Kentucky / St Claire Regional Medical Center
CMS certification 180018 · Morehead, KY · 3 entries in CMS's price-transparency list
St Claire Regional Medical Center: charges and Medicare payments
St Claire Regional Medical Center reported 486 Medicare inpatient stays across 15 DRGs in 2024. Across them it charged 2.78 times what it was paid — among the lower ratios in Kentucky, number 43 of 51 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 198 stays at an average charge of $40,775, 55% below the national average. It also billed 951 outpatient services, charging 6.19 times what Medicare paid.
- 1Medicare inpatient stays 486
- 2Charge ÷ paid, inpatient 2.78×
- 3Rank in KY (highest ratio = 1) 43 of 51
- 4CMS price-transparency actions 3
Inpatient stays
For the 15 DRGs that can be compared with the national average, St Claire Regional Medical Center 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 | 198 | $40,775 | -55% | $14,457 |
| 291 Heart Failure and Shock with MCC | 39 | $24,350 | -57% | $9,659 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 35 | $42,167 | -43% | $12,860 |
| 189 Pulmonary Edema and Respiratory Failure | 28 | $26,711 | -54% | $9,388 |
| 177 Respiratory Infections and Inflammations with MCC | 25 | $37,393 | -47% | $11,667 |
| 683 Renal Failure with CC | 23 | $17,100 | -58% | $6,968 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 22 | $92,997 | -59% | $36,134 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 21 | $16,248 | -67% | $7,743 |
| 193 Simple Pneumonia and Pleurisy with MCC | 20 | $28,497 | -52% | $9,733 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $15,714 | -56% | $5,899 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 13 | $35,254 | -45% | $8,191 |
| 682 Renal Failure with MCC | 13 | $23,129 | -65% | $10,702 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $16,857 | -55% | $6,220 |
| 811 Red Blood Cell Disorders with MCC | 12 | $23,438 | -66% | $10,628 |
| 689 Kidney and Urinary Tract Infections with MCC | 11 | $18,413 | -64% | $8,268 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 187 | $10,096 | $2,148 |
| Comprehensive Observation Services | 179 | $13,328 | $2,523 |
| Level 2 Urology and Related Services | 84 | $1,411 | $630 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 78 | $5,244 | $1,494 |
| Level 3 Urology and Related Services | 54 | $7,604 | $1,877 |
| Level 4 Urology and Related Services | 47 | $16,586 | $3,213 |
| Level 1 Nerve Procedures | 46 | $8,770 | $1,780 |
| Level 1 Endovascular Procedures | 44 | $24,505 | $3,008 |
| Level 5 Urology and Related Services | 34 | $22,241 | $4,770 |
| Level 3 Vascular Procedures | 29 | $13,517 | $2,938 |
| Level 3 Musculoskeletal Procedures | 23 | $12,958 | $2,984 |
| Level 2 Upper GI Procedures | 23 | $9,875 | $1,716 |
| Level 3 Endovascular Procedures | 21 | $58,662 | $10,132 |
| Level 4 Musculoskeletal Procedures | 20 | $31,182 | $6,594 |
| Level 2 Vascular Procedures | 19 | $4,484 | $1,437 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 19 | $16,704 | $3,189 |
| Level 5 Musculoskeletal Procedures | 16 | $56,284 | $12,115 |
| Level 4 Endovascular Procedures | 15 | $88,408 | $16,130 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 13 | $9,666 | $2,418 |
Against the Kentucky average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Claire Regional Medical Center charged $40,775 on average, 36% less than the Kentucky average of $63,454, and was paid $14,457 against a state average of $14,765. For Heart Failure and Shock with MCC (DRG 291), St Claire Regional Medical Center charged $24,350 on average, 40% less than the Kentucky average of $40,730, and was paid $9,659 against a state average of $9,552. For Other Kidney and Urinary Tract Diagnoses with MCC (DRG 698), St Claire Regional Medical Center charged $42,167 on average, 15% less than the Kentucky average of $49,433, and was paid $12,860 against a state average of $12,347. For Pulmonary Edema and Respiratory Failure (DRG 189), St Claire Regional Medical Center charged $26,711 on average, 36% less than the Kentucky average of $42,054, and was paid $9,388 against a state average of $9,410. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,096 was 9% below the state average of $11,097. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $13,328 was 34% below the state average of $20,333. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,411 was 55% below the state average of $3,127. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $5,244 was 56% below the state average of $11,961.
Price-transparency record
CMS's enforcement list records these actions for a hospital named St Claire Regional Medical Center in Morehead, KY, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-08-05 (CMS case 2265)
- Closure Notice — 2024-08-27 (CMS case 2265)
- Met Requirements — 2025-09-12 (CMS case 6592)
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.