Virginia / Tricities Hospital
CMS certification 490020 · Hopewell, VA · 3 entries in CMS's price-transparency list
Tricities Hospital: charges and Medicare payments
Tricities Hospital reported 675 Medicare inpatient stays across 29 DRGs in 2024. Across them it charged 8.36 times what it was paid — among the higher ratios in Virginia, number 4 of 66 hospitals with at least 100 stays (state median 3.6×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 67 stays at an average charge of $68,478, 21% above the national average. It also billed 482 outpatient services, charging 32.4 times what Medicare paid.
- 1Medicare inpatient stays 675
- 2Charge ÷ paid, inpatient 8.36×
- 3Rank in VA (highest ratio = 1) 4 of 66
- 4CMS price-transparency actions 3
Inpatient stays
For the 29 DRGs that can be compared with the national average, Tricities Hospital charged more than the national average in 25 (86%). 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 | 67 | $68,478 | +21% | $9,235 |
| 193 Simple Pneumonia and Pleurisy with MCC | 58 | $82,858 | +39% | $9,638 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 56 | $145,416 | +61% | $13,657 |
| 683 Renal Failure with CC | 42 | $54,483 | +34% | $6,791 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 39 | $62,001 | +54% | $6,049 |
| 189 Pulmonary Edema and Respiratory Failure | 31 | $62,232 | +8% | $9,091 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 28 | $78,156 | +3% | $11,198 |
| 177 Respiratory Infections and Inflammations with MCC | 27 | $104,140 | +48% | $11,418 |
| 312 Syncope and Collapse | 26 | $49,678 | +9% | $6,892 |
| 682 Renal Failure with MCC | 24 | $83,380 | +26% | $10,343 |
| 638 Diabetes with CC | 20 | $49,451 | +19% | $7,459 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 20 | $66,652 | +11% | $9,587 |
| 637 Diabetes with MCC | 18 | $75,034 | +13% | $10,051 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 18 | $71,300 | +45% | $7,646 |
| 884 Organic Disturbances and Intellectual Disability | 18 | $57,855 | -7% | $11,486 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $45,977 | +24% | $5,902 |
| 305 Hypertension without MCC | 16 | $43,285 | +8% | $5,827 |
| 069 Transient Ischemia without Thrombolytic | 15 | $42,073 | -17% | $6,316 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $60,894 | +69% | $5,770 |
| 481 Hip and Femur Procedures except Major Joint with CC | 14 | $210,001 | +108% | $14,963 |
| 689 Kidney and Urinary Tract Infections with MCC | 14 | $46,884 | -9% | $8,277 |
| 389 Gastrointestinal Obstruction with CC | 13 | $46,257 | +19% | $5,987 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $57,622 | +52% | $6,205 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 12 | $66,651 | +20% | $7,625 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 11 | $73,452 | +30% | $10,455 |
| 603 Cellulitis without MCC | 11 | $52,396 | +41% | $6,503 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 11 | $62,161 | -15% | $10,199 |
| 811 Red Blood Cell Disorders with MCC | 11 | $84,332 | +24% | $10,240 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 11 | $66,632 | +80% | $6,575 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Excision/ Biopsy/ Incision and Drainage | 64 | $27,240 | $1,393 |
| Level 5 Musculoskeletal Procedures | 64 | $287,754 | $11,133 |
| Comprehensive Observation Services | 64 | $36,621 | $2,382 |
| Level 1 Intraocular Procedures | 55 | $52,161 | $1,998 |
| Level 4 Musculoskeletal Procedures | 36 | $212,110 | $6,225 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 35 | $47,626 | $2,472 |
| Level 1 Nerve Procedures | 31 | $65,413 | $1,557 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 27 | $94,124 | $3,010 |
| Level 3 Musculoskeletal Procedures | 26 | $79,139 | $2,558 |
| Level 1 Laparoscopy and Related Services | 26 | $135,659 | $4,867 |
| Level 2 Musculoskeletal Procedures | 20 | $42,775 | $1,343 |
| Level 3 Lower GI Procedures | 12 | $73,386 | $2,443 |
| Level 1 Breast/Lymphatic Surgery and Related Procedures | 11 | $62,073 | $3,317 |
| Level 6 Musculoskeletal Procedures | 11 | $478,676 | $16,182 |
Against the Virginia average
For Heart Failure and Shock with MCC (DRG 291), Tricities Hospital charged $68,478 on average, 68% more than the Virginia average of $40,795, and was paid $9,235 against a state average of $11,030. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Tricities Hospital charged $82,858 on average, 85% more than the Virginia average of $44,717, and was paid $9,638 against a state average of $11,065. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Tricities Hospital charged $145,416 on average, 123% more than the Virginia average of $65,235, and was paid $13,657 against a state average of $16,367. For Renal Failure with CC (DRG 683), Tricities Hospital charged $54,483 on average, 73% more than the Virginia average of $31,514, and was paid $6,791 against a state average of $7,782. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $27,240 was 143% above the state average of $11,217. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $287,754 was 243% above the state average of $83,920. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $36,621 was 88% above the state average of $19,506. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $52,161 was 343% above the state average of $11,766.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Tricities Hospital in Hopewell, VA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-07-10 (CMS case 1128)
- Closure Notice — 2023-10-30 (CMS case 1128)
- Met Requirements — 2025-04-30 (CMS case 4203)
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.