Massachusetts / St Vincent Hospital
CMS certification 220176 · Worcester, MA · 3 entries in CMS's price-transparency list
St Vincent Hospital: charges and Medicare payments
St Vincent Hospital reported 1,894 Medicare inpatient stays across 61 DRGs in 2024. Across them it charged 4.63 times what it was paid — among the higher ratios in Massachusetts, number 2 of 52 hospitals with at least 100 stays (state median 2×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 221 stays at an average charge of $88,937, 2% below the national average. It also billed 2,276 outpatient services, charging 11.18 times what Medicare paid.
- 1Medicare inpatient stays 1,894
- 2Charge ÷ paid, inpatient 4.63×
- 3Rank in MA (highest ratio = 1) 2 of 52
- 4CMS price-transparency actions 3
Inpatient stays
For the 61 DRGs that can be compared with the national average, St Vincent Hospital charged more than the national average in 37 (61%). 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 | 221 | $88,937 | -2% | $22,468 |
| 291 Heart Failure and Shock with MCC | 157 | $57,342 | +2% | $14,682 |
| 193 Simple Pneumonia and Pleurisy with MCC | 98 | $63,849 | +7% | $14,842 |
| 177 Respiratory Infections and Inflammations with MCC | 64 | $78,275 | +11% | $18,235 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 50 | $124,798 | +34% | $20,826 |
| 189 Pulmonary Edema and Respiratory Failure | 48 | $45,129 | -22% | $13,764 |
| 683 Renal Failure with CC | 46 | $45,578 | +12% | $10,299 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 44 | $176,500 | -23% | $47,410 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 42 | $45,179 | +12% | $9,340 |
| 682 Renal Failure with MCC | 42 | $63,535 | -4% | $17,333 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 39 | $185,799 | +62% | $20,459 |
| 690 Kidney and Urinary Tract Infections without MCC | 38 | $54,309 | +44% | $9,930 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 37 | $36,396 | +1% | $8,650 |
| 377 Gastrointestinal Hemorrhage with MCC | 35 | $82,827 | -3% | $19,637 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 33 | $94,483 | +25% | $19,512 |
| 312 Syncope and Collapse | 32 | $45,472 | 0% | $10,195 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 32 | $66,817 | +36% | $12,238 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 29 | $110,444 | -2% | $24,361 |
| 378 Gastrointestinal Hemorrhage with CC | 29 | $48,411 | 0% | $11,825 |
| 689 Kidney and Urinary Tract Infections with MCC | 29 | $62,865 | +22% | $13,624 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 28 | $74,433 | -25% | $21,257 |
| 603 Cellulitis without MCC | 28 | $46,689 | +25% | $10,606 |
| 638 Diabetes with CC | 28 | $49,294 | +18% | $11,528 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 27 | $81,042 | +27% | $13,835 |
| 314 Other Circulatory System Diagnoses with MCC | 26 | $109,745 | +16% | $24,341 |
| 811 Red Blood Cell Disorders with MCC | 25 | $54,095 | -21% | $15,422 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 24 | $75,552 | +3% | $18,887 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 23 | $250,010 | +53% | $30,757 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $49,504 | -18% | $14,229 |
| 253 Other Vascular Procedures with CC | 22 | $145,374 | +10% | $27,215 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 22 | $63,191 | +12% | $14,283 |
| 637 Diabetes with MCC | 22 | $65,789 | -1% | $16,215 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 21 | $236,897 | -27% | $72,428 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 20 | $53,132 | -5% | $9,969 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 20 | $52,473 | -14% | $14,508 |
| 178 Respiratory Infections and Inflammations with CC | 19 | $55,201 | +22% | $11,088 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 19 | $246,797 | +57% | $34,174 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 19 | $30,124 | +5% | $6,937 |
| 552 Medical Back Problems without MCC | 19 | $57,961 | +19% | $10,021 |
| 194 Simple Pneumonia and Pleurisy with CC | 18 | $40,731 | +6% | $9,215 |
| 481 Hip and Femur Procedures except Major Joint with CC | 18 | $123,931 | +23% | $22,343 |
| 313 Chest Pain | 17 | $46,389 | +16% | $8,384 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $47,850 | +29% | $9,452 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 16 | $358,072 | +62% | $48,437 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 16 | $67,948 | +35% | $10,689 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 16 | $197,894 | -8% | $44,262 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 15 | $35,328 | -30% | $12,744 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 15 | $165,904 | +49% | $27,645 |
| 069 Transient Ischemia without Thrombolytic | 14 | $43,544 | -14% | $9,707 |
| 242 Permanent Cardiac Pacemaker Implant with MCC | 14 | $237,388 | +48% | $37,865 |
| 393 Other Digestive System Diagnoses with MCC | 14 | $62,153 | -19% | $18,692 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 14 | $45,965 | -3% | $11,487 |
| 038 Extracranial Procedures with CC | 13 | $137,317 | +57% | $17,354 |
| 205 Other Respiratory System Diagnoses with MCC | 13 | $76,859 | -13% | $19,344 |
| 270 Other Major Cardiovascular Procedures with MCC | 13 | $197,587 | -24% | $51,080 |
| 101 Seizures without MCC | 12 | $50,002 | +3% | $10,502 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 12 | $68,236 | +5% | $15,686 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 12 | $232,384 | +10% | $41,566 |
| 315 Other Circulatory System Diagnoses with CC | 12 | $43,676 | -9% | $11,061 |
| 394 Other Digestive System Diagnoses with CC | 12 | $49,332 | +5% | $10,861 |
Showing the 60 most frequent of 61 DRGs.
Outpatient services
Against the Massachusetts average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Vincent Hospital charged $88,937 on average, 97% more than the Massachusetts average of $45,229, and was paid $22,468 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), St Vincent Hospital charged $57,342 on average, 89% more than the Massachusetts average of $30,373, and was paid $14,682 against a state average of $12,996. For Simple Pneumonia and Pleurisy with MCC (DRG 193), St Vincent Hospital charged $63,849 on average, 127% more than the Massachusetts average of $28,077, and was paid $14,842 against a state average of $12,627. For Respiratory Infections and Inflammations with MCC (DRG 177), St Vincent Hospital charged $78,275 on average, 111% more than the Massachusetts average of $37,072, and was paid $18,235 against a state average of $15,861. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $33,282 was 138% above the state average of $14,010. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $43,833 was 124% above the state average of $19,611. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $114,847 was 223% above the state average of $35,549. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $56,760 was 197% above the state average of $19,105.
Price-transparency record
CMS's enforcement list records these actions for a hospital named St Vincent Hospital in Worcester, MA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-04-25 (CMS case 610)
- Closure Notice — 2023-08-17 (CMS case 610)
- Met Requirements — 2025-03-27 (CMS case 3234)
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.