Massachusetts / Winchester Hospital

CMS certification 220105 · Winchester, MA · 1 entry in CMS's price-transparency list

Winchester Hospital: charges and Medicare payments

Winchester Hospital reported 3,636 Medicare inpatient stays across 89 DRGs in 2024. Across them it charged 1.9 times what it was paid — among the lower ratios in Massachusetts, number 37 of 52 hospitals with at least 100 stays (state median 2×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 327 stays at an average charge of $29,921, 67% below the national average. It also billed 2,215 outpatient services, charging 2.85 times what Medicare paid.

1Medicare inpatient stays 3,636
2Charge ÷ paid, inpatient 1.9×
3Rank in MA (highest ratio = 1) 37 of 52
4CMS price-transparency actions 1

Average charge per stay at Winchester Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 89 DRGs that can be compared with the national average, Winchester 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
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	327	$29,921	-67%	$15,314
291 Heart Failure and Shock with MCC	221	$19,317	-66%	$10,275
177 Respiratory Infections and Inflammations with MCC	209	$25,568	-64%	$13,070
193 Simple Pneumonia and Pleurisy with MCC	158	$19,957	-67%	$10,472
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	127	$12,759	-68%	$6,516
683 Renal Failure with CC	92	$14,545	-64%	$8,839
689 Kidney and Urinary Tract Infections with MCC	86	$14,734	-71%	$9,283
189 Pulmonary Edema and Respiratory Failure	84	$17,287	-70%	$10,577
603 Cellulitis without MCC	83	$10,612	-72%	$7,421
690 Kidney and Urinary Tract Infections without MCC	77	$12,751	-66%	$6,477
280 Acute Myocardial Infarction, Discharged Alive with MCC	75	$24,069	-68%	$12,801
682 Renal Failure with MCC	74	$19,830	-70%	$11,878
698 Other Kidney and Urinary Tract Diagnoses with MCC	73	$23,422	-68%	$12,573
194 Simple Pneumonia and Pleurisy with CC	68	$12,674	-67%	$6,587
470 Major Hip and Knee Joint Replacement or Reattachment of...	64	$31,714	-66%	$16,109
312 Syncope and Collapse	63	$13,414	-71%	$7,022
552 Medical Back Problems without MCC	61	$10,616	-78%	$7,950
178 Respiratory Infections and Inflammations with CC	54	$17,166	-62%	$8,901
378 Gastrointestinal Hemorrhage with CC	52	$19,636	-60%	$7,725
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	52	$11,899	-68%	$6,184
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	51	$19,416	-60%	$8,836
377 Gastrointestinal Hemorrhage with MCC	49	$30,821	-64%	$14,374
543 Pathological Fractures and Musculoskeletal and Connective...	49	$14,396	-71%	$8,643
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	43	$12,556	-71%	$7,333
190 Chronic Obstructive Pulmonary Disease with MCC	42	$18,082	-64%	$9,589
202 Bronchitis and Asthma with CC/MCC	42	$14,186	-69%	$7,766
313 Chest Pain	39	$12,938	-68%	$6,244
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	38	$18,669	-71%	$11,591
309 Cardiac Arrhythmia and Conduction Disorders with CC	36	$15,296	-58%	$6,873
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	36	$18,937	-69%	$10,309
813 Coagulation Disorders	36	$27,037	-66%	$12,604
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	34	$17,153	-72%	$9,896
149 Dysequilibrium	31	$10,453	-76%	$6,326
308 Cardiac Arrhythmia and Conduction Disorders with MCC	30	$18,168	-68%	$10,043
394 Other Digestive System Diagnoses with CC	30	$18,299	-61%	$7,638
853 Infectious and Parasitic Diseases with O.R. Procedures with...	30	$53,859	-76%	$36,293
393 Other Digestive System Diagnoses with MCC	29	$18,668	-76%	$13,147
699 Other Kidney and Urinary Tract Diagnoses with CC	28	$14,891	-69%	$7,906
638 Diabetes with CC	27	$17,039	-59%	$8,004
811 Red Blood Cell Disorders with MCC	27	$26,547	-61%	$11,565
389 Gastrointestinal Obstruction with CC	26	$12,006	-69%	$6,443
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	26	$15,558	-58%	$6,993
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	24	$23,223	-77%	$14,462
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	24	$32,666	-68%	$16,599
812 Red Blood Cell Disorders without MCC	24	$20,535	-54%	$7,366
191 Chronic Obstructive Pulmonary Disease with CC	23	$14,102	-64%	$6,927
481 Hip and Femur Procedures except Major Joint with CC	23	$34,958	-65%	$16,626
605 Trauma To The Skin, Subcutaneous Tissue and Breast without...	22	$15,500	-67%	$7,925
281 Acute Myocardial Infarction, Discharged Alive with CC	21	$16,194	-68%	$7,094
057 Degenerative Nervous System Disorders without MCC	20	$12,790	-77%	$10,172
176 Pulmonary Embolism without MCC	20	$19,836	-52%	$6,678
305 Hypertension without MCC	20	$11,260	-72%	$6,078
069 Transient Ischemia without Thrombolytic	19	$14,304	-72%	$6,486
542 Pathological Fractures and Musculoskeletal and Connective...	19	$24,171	-70%	$13,947
602 Cellulitis with MCC	19	$16,799	-72%	$10,954
884 Organic Disturbances and Intellectual Disability	19	$15,084	-76%	$11,393
372 Major Gastrointestinal Disorders and Peritoneal Infections...	18	$13,733	-71%	$8,087
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	17	$18,025	-68%	$8,131
195 Simple Pneumonia and Pleurisy without CC/MCC	17	$12,212	-60%	$5,510
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	17	$15,456	-46%	$4,510

Showing the 60 most frequent of 89 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	283	$25,945	$14,022
Level 2 Excision/ Biopsy/ Incision and Drainage	247	$4,807	$1,724
Comprehensive Observation Services	177	$10,447	$2,876
Level 1 Nerve Procedures	151	$7,730	$2,049
Level 2 Upper GI Procedures	148	$6,973	$2,022
Level 2 Musculoskeletal Procedures	146	$5,056	$1,702
Level 1 Laparoscopy and Related Services	131	$13,947	$6,085
Level 5 Urology and Related Services	116	$10,550	$5,557
Level 4 Musculoskeletal Procedures	104	$23,135	$7,565
Level 4 Urology and Related Services	104	$7,555	$3,687
Level 3 Musculoskeletal Procedures	85	$9,282	$3,444
Level 3 Excision/ Biopsy/ Incision and Drainage	71	$8,641	$3,052
Level 3 Vascular Procedures	66	$7,501	$3,371
Level 1 Breast/Lymphatic Surgery and Related Procedures	62	$10,381	$3,975
Level 4 Gynecologic Procedures	46	$7,156	$3,358
Level 2 Vascular Procedures	43	$6,456	$1,700
Level 3 Urology and Related Services	41	$5,707	$2,187
Level 2 Laparoscopy and Related Services	38	$25,223	$11,043
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	30	$10,085	$3,716
Level 5 Gynecologic Procedures	27	$11,018	$5,184
Level 3 Lower GI Procedures	24	$7,703	$3,015
Level 6 Musculoskeletal Procedures	23	$40,313	$19,966
Level 2 Breast/Lymphatic Surgery and Related Procedures	20	$17,876	$6,724
Level 3 Endovascular Procedures	17	$38,747	$11,799
Level 4 Vascular Procedures	15	$15,998	$5,902

Against the Massachusetts average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Winchester Hospital charged $29,921 on average, 34% less than the Massachusetts average of $45,229, and was paid $15,314 against a state average of $19,536. For Heart Failure and Shock with MCC (DRG 291), Winchester Hospital charged $19,317 on average, 36% less than the Massachusetts average of $30,373, and was paid $10,275 against a state average of $12,996. For Respiratory Infections and Inflammations with MCC (DRG 177), Winchester Hospital charged $25,568 on average, 31% less than the Massachusetts average of $37,072, and was paid $13,070 against a state average of $15,861. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Winchester Hospital charged $19,957 on average, 29% less than the Massachusetts average of $28,077, and was paid $10,472 against a state average of $12,627. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $25,945 was 27% below the state average of $35,549. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $4,807 was 27% below the state average of $6,596. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $10,447 was 25% below the state average of $14,010. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $7,730 was 6% below the state average of $8,267.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Winchester Hospital in Winchester, MA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2025-09-04 (CMS case 6493)

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.