Illinois / The Carle Foundation Hospital
CMS certification 140091 · Urbana, IL
The Carle Foundation Hospital: charges and Medicare payments
The Carle Foundation Hospital reported 4,367 Medicare inpatient stays across 126 DRGs in 2024. Across them it charged 5.01 times what it was paid — among the higher ratios in Illinois, number 18 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 315 stays at an average charge of $48,796, 13% below the national average. It also billed 3,813 outpatient services, charging 6.69 times what Medicare paid.
- 1Medicare inpatient stays 4,367
- 2Charge ÷ paid, inpatient 5.01×
- 3Rank in IL (highest ratio = 1) 18 of 106
- 4CMS price-transparency actions 0
Inpatient stays
For the 126 DRGs that can be compared with the national average, The Carle Foundation Hospital charged more than the national average in 42 (33%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 315 | $48,796 | -13% | $11,538 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 282 | $97,235 | +8% | $16,492 |
| 177 Respiratory Infections and Inflammations with MCC | 153 | $77,444 | +10% | $13,846 |
| 689 Kidney and Urinary Tract Infections with MCC | 95 | $53,502 | +4% | $10,083 |
| 690 Kidney and Urinary Tract Infections without MCC | 94 | $37,591 | -1% | $7,892 |
| 193 Simple Pneumonia and Pleurisy with MCC | 87 | $66,088 | +11% | $11,406 |
| 552 Medical Back Problems without MCC | 83 | $51,171 | +5% | $8,482 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 77 | $97,341 | -3% | $18,573 |
| 683 Renal Failure with CC | 76 | $39,350 | -3% | $8,699 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 74 | $37,824 | -6% | $7,301 |
| 378 Gastrointestinal Hemorrhage with CC | 70 | $42,678 | -12% | $8,902 |
| 682 Renal Failure with MCC | 70 | $57,996 | -12% | $12,518 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 70 | $189,624 | -17% | $45,083 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 69 | $55,131 | -1% | $8,763 |
| 377 Gastrointestinal Hemorrhage with MCC | 68 | $70,249 | -18% | $14,875 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 67 | $58,857 | -20% | $14,565 |
| 603 Cellulitis without MCC | 64 | $32,533 | -13% | $8,073 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 60 | $107,417 | -4% | $19,143 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 60 | $55,383 | -8% | $11,334 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 59 | $65,574 | -14% | $14,065 |
| 189 Pulmonary Edema and Respiratory Failure | 58 | $59,107 | +3% | $11,260 |
| 330 Major Small and Large Bowel Procedures with CC | 52 | $88,429 | -26% | $21,531 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 50 | $36,533 | +1% | $7,035 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 49 | $193,703 | -12% | $38,255 |
| 178 Respiratory Infections and Inflammations with CC | 48 | $49,690 | +10% | $9,615 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 47 | $87,933 | -23% | $14,492 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 46 | $72,091 | +11% | $12,452 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 45 | $119,720 | -24% | $25,320 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 45 | $41,136 | -13% | $9,000 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 42 | $33,648 | -9% | $6,767 |
| 394 Other Digestive System Diagnoses with CC | 41 | $41,536 | -12% | $9,053 |
| 481 Hip and Femur Procedures except Major Joint with CC | 40 | $86,041 | -15% | $16,500 |
| 638 Diabetes with CC | 39 | $37,768 | -9% | $8,982 |
| 101 Seizures without MCC | 37 | $39,957 | -18% | $8,229 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 35 | $122,025 | -10% | $22,823 |
| 312 Syncope and Collapse | 35 | $35,487 | -22% | $7,404 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 35 | $138,348 | -15% | $24,582 |
| 314 Other Circulatory System Diagnoses with MCC | 34 | $106,320 | +12% | $17,704 |
| 329 Major Small and Large Bowel Procedures with MCC | 34 | $218,610 | +2% | $44,404 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 33 | $47,229 | -4% | $9,814 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 30 | $40,293 | +2% | $7,331 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 30 | $38,937 | -23% | $8,043 |
| 551 Medical Back Problems with MCC | 30 | $72,535 | -8% | $13,995 |
| 100 Seizures with MCC | 28 | $74,963 | -21% | $17,443 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 28 | $41,859 | -12% | $9,045 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 28 | $73,674 | +21% | $11,839 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 27 | $77,365 | +13% | $10,770 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 27 | $38,832 | -31% | $10,180 |
| 393 Other Digestive System Diagnoses with MCC | 26 | $78,048 | +2% | $15,565 |
| 811 Red Blood Cell Disorders with MCC | 26 | $56,273 | -17% | $11,792 |
| 202 Bronchitis and Asthma with CC/MCC | 25 | $34,093 | -26% | $9,431 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 25 | $50,692 | -21% | $11,873 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 25 | $56,039 | +14% | $9,523 |
| 812 Red Blood Cell Disorders without MCC | 25 | $42,880 | -3% | $7,960 |
| 919 Complications of Treatment with MCC | 25 | $92,904 | +5% | $24,907 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 24 | $241,506 | +4% | $39,380 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 24 | $46,146 | -9% | $9,104 |
| 057 Degenerative Nervous System Disorders without MCC | 23 | $59,425 | +5% | $14,210 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 23 | $102,680 | -14% | $19,329 |
| 432 Cirrhosis and Alcoholic Hepatitis with MCC | 22 | $73,734 | -23% | $19,486 |
Showing the 60 most frequent of 126 DRGs.
Outpatient services
Against the Illinois average
For Heart Failure and Shock with MCC (DRG 291), The Carle Foundation Hospital charged $48,796 on average, 5% more than the Illinois average of $46,293, and was paid $11,538 against a state average of $11,813. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), The Carle Foundation Hospital charged $97,235 on average, 31% more than the Illinois average of $73,987, and was paid $16,492 against a state average of $17,651. For Respiratory Infections and Inflammations with MCC (DRG 177), The Carle Foundation Hospital charged $77,444 on average, 30% more than the Illinois average of $59,769, and was paid $13,846 against a state average of $14,404. For Kidney and Urinary Tract Infections with MCC (DRG 689), The Carle Foundation Hospital charged $53,502 on average, 34% more than the Illinois average of $40,075, and was paid $10,083 against a state average of $10,117. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,531 was 5% above the state average of $21,498. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,193 was 45% below the state average of $4,013. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $10,147 was 26% below the state average of $13,666. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,312 was 4% below the state average of $11,818.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.