Georgia / Upson Regional Medical Center
CMS certification 110002 · Thomaston, GA · 1 entry in CMS's price-transparency list
Upson Regional Medical Center: charges and Medicare payments
Upson Regional Medical Center reported 193 Medicare inpatient stays across 11 DRGs in 2024. Across them it charged 3.66 times what it was paid — among the lower ratios in Georgia, number 55 of 74 hospitals with at least 100 stays (state median 4.44×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 33 stays at an average charge of $48,420, 46% below the national average. It also billed 307 outpatient services, charging 8.73 times what Medicare paid.
- 1Medicare inpatient stays 193
- 2Charge ÷ paid, inpatient 3.66×
- 3Rank in GA (highest ratio = 1) 55 of 74
- 4CMS price-transparency actions 1
Inpatient stays
For the 11 DRGs that can be compared with the national average, Upson Regional Medical Center charged more than the national average in 0 (0%). 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 | 33 | $48,420 | -46% | $15,233 |
| 291 Heart Failure and Shock with MCC | 25 | $36,267 | -36% | $11,608 |
| 690 Kidney and Urinary Tract Infections without MCC | 21 | $26,033 | -31% | $7,257 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 19 | $76,885 | -25% | $16,306 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $29,971 | -19% | $7,002 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $30,305 | -25% | $7,144 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $38,292 | -33% | $10,270 |
| 683 Renal Failure with CC | 13 | $33,690 | -17% | $7,925 |
| 194 Simple Pneumonia and Pleurisy with CC | 12 | $21,800 | -43% | $7,431 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $53,875 | -47% | $15,984 |
| 812 Red Blood Cell Disorders without MCC | 11 | $26,821 | -40% | $7,890 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 97 | $24,600 | $2,629 |
| Level 1 Laparoscopy and Related Services | 32 | $34,586 | $5,634 |
| Level 4 Urology and Related Services | 28 | $31,808 | $3,404 |
| Level 1 Intraocular Procedures | 28 | $13,611 | $2,276 |
| Level 5 Urology and Related Services | 19 | $30,910 | $5,053 |
| Level 3 Vascular Procedures | 16 | $15,453 | $3,112 |
| Level 1 Endovascular Procedures | 16 | $18,418 | $3,055 |
| Level 3 Musculoskeletal Procedures | 14 | $20,512 | $2,981 |
| Level 4 Musculoskeletal Procedures | 12 | $31,385 | $6,986 |
| Level 1 Nerve Procedures | 12 | $12,495 | $1,885 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 11 | $13,072 | $1,439 |
| Level 5 Musculoskeletal Procedures | 11 | $72,770 | $12,832 |
| Level 2 Upper GI Procedures | 11 | $12,774 | $1,858 |
Against the Georgia average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Upson Regional Medical Center charged $48,420 on average, 43% less than the Georgia average of $85,396, and was paid $15,233 against a state average of $17,147. For Heart Failure and Shock with MCC (DRG 291), Upson Regional Medical Center charged $36,267 on average, 31% less than the Georgia average of $52,781, and was paid $11,608 against a state average of $12,005. For Kidney and Urinary Tract Infections without MCC (DRG 690), Upson Regional Medical Center charged $26,033 on average, 21% less than the Georgia average of $32,908, and was paid $7,257 against a state average of $8,115. For Hip Replacement with Principal Diagnosis of Hip Fracture without MCC (DRG 522), Upson Regional Medical Center charged $76,885 on average, 25% less than the Georgia average of $102,012, and was paid $16,306 against a state average of $18,143. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,600 was 18% above the state average of $20,900. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $34,586 was 21% below the state average of $43,535. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $31,808 was 17% above the state average of $27,163. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $13,611 was 25% below the state average of $18,060.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Upson Regional Medical Center in Thomaston, GA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2026-07-08 (CMS case 8205)
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.