Tennessee / Tristar Horizon Medical Center
CMS certification 440046 · Dickson, TN · 3 entries in CMS's price-transparency list
Tristar Horizon Medical Center: charges and Medicare payments
Tristar Horizon Medical Center reported 846 Medicare inpatient stays across 30 DRGs in 2024. Across them it charged 6.53 times what it was paid — among the higher ratios in Tennessee, number 13 of 65 hospitals with at least 100 stays (state median 4.42×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 181 stays at an average charge of $81,019, 10% below the national average. It also billed 591 outpatient services, charging 12.88 times what Medicare paid.
- 1Medicare inpatient stays 846
- 2Charge ÷ paid, inpatient 6.53×
- 3Rank in TN (highest ratio = 1) 13 of 65
- 4CMS price-transparency actions 3
Inpatient stays
For the 30 DRGs that can be compared with the national average, Tristar Horizon Medical Center charged more than the national average in 21 (70%). 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 | 181 | $81,019 | -10% | $13,622 |
| 291 Heart Failure and Shock with MCC | 100 | $43,578 | -23% | $9,393 |
| 193 Simple Pneumonia and Pleurisy with MCC | 52 | $51,914 | -13% | $9,807 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 40 | $82,309 | +9% | $10,919 |
| 683 Renal Failure with CC | 31 | $43,421 | +7% | $7,243 |
| 189 Pulmonary Edema and Respiratory Failure | 30 | $56,586 | -2% | $9,847 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $53,207 | -12% | $9,290 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 27 | $57,265 | +17% | $8,837 |
| 689 Kidney and Urinary Tract Infections with MCC | 25 | $48,747 | -5% | $8,470 |
| 682 Renal Failure with MCC | 24 | $73,246 | +11% | $11,161 |
| 177 Respiratory Infections and Inflammations with MCC | 23 | $56,255 | -20% | $12,700 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $52,215 | +30% | $6,349 |
| 481 Hip and Femur Procedures except Major Joint with CC | 18 | $123,561 | +23% | $16,674 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 18 | $120,361 | +18% | $14,870 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $80,504 | +10% | $11,318 |
| 312 Syncope and Collapse | 17 | $66,659 | +46% | $6,775 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 17 | $142,364 | +3% | $19,856 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $260,455 | +14% | $32,018 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 16 | $71,182 | +28% | $7,398 |
| 884 Organic Disturbances and Intellectual Disability | 16 | $56,125 | -10% | $11,092 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $148,871 | +30% | $13,059 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 14 | $64,144 | +51% | $6,996 |
| 690 Kidney and Urinary Tract Infections without MCC | 14 | $45,111 | +19% | $6,303 |
| 069 Transient Ischemia without Thrombolytic | 13 | $71,175 | +41% | $7,775 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 13 | $34,564 | +20% | $4,924 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 12 | $45,254 | +25% | $6,792 |
| 638 Diabetes with CC | 12 | $63,271 | +52% | $6,658 |
| 305 Hypertension without MCC | 11 | $53,396 | +33% | $5,984 |
| 377 Gastrointestinal Hemorrhage with MCC | 11 | $67,144 | -21% | $10,618 |
| 637 Diabetes with MCC | 11 | $83,125 | +25% | $10,157 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 106 | $32,329 | $2,323 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 84 | $6,878 | $1,397 |
| Level 2 Upper GI Procedures | 71 | $21,349 | $1,620 |
| Level 1 Intraocular Procedures | 55 | $13,383 | $1,951 |
| Level 1 Laparoscopy and Related Services | 47 | $37,341 | $4,918 |
| Level 1 Endovascular Procedures | 39 | $55,760 | $2,812 |
| Level 3 Endovascular Procedures | 25 | $107,643 | $9,255 |
| Level 3 Vascular Procedures | 23 | $24,692 | $2,660 |
| Level 4 Endovascular Procedures | 22 | $152,692 | $15,079 |
| Level 2 Urology and Related Services | 22 | $13,305 | $567 |
| Level 3 Urology and Related Services | 22 | $14,365 | $1,755 |
| Level 3 Musculoskeletal Procedures | 21 | $30,785 | $2,683 |
| Level 5 Musculoskeletal Procedures | 18 | $85,916 | $11,326 |
| Level 5 Urology and Related Services | 13 | $39,164 | $4,458 |
| Level 4 Musculoskeletal Procedures | 12 | $65,446 | $6,164 |
| Level 2 Musculoskeletal Procedures | 11 | $19,364 | $1,385 |
Against the Tennessee average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Tristar Horizon Medical Center charged $81,019 on average, 15% more than the Tennessee average of $70,379, and was paid $13,622 against a state average of $15,065. For Heart Failure and Shock with MCC (DRG 291), Tristar Horizon Medical Center charged $43,578 on average, 6% less than the Tennessee average of $46,128, and was paid $9,393 against a state average of $10,346. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Tristar Horizon Medical Center charged $51,914 on average, 8% more than the Tennessee average of $48,160, and was paid $9,807 against a state average of $10,379. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Tristar Horizon Medical Center charged $82,309 on average, 35% more than the Tennessee average of $60,791, and was paid $10,919 against a state average of $12,633. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $32,329 was 62% above the state average of $19,917. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,878 was 33% below the state average of $10,318. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $21,349 was 89% above the state average of $11,319. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $13,383 was 26% above the state average of $10,656.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Tristar Horizon Medical Center in Dickson, TN, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-12-01 (CMS case 1994)
- Met Requirements — 2025-04-01 (CMS case 3502)
- Met Requirements — 2025-05-06 (CMS case 4334)
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.