Virginia / Twin County Regional Hospital
CMS certification 490115 · Galax, VA · 3 entries in CMS's price-transparency list
Twin County Regional Hospital: charges and Medicare payments
Twin County Regional Hospital reported 209 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 4.74 times what it was paid — among the higher ratios in Virginia, number 14 of 66 hospitals with at least 100 stays (state median 3.6×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 69 stays at an average charge of $76,929, 15% below the national average. It also billed 398 outpatient services, charging 12.72 times what Medicare paid.
- 1Medicare inpatient stays 209
- 2Charge ÷ paid, inpatient 4.74×
- 3Rank in VA (highest ratio = 1) 14 of 66
- 4CMS price-transparency actions 3
Inpatient stays
For the 7 DRGs that can be compared with the national average, Twin County Regional Hospital charged more than the national average in 2 (29%). 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 | 69 | $76,929 | -15% | $16,345 |
| 885 Psychoses | 31 | $45,191 | +3% | $11,570 |
| 177 Respiratory Infections and Inflammations with MCC | 30 | $73,252 | +4% | $14,011 |
| 291 Heart Failure and Shock with MCC | 28 | $50,644 | -10% | $10,639 |
| 193 Simple Pneumonia and Pleurisy with MCC | 22 | $53,316 | -11% | $10,929 |
| 189 Pulmonary Edema and Respiratory Failure | 18 | $56,599 | -2% | $10,209 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 11 | $58,827 | -20% | $13,622 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 158 | $31,867 | $2,498 |
| Level 2 Upper GI Procedures | 81 | $15,707 | $1,729 |
| Level 4 Urology and Related Services | 51 | $27,639 | $3,164 |
| Level 1 Laparoscopy and Related Services | 22 | $44,710 | $5,320 |
| Level 5 Musculoskeletal Procedures | 16 | $106,398 | $11,467 |
| Level 2 Musculoskeletal Procedures | 15 | $14,862 | $1,482 |
| Level 5 Urology and Related Services | 15 | $30,857 | $4,771 |
| Level 3 Vascular Procedures | 14 | $40,429 | $2,939 |
| Level 1 Nerve Procedures | 14 | $16,389 | $1,780 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 12 | $28,605 | $3,190 |
Against the Virginia average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Twin County Regional Hospital charged $76,929 on average, 18% more than the Virginia average of $65,235, and was paid $16,345 against a state average of $16,367. For Psychoses (DRG 885), Twin County Regional Hospital charged $45,191 on average, 48% more than the Virginia average of $30,531, and was paid $11,570 against a state average of $11,921. For Respiratory Infections and Inflammations with MCC (DRG 177), Twin County Regional Hospital charged $73,252 on average, 48% more than the Virginia average of $49,485, and was paid $14,011 against a state average of $13,709. For Heart Failure and Shock with MCC (DRG 291), Twin County Regional Hospital charged $50,644 on average, 24% more than the Virginia average of $40,795, and was paid $10,639 against a state average of $11,030. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $31,867 was 63% above the state average of $19,506. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $15,707 was 13% above the state average of $13,852. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $27,639 was 26% above the state average of $21,969. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $44,710 was 1% below the state average of $45,021.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Twin County Regional Hospital in Galax, VA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-09-06 (CMS case 2529)
- Warning Notice — 2025-06-17 (CMS case 5227)
- Closure Notice — 2025-06-24 (CMS case 5227)
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.