Medical City Plano

Medical City Plano in Plano, TX charges 14.6x the Medicare reimbursement rate on average, with 69% of its 150 analyzed procedures showing significant price variations.

Plano, TX 75075 · Acute Care Hospitals · CMS Rating: 2/5

By Elena Vasquez , Medical Billing Research Lead · Published March 15, 2026 · Updated April 3, 2026

Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.

About the analyst

Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.

150 procedures analyzed

CMS price transparency data

Updated 2026-04-03

14.6x

Medicare markup ratio

TX lowestMedical City PlanoTX highest

14.6x

Avg markup ratio

14.2x

Median markup

150

Procedures

69%

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

Very high

Avg markup vs Medicare

14.61x

Charge / Medicare rate

Max markup

25.02x

Worst procedure

Procedures analyzed

150

With pricing data

Outlier procedures

69.3%

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
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC	494	$273,538	$136,769	—	25x
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES	483	$634,793	$317,396	—	24.9x
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC	486	$447,969	$223,985	—	23.7x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC	274	$562,617	$281,308	—	23.2x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	470	$278,007	$139,004	—	22.5x
MAJOR CHEST PROCEDURES WITH CC	164	$290,160	$145,080	—	22.3x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC	522	$284,271	$142,136	—	21x
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC	439	$99,064	$49,532	—	20.9x
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC	271	$418,400	$209,200	—	20.7x
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC	468	$477,673	$238,836	—	20.1x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTA	469	$446,477	$223,238	—	20.1x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC	247	$228,785	$114,393	—	20x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC	455	$652,103	$326,052	—	20x
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	460	$499,661	$249,831	—	19.9x
HEADACHES WITHOUT MCC	103	$81,558	$40,779	—	19.7x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC	482	$210,407	$105,203	—	19.4x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS	065	$120,166	$60,083	—	19.4x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC	309	$92,602	$46,301	—	19.3x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC	390	$58,783	$29,392	—	19.2x
REVISION OF HIP OR KNEE REPLACEMENT WITH CC	467	$732,100	$366,050	—	18.9x
PULMONARY EMBOLISM WITHOUT MCC	176	$90,421	$45,211	—	18.9x
MAJOR CHEST TRAUMA WITH CC	184	$131,163	$65,581	—	18.4x
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC	478	$348,238	$174,119	—	18.4x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC	418	$213,501	$106,750	—	18.3x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC	454	$924,309	$462,155	—	18.1x
STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC	328	$178,913	$89,457	—	17.7x
DISORDERS OF THE BILIARY TRACT WITH MCC	444	$227,770	$113,885	—	17.6x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC	069	$91,686	$45,843	—	17.5x
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC	025	$498,587	$249,294	—	17.4x
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE D	464	$657,750	$328,875	—	17.3x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC	517	$169,754	$84,877	—	17.2x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC	331	$179,906	$89,953	—	17x
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE D	463	$812,890	$406,445	—	17x
CERVICAL SPINAL FUSION WITH CC	472	$335,424	$167,712	—	17x
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC	466	$783,408	$391,704	—	17x
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC	493	$264,361	$132,180	—	16.7x
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC	520	$163,625	$81,812	—	16.6x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC	516	$222,375	$111,188	—	16.5x
SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE	456	$985,682	$492,841	—	16.5x
OTHER O.R. PROCEDURES FOR INJURIES WITH CC	908	$218,046	$109,023	—	16.3x
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O	023	$552,081	$276,041	—	16.3x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC	481	$214,345	$107,172	—	16.1x
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC	519	$212,257	$106,128	—	16.1x
GASTROINTESTINAL OBSTRUCTION WITH MCC	388	$149,346	$74,673	—	16.1x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC	453	$1,127,664	$563,832	—	16.1x
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC	039	$111,090	$55,545	—	16x
DIABETES WITH CC	638	$103,338	$51,669	—	15.9x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	281	$91,879	$45,940	—	15.9x
DYSEQUILIBRIUM	149	$79,592	$39,796	—	15.9x
CERVICAL SPINAL FUSION WITH MCC	471	$546,066	$273,033	—	15.8x

Showing 50 of 150 procedures

How MEDICAL CITY PLANO compares to nearby hospitals

Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.

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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.

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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