Ohio / Wilson Memorial Hospital
CMS certification 360013 · Sidney, OH · 5 entries in CMS's price-transparency list
Wilson Memorial Hospital: charges and Medicare payments
Wilson Memorial Hospital reported 162 Medicare inpatient stays across 10 DRGs in 2024. Across them it charged 2.87 times what it was paid — among the lower ratios in Ohio, number 81 of 104 hospitals with at least 100 stays (state median 4.01×, national 4.15×). Its most frequent stay was DRG 690, Kidney and Urinary Tract Infections without MCC: 23 stays at an average charge of $19,738, 48% below the national average. It also billed 766 outpatient services, charging 5.72 times what Medicare paid.
- 1Medicare inpatient stays 162
- 2Charge ÷ paid, inpatient 2.87×
- 3Rank in OH (highest ratio = 1) 81 of 104
- 4CMS price-transparency actions 5
Inpatient stays
For the 10 DRGs that can be compared with the national average, Wilson Memorial Hospital 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 |
|---|---|---|---|---|
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $19,738 | -48% | $6,658 |
| 291 Heart Failure and Shock with MCC | 22 | $20,610 | -63% | $10,186 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $32,803 | -43% | $9,853 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $29,883 | -58% | $11,992 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $21,856 | -41% | $6,637 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $28,051 | -43% | $8,506 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 14 | $21,246 | -47% | $6,786 |
| 193 Simple Pneumonia and Pleurisy with MCC | 13 | $31,693 | -47% | $10,479 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 13 | $30,968 | -66% | $12,484 |
| 194 Simple Pneumonia and Pleurisy with CC | 12 | $25,508 | -34% | $6,716 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 199 | $13,538 | $2,423 |
| Level 5 Musculoskeletal Procedures | 105 | $44,833 | $11,797 |
| Level 4 Musculoskeletal Procedures | 49 | $31,116 | $6,421 |
| Level 2 Pacemaker and Similar Procedures | 49 | $20,029 | $7,625 |
| Level 3 Musculoskeletal Procedures | 45 | $18,317 | $2,802 |
| Level 1 Endovascular Procedures | 43 | $27,462 | $2,929 |
| Level 1 Nerve Procedures | 33 | $13,631 | $1,733 |
| Level 5 Urology and Related Services | 32 | $25,414 | $4,644 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 31 | $11,930 | $1,405 |
| Level 2 Upper GI Procedures | 30 | $15,573 | $1,708 |
| Level 4 Urology and Related Services | 28 | $17,374 | $3,040 |
| Level 6 Musculoskeletal Procedures | 24 | $51,815 | $16,690 |
| Level 3 Urology and Related Services | 24 | $14,638 | $1,828 |
| Level 2 Musculoskeletal Procedures | 22 | $10,517 | $1,443 |
| Level 1 Laparoscopy and Related Services | 22 | $31,786 | $5,179 |
| Level 3 Pacemaker and Similar Procedures | 17 | $51,972 | $9,577 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 13 | $16,338 | $2,550 |
Against the Ohio average
For Kidney and Urinary Tract Infections without MCC (DRG 690), Wilson Memorial Hospital charged $19,738 on average, 23% less than the Ohio average of $25,492, and was paid $6,658 against a state average of $6,811. For Heart Failure and Shock with MCC (DRG 291), Wilson Memorial Hospital charged $20,610 on average, 52% less than the Ohio average of $42,986, and was paid $10,186 against a state average of $10,652. For Pulmonary Edema and Respiratory Failure (DRG 189), Wilson Memorial Hospital charged $32,803 on average, 25% less than the Ohio average of $44,002, and was paid $9,853 against a state average of $10,477. For Respiratory Infections and Inflammations with MCC (DRG 177), Wilson Memorial Hospital charged $29,883 on average, 41% less than the Ohio average of $50,577, and was paid $11,992 against a state average of $13,102. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $13,538 was 21% below the state average of $17,044. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $44,833 was 23% below the state average of $58,420. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $31,116 was 23% below the state average of $40,587. For Level 2 Pacemaker and Similar Procedures (outpatient APC 5222), its average charge of $20,029 was 36% below the state average of $31,409.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Wilson Memorial Hospital in Sidney, OH, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-09-11 (CMS case 2525)
- CAP Request — 2025-01-06 (CMS case 2525)
- Closure Notice — 2025-02-12 (CMS case 2525)
- Warning Notice — 2026-05-27 (CMS case 7867)
- Closure Notice — 2026-06-04 (CMS case 7867)
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.