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Lewisgale Medical Center

LEWISGALE MEDICAL CENTER in Salem, VA charges 10.0x the Medicare reimbursement rate across 111 analyzed procedures, with 21% showing significant pricing variations.

Salem, VA 24153 · Acute Care Hospitals · CMS Rating: 2/5

By Priya Iyengar , Senior Billing Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
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.

111 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 7.0x4.0x16.0x
10.0x
Medicare markup ratio
VA lowestLewisgale Medical CenterVA highest
10.0x
Avg markup ratio
8.7x
Median markup
111
Procedures
21%
Outlier procedures
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Billing patterns — for-profit

For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.

Pricing grade

F

Very high

Avg markup vs Medicare

10.01x

Charge / Medicare rate

Max markup

21.37x

Worst procedure

Procedures analyzed

111

With pricing data

Outlier procedures

20.7%

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.

ProcedureCodeGross chargeCash priceMedicareMarkup
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC482$204,536$102,26821.4x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC331$193,322$96,66119.6x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC418$196,041$98,02118.6x
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC236$424,507$212,25317.4x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC330$253,190$126,59517.1x
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC039$113,419$56,71017x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$199,251$99,62616.6x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC470$192,944$96,47216x
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES483$232,808$116,40415.6x
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC435$193,809$96,90415.6x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC419$126,990$63,49515.4x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC286$207,890$103,94515x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC390$39,921$19,96114.9x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC516$181,128$90,56414.5x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC287$97,768$48,88414.4x
DISORDERS OF THE BILIARY TRACT WITH CC445$101,275$50,63714.1x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC393$156,983$78,49113.7x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC417$216,640$108,32013.6x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC481$182,864$91,43213.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O246$251,205$125,60313.2x
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC267$465,099$232,54913.1x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC282$52,877$26,43813.1x
REVISION OF HIP OR KNEE REPLACEMENT WITH CC467$272,257$136,12912.9x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC522$177,423$88,71112.5x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$55,017$27,50912.2x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC274$270,843$135,42112.1x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC480$221,332$110,66611.9x
GASTROINTESTINAL OBSTRUCTION WITH CC389$58,315$29,15711.8x
HYPERTENSION WITHOUT MCC305$43,891$21,94511.6x
RED BLOOD CELL DISORDERS WITHOUT MCC812$57,126$28,56311.5x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC521$209,079$104,53911.4x
PNEUMOTHORAX WITH CC200$74,065$37,03211.3x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC329$392,656$196,32811.2x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC854$144,424$72,21211.2x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC394$62,350$31,17510.8x
GASTROINTESTINAL HEMORRHAGE WITH CC378$65,512$32,75610.8x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC066$40,946$20,47310.7x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC243$166,184$83,09210.6x
CHEST PAIN313$40,788$20,39410.3x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC242$251,786$125,89310.3x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$61,394$30,69710.3x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$56,813$28,40610.2x
DYSEQUILIBRIUM149$43,471$21,7359.9x
FRACTURES OF HIP AND PELVIS WITHOUT MCC536$43,845$21,9239.8x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$44,043$22,0219.8x
TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC087$54,498$27,2499.8x
PERIPHERAL VASCULAR DISORDERS WITH MCC299$103,282$51,6419.7x
SEIZURES WITHOUT MCC101$51,631$25,8169.5x
FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC562$86,671$43,3359.5x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC853$299,495$149,7489.4x

Showing 50 of 111 procedures

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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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?
Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.
Why do for-profit hospitals charge more than Medicare rates?
For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.
Does insurance typically pay the full hospital charge amount?
Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.
What should I know about billing differences between hospital types?
For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

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

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