MAINEHEALTH PEN BAY HOSPITAL
ROCKPORT, ME 04856 · Acute Care Hospitals
11 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
11
With CMS pricing data
Avg Charge-to-Medicare Ratio
3.4x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Private
Above 90th Percentile
0%
Compared to ME hospitals
Understanding Your Costs
When you receive a bill from MAINEHEALTH PEN BAY HOSPITAL, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, MAINEHEALTH PEN BAY HOSPITAL lists chargemaster rates that average 3.4x the corresponding Medicare reimbursement amount across 11 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in ME has a chargemaster-to-Medicare ratio of 3.5x, with ratios across the state ranging from 2.6x to 5.1x. At 3.4x, this facility’s average ratio is below the state median. 13 hospitals in ME report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at MAINEHEALTH PEN BAY HOSPITAL is PULMONARY EDEMA AND RESPIRATORY FAILURE (DRG 189). The listed chargemaster rate is $48,636, while Medicare reimburses $10,091 for the same procedure — a ratio of 4.8x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
MAINEHEALTH PEN BAY HOSPITAL is a voluntary non-profit - private acute care hospitals facility with a CMS quality rating of 2/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $48,636 | $10,091 | 4.8x | 1th | Compare your bill |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $27,569 | $6,432 | 4.3x | 0th | Compare your bill |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $36,889 | $8,987 | 4.1x | 1th | Compare your bill |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $82,134 | $20,608 | 4.0x | 0th | Compare your bill |
| PSYCHOSES | 885 | $46,091 | $13,061 | 3.5x | 1th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $26,685 | $8,392 | 3.2x | 0th | Compare your bill |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $32,376 | $11,278 | 2.9x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $20,795 | $7,598 | 2.7x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $37,435 | $13,764 | 2.7x | 0th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $49,372 | $19,781 | 2.5x | 0th | Compare your bill |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $37,456 | $16,019 | 2.3x | 0th | Compare your bill |
Showing 11 of 11 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across ME hospitals
13 hospitals in ME report pricing data to CMS. This facility's average ratio of 3.4x places it at the lower-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About MAINEHEALTH PEN BAY HOSPITAL
How much does MAINEHEALTH PEN BAY HOSPITAL charge compared to Medicare?
According to CMS IPPS data, MAINEHEALTH PEN BAY HOSPITAL's listed chargemaster rates average 3.4x the Medicare reimbursement amount across 11 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at MAINEHEALTH PEN BAY HOSPITAL?
The procedure with the highest chargemaster-to-Medicare ratio at MAINEHEALTH PEN BAY HOSPITAL is PULMONARY EDEMA AND RESPIRATORY FAILURE (DRG 189), with a listed charge of $48,636 compared to Medicare reimbursement of $10,091 — a ratio of 4.8x. Source: CMS IPPS Provider Summary.
Is MAINEHEALTH PEN BAY HOSPITAL expensive compared to other ME hospitals?
MAINEHEALTH PEN BAY HOSPITAL's average chargemaster-to-Medicare ratio is 3.4x. Ratios vary significantly across ME hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for MAINEHEALTH PEN BAY HOSPITAL come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from MAINEHEALTH PEN BAY HOSPITAL is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does MAINEHEALTH PEN BAY HOSPITAL in ROCKPORT, ME accept Medicare?
MAINEHEALTH PEN BAY HOSPITAL is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact MAINEHEALTH PEN BAY HOSPITAL directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.