Knox Community Hospital
KNOX COMMUNITY HOSPITAL in Mount Vernon, OH charges 3.8x the Medicare reimbursement rate across 24 analyzed procedures at this nonprofit facility.
Mount Vernon, OH 43050 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
C
Average
Avg markup vs Medicare
3.82x
Charge / Medicare rate
Max markup
6.16x
Worst procedure
Procedures analyzed
24
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $40,779 | $20,390 | — | 6.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $27,444 | $13,722 | — | 5.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $69,610 | $34,805 | — | 5.4x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $22,640 | $11,320 | — | 4.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $22,290 | $11,145 | — | 4.6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $32,011 | $16,005 | — | 4.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $20,471 | $10,236 | — | 4.5x |
| RENAL FAILURE WITH CC | 683 | $26,371 | $13,185 | — | 4.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $88,873 | $44,436 | — | 4.1x |
| CELLULITIS WITHOUT MCC | 603 | $21,413 | $10,707 | — | 4x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $34,582 | $17,291 | — | 3.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $30,510 | $15,255 | — | 3.8x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $22,845 | $11,423 | — | 3.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $39,880 | $19,940 | — | 3.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $32,441 | $16,220 | — | 3.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $17,095 | $8,548 | — | 3.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $16,572 | $8,286 | — | 3.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $29,247 | $14,623 | — | 3.3x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $27,866 | $13,933 | — | 3.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $44,835 | $22,418 | — | 3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $21,335 | $10,668 | — | 2.7x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $31,186 | $15,593 | — | 2.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $32,913 | $16,456 | — | 2.3x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $6,479 | $3,240 | — | 1.2x |
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use