Texas Health Presbyterian Hospital Plano: charges and Medicare payments

Texas Health Presbyterian Hospital Plano reported 3,045 Medicare inpatient stays across 93 DRGs in 2024. Across them it charged 4.78 times what it was paid — mid-range in Texas, number 114 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: 396 stays at an average charge of $68,983, 24% below the national average. It also billed 1,920 outpatient services, charging 7.06 times what Medicare paid.

1Medicare inpatient stays 3,045
2Charge ÷ paid, inpatient 4.78×
3Rank in TX (highest ratio = 1) 114 of 190
4CMS price-transparency actions 1

Average charge per stay at Texas Health Presbyterian Hospital Plano, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 93 DRGs that can be compared with the national average, Texas Health Presbyterian Hospital Plano charged more than the national average in 8 (9%). 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	396	$68,983	-24%	$15,141
291 Heart Failure and Shock with MCC	144	$52,049	-8%	$10,400
177 Respiratory Infections and Inflammations with MCC	116	$64,314	-9%	$12,806
481 Hip and Femur Procedures except Major Joint with CC	74	$79,799	-21%	$16,897
698 Other Kidney and Urinary Tract Diagnoses with MCC	72	$66,109	-10%	$13,577
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	70	$43,094	-12%	$8,801
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	67	$82,555	-17%	$15,782
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	67	$36,336	-10%	$6,941
689 Kidney and Urinary Tract Infections with MCC	66	$46,472	-9%	$9,173
193 Simple Pneumonia and Pleurisy with MCC	64	$49,804	-17%	$10,403
682 Renal Failure with MCC	64	$53,058	-20%	$11,718
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	63	$53,218	-12%	$10,907
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	56	$51,449	-8%	$9,137
690 Kidney and Urinary Tract Infections without MCC	54	$33,795	-11%	$7,380
603 Cellulitis without MCC	53	$33,620	-10%	$8,127
683 Renal Failure with CC	51	$35,539	-13%	$8,437
853 Infectious and Parasitic Diseases with O.R. Procedures with...	45	$143,530	-37%	$33,783
378 Gastrointestinal Hemorrhage with CC	38	$43,408	-11%	$8,129
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	38	$34,630	-7%	$6,890
189 Pulmonary Edema and Respiratory Failure	36	$47,499	-17%	$10,164
330 Major Small and Large Bowel Procedures with CC	36	$85,836	-28%	$17,870
552 Medical Back Problems without MCC	36	$39,187	-20%	$8,006
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	35	$87,746	-14%	$16,543
377 Gastrointestinal Hemorrhage with MCC	34	$75,198	-12%	$15,399
308 Cardiac Arrhythmia and Conduction Disorders with MCC	32	$55,044	-3%	$10,267
389 Gastrointestinal Obstruction with CC	31	$37,719	-3%	$7,484
274 Percutaneous and Other Intracardiac Procedures without MCC	30	$88,030	-44%	$24,847
178 Respiratory Infections and Inflammations with CC	29	$38,088	-16%	$8,035
467 Revision of Hip or Knee Replacement with CC	29	$133,974	-15%	$24,244
025 Craniotomy and Endovascular Intracranial Procedures with MCC	28	$147,690	-36%	$29,921
085 Traumatic Stupor and Coma <1 Hour with MCC	28	$79,410	-27%	$16,232
194 Simple Pneumonia and Pleurisy with CC	28	$40,132	+5%	$8,033
322 Percutaneous Cardiovascular Procedures with Intraluminal...	28	$93,874	-18%	$19,904
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	28	$84,633	-29%	$18,150
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	26	$60,805	0%	$10,951
267 Endovascular Cardiac Valve Replacement and Supplement...	25	$142,071	-36%	$33,880
305 Hypertension without MCC	25	$45,422	+13%	$6,571
331 Major Small and Large Bowel Procedures without CC/MCC	25	$74,382	-13%	$15,623
483 Major Joint or Limb Reattachment Procedures of Upper...	25	$114,215	-10%	$20,650
470 Major Hip and Knee Joint Replacement or Reattachment of...	24	$87,496	-6%	$14,167
812 Red Blood Cell Disorders without MCC	24	$48,116	+8%	$8,062
086 Traumatic Stupor and Coma <1 Hour with CC	23	$47,785	-30%	$11,528
100 Seizures with MCC	23	$56,713	-40%	$16,411
468 Revision of Hip or Knee Replacement without CC/MCC	22	$91,462	-26%	$19,335
280 Acute Myocardial Infarction, Discharged Alive with MCC	21	$58,519	-23%	$14,067
312 Syncope and Collapse	21	$45,684	0%	$8,133
637 Diabetes with MCC	21	$57,614	-13%	$10,737
309 Cardiac Arrhythmia and Conduction Disorders with CC	20	$34,753	-4%	$7,652
480 Hip and Femur Procedures except Major Joint with MCC	20	$122,989	-11%	$20,588
854 Infectious and Parasitic Diseases with O.R. Procedures with...	20	$110,211	+12%	$15,080
329 Major Small and Large Bowel Procedures with MCC	19	$181,990	-15%	$52,480
417 Laparoscopic Cholecystectomy without C.D.E. with MCC	19	$116,313	-7%	$18,008
418 Laparoscopic Cholecystectomy without C.D.E. with CC	19	$79,878	-14%	$14,839
811 Red Blood Cell Disorders with MCC	19	$57,680	-15%	$10,973
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	18	$55,025	-16%	$11,881
208 Respiratory System Diagnosis with Ventilator Support <=96...	18	$89,748	-34%	$20,887
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	18	$31,000	+8%	$5,602
372 Major Gastrointestinal Disorders and Peritoneal Infections...	18	$39,690	-16%	$9,105
066 Intracranial Hemorrhage or Cerebral Infarction without...	17	$40,463	-4%	$7,248
087 Traumatic Stupor and Coma <1 Hour without CC/MCC	17	$40,356	-22%	$7,492

Showing the 60 most frequent of 93 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	488	$23,668	$2,443
Level 5 Musculoskeletal Procedures	295	$65,541	$11,759
Level 1 Laparoscopy and Related Services	155	$34,227	$5,140
Level 2 Excision/ Biopsy/ Incision and Drainage	116	$9,470	$1,447
Level 2 Upper GI Procedures	115	$11,752	$1,700
Level 3 Electrophysiologic Procedures	95	$93,733	$21,319
Level 1 Endovascular Procedures	71	$21,803	$2,937
Level 3 Excision/ Biopsy/ Incision and Drainage	51	$23,422	$2,517
Level 5 Urology and Related Services	48	$18,512	$4,657
Level 4 Musculoskeletal Procedures	44	$40,364	$6,438
Level 3 Endovascular Procedures	43	$64,044	$9,893
Level 2 Laparoscopy and Related Services	39	$57,651	$9,259
Level 6 Musculoskeletal Procedures	38	$68,815	$16,735
Level 4 Urology and Related Services	36	$15,812	$3,137
Level 3 Vascular Procedures	35	$13,491	$2,803
Level 5 Airway Endoscopy	33	$41,939	$5,862
Level 2 Vascular Procedures	32	$5,965	$1,441
Level 3 Pacemaker and Similar Procedures	28	$52,366	$9,603
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	25	$25,017	$3,113
Level 3 Urology and Related Services	22	$11,302	$1,833
Level 4 Airway Endoscopy	16	$23,244	$3,370
Level 4 Endovascular Procedures	16	$80,518	$15,749
Level 3 Airway Endoscopy	15	$13,227	$1,527
Level 4 Vascular Procedures	15	$32,489	$4,946
Level 5 Gynecologic Procedures	13	$23,290	$4,202

Against the Texas average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Texas Health Presbyterian Hospital Plano charged $68,983 on average, 38% less than the Texas average of $111,133, and was paid $15,141 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), Texas Health Presbyterian Hospital Plano charged $52,049 on average, 23% less than the Texas average of $67,944, and was paid $10,400 against a state average of $11,820. For Respiratory Infections and Inflammations with MCC (DRG 177), Texas Health Presbyterian Hospital Plano charged $64,314 on average, 21% less than the Texas average of $81,715, and was paid $12,806 against a state average of $13,815. For Hip and Femur Procedures except Major Joint with CC (DRG 481), Texas Health Presbyterian Hospital Plano charged $79,799 on average, 38% less than the Texas average of $129,043, and was paid $16,897 against a state average of $17,871. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,668 was 15% below the state average of $27,955. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $65,541 was 34% below the state average of $98,771. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $34,227 was 33% below the state average of $50,995. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,470 was 33% below the state average of $14,089.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Texas Health Presbyterian Hospital Plano in Plano, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2025-08-19 (CMS case 6281)

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.