Texas / UT Health East Texas Athens Hospital
CMS certification 450389 · Athens, TX
UT Health East Texas Athens Hospital: charges and Medicare payments
UT Health East Texas Athens Hospital reported 603 Medicare inpatient stays across 18 DRGs in 2024. Across them it charged 6.92 times what it was paid — mid-range in Texas, number 68 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 119 stays at an average charge of $96,590, 7% above the national average. It also billed 421 outpatient services, charging 11.56 times what Medicare paid.
- 1Medicare inpatient stays 603
- 2Charge ÷ paid, inpatient 6.92×
- 3Rank in TX (highest ratio = 1) 68 of 190
- 4CMS price-transparency actions 0
Inpatient stays
For the 18 DRGs that can be compared with the national average, UT Health East Texas Athens Hospital charged more than the national average in 16 (89%). 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 | 119 | $96,590 | +7% | $14,229 |
| 193 Simple Pneumonia and Pleurisy with MCC | 76 | $80,204 | +34% | $10,255 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 43 | $80,782 | +7% | $12,069 |
| 689 Kidney and Urinary Tract Infections with MCC | 41 | $50,645 | -1% | $9,388 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 37 | $63,701 | +30% | $8,476 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 35 | $43,244 | +17% | $6,874 |
| 291 Heart Failure and Shock with MCC | 32 | $64,935 | +15% | $10,273 |
| 194 Simple Pneumonia and Pleurisy with CC | 28 | $47,263 | +23% | $7,097 |
| 690 Kidney and Urinary Tract Infections without MCC | 27 | $47,565 | +26% | $7,025 |
| 177 Respiratory Infections and Inflammations with MCC | 26 | $93,166 | +32% | $12,220 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 21 | $44,316 | -12% | $7,701 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $49,672 | +24% | $6,995 |
| 683 Renal Failure with CC | 19 | $53,231 | +31% | $7,652 |
| 189 Pulmonary Edema and Respiratory Failure | 18 | $99,162 | +72% | $10,074 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $89,017 | +21% | $12,546 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 17 | $60,416 | +19% | $9,151 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $56,599 | +17% | $8,311 |
| 603 Cellulitis without MCC | 12 | $42,256 | +13% | $7,608 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 94 | $30,244 | $2,442 |
| Level 5 Urology and Related Services | 85 | $29,780 | $4,566 |
| Level 4 Urology and Related Services | 63 | $27,992 | $3,058 |
| Level 2 Upper GI Procedures | 47 | $12,876 | $1,676 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 31 | $31,841 | $3,113 |
| Level 1 Laparoscopy and Related Services | 23 | $41,293 | $5,043 |
| Level 3 Vascular Procedures | 20 | $37,088 | $2,868 |
| Level 3 Musculoskeletal Procedures | 16 | $26,827 | $2,549 |
| Level 3 Urology and Related Services | 16 | $26,767 | $1,833 |
| Level 4 Musculoskeletal Procedures | 13 | $57,559 | $6,057 |
| Level 1 Nerve Procedures | 13 | $12,950 | $1,738 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UT Health East Texas Athens Hospital charged $96,590 on average, 13% less than the Texas average of $111,133, and was paid $14,229 against a state average of $16,694. For Simple Pneumonia and Pleurisy with MCC (DRG 193), UT Health East Texas Athens Hospital charged $80,204 on average, 9% more than the Texas average of $73,756, and was paid $10,255 against a state average of $11,597. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), UT Health East Texas Athens Hospital charged $80,782 on average, 13% less than the Texas average of $92,713, and was paid $12,069 against a state average of $13,694. For Kidney and Urinary Tract Infections with MCC (DRG 689), UT Health East Texas Athens Hospital charged $50,645 on average, 12% less than the Texas average of $57,563, and was paid $9,388 against a state average of $10,503. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $30,244 was 8% above the state average of $27,955. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $29,780 was 23% below the state average of $38,562. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $27,992 was 10% below the state average of $31,008. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,876 was 21% below the state average of $16,236.
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.