Pennsylvania / Wellspan Ephrata Community Hospital
CMS certification 390225 · Ephrata, PA
Wellspan Ephrata Community Hospital: charges and Medicare payments
Wellspan Ephrata Community Hospital reported 876 Medicare inpatient stays across 30 DRGs in 2024. Across them it charged 4.92 times what it was paid — mid-range in Pennsylvania, number 47 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 258 stays at an average charge of $59,119, 35% below the national average. It also billed 1,022 outpatient services, charging 9.7 times what Medicare paid.
- 1Medicare inpatient stays 876
- 2Charge ÷ paid, inpatient 4.92×
- 3Rank in PA (highest ratio = 1) 47 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 30 DRGs that can be compared with the national average, Wellspan Ephrata Community Hospital charged more than the national average in 6 (20%). 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 | 258 | $59,119 | -35% | $13,698 |
| 291 Heart Failure and Shock with MCC | 110 | $43,276 | -23% | $9,148 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 50 | $46,159 | -6% | $8,030 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 27 | $165,294 | -28% | $38,374 |
| 193 Simple Pneumonia and Pleurisy with MCC | 26 | $40,969 | -31% | $9,478 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 26 | $106,253 | -7% | $16,342 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 24 | $53,020 | -28% | $11,269 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 23 | $40,448 | +12% | $6,232 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 23 | $33,654 | -16% | $5,854 |
| 378 Gastrointestinal Hemorrhage with CC | 20 | $43,959 | -9% | $7,156 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $96,681 | -4% | $15,742 |
| 467 Revision of Hip or Knee Replacement with CC | 17 | $149,558 | -5% | $29,096 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 16 | $42,420 | -24% | $8,617 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 16 | $44,980 | -41% | $9,858 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 16 | $91,807 | -18% | $14,484 |
| 389 Gastrointestinal Obstruction with CC | 16 | $34,019 | -13% | $7,682 |
| 683 Renal Failure with CC | 16 | $30,801 | -24% | $7,716 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 15 | $50,200 | -50% | $13,416 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 15 | $74,180 | +16% | $8,263 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $62,867 | +4% | $12,132 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $41,578 | -28% | $8,904 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $58,258 | +3% | $8,676 |
| 682 Renal Failure with MCC | 14 | $34,128 | -48% | $10,172 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $110,611 | -32% | $22,254 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $40,633 | +7% | $6,084 |
| 177 Respiratory Infections and Inflammations with MCC | 12 | $49,180 | -30% | $11,044 |
| 330 Major Small and Large Bowel Procedures with CC | 12 | $142,042 | +19% | $18,237 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $65,021 | -24% | $11,639 |
| 689 Kidney and Urinary Tract Infections with MCC | 12 | $50,648 | -1% | $8,590 |
| 603 Cellulitis without MCC | 11 | $27,305 | -27% | $8,515 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Wellspan Ephrata Community Hospital charged $59,119 on average, 33% less than the Pennsylvania average of $88,167, and was paid $13,698 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Wellspan Ephrata Community Hospital charged $43,276 on average, 25% less than the Pennsylvania average of $57,362, and was paid $9,148 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Wellspan Ephrata Community Hospital charged $46,159 on average, 7% less than the Pennsylvania average of $49,758, and was paid $8,030 against a state average of $9,077. For Infectious and Parasitic Diseases with O.R. Procedures with MCC (DRG 853), Wellspan Ephrata Community Hospital charged $165,294 on average, 29% less than the Pennsylvania average of $232,291, and was paid $38,374 against a state average of $44,314. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,479 was 8% above the state average of $21,732. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $86,095 was 35% above the state average of $63,627. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $33,901 was 19% above the state average of $28,496. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,731 was 15% above the state average of $13,651.
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.