 21 | $59,522 | -48% | $13,637 |
| 638 Diabetes with CC | 21 | $21,754 | -48% | $6,485 |
| 194 Simple Pneumonia and Pleurisy with CC | 20 | $24,750 | -36% | $5,907 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 19 | $37,365 | -42% | $7,933 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 19 | $33,479 | -41% | $8,608 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 19 | $22,291 | -48% | $6,207 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $21,136 | -43% | $5,640 |
| 092 Other Disorders of Nervous System with CC | 17 | $27,610 | -46% | $7,359 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $26,670 | -56% | $8,933 |
| 377 Gastrointestinal Hemorrhage with MCC | 16 | $47,995 | -44% | $12,246 |
| 521 Hip Replacement with Principal Diagnosis of Hip Fracture... | 16 | $56,710 | -58% | $18,558 |
| 057 Degenerative Nervous System Disorders without MCC | 15 | $27,712 | -51% | $9,399 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 15 | $35,127 | -30% | $6,589 |
| 389 Gastrointestinal Obstruction with CC | 15 | $16,579 | -57% | $5,835 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 15 | $65,544 | -53% | $19,457 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 14 | $85,383 | -48% | $20,149 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 14 | $58,466 | -41% | $14,267 |
| 884 Organic Disturbances and Intellectual Disability | 14 | $23,815 | -62% | $11,060 |
| 951 Other Factors Influencing Health Status | 14 | $18,697 | -27% | $4,403 |
| 149 Dysequilibrium | 13 | $21,485 | -52% | $5,469 |
| 178 Respiratory Infections and Inflammations with CC | 13 | $17,978 | -60% | $7,876 |
| 536 Fractures of Hip and Pelvis without MCC | 13 | $16,613 | -56% | $5,763 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 13 | $25,419 | -46% | $7,701 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 12 | $36,360 | -64% | $13,014 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $23,597 | -53% | $7,433 |
| 394 Other Digestive System Diagnoses with CC | 12 | $21,209 | -55% | $6,932 |
| 101 Seizures without MCC | 11 | $20,088 | -59% | $6,405 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 11 | $62,151 | -48% | $15,420 |
| 554 Bone Diseases and Arthropathies without MCC | 11 | $16,298 | -57% | $6,006 |
| 617 Amputation of Lower Limb for Endocrine, Nutritional and... | 11 | $46,409 | -47% | $13,914 |
Outpatient services
Against the Missouri average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), SSM Health St Joseph Hospital-Lake Saint Louis charged $46,053 on average, 37% less than the Missouri average of $72,886, and was paid $13,149 against a state average of $15,808. For Heart Failure and Shock with MCC (DRG 291), SSM Health St Joseph Hospital-Lake Saint Louis charged $34,689 on average, 25% less than the Missouri average of $46,468, and was paid $8,744 against a state average of $10,539. For Respiratory Infections and Inflammations with MCC (DRG 177), SSM Health St Joseph Hospital-Lake Saint Louis charged $31,407 on average, 46% less than the Missouri average of $58,162, and was paid $10,898 against a state average of $13,151. For Simple Pneumonia and Pleurisy with MCC (DRG 193), SSM Health St Joseph Hospital-Lake Saint Louis charged $39,267 on average, 18% less than the Missouri average of $47,966, and was paid $9,253 against a state average of $10,821. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,192 was 31% below the state average of $20,571. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,177 was 60% below the state average of $2,933. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,773 was 21% below the state average of $9,865. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $18,095 was 24% below the state average of $23,828.
Price-transparency record
CMS's enforcement list records these actions for a hospital named SSM Health St Joseph Hospital-Lake Saint Louis in Lake Saint Louis, MO, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-09 (CMS case 1304)
- Met Requirements — 2025-04-02 (CMS case 3545)
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.