Medstar Georgetown University Hospital
MedStar Georgetown University Hospital in Washington, DC charges 5.9x the Medicare reimbursement rate across 126 analyzed procedures at this for-profit medical facility.
Washington, DC 20007 · 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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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
D
High
Avg markup vs Medicare
5.88x
Charge / Medicare rate
Max markup
11.43x
Worst procedure
Procedures analyzed
126
With pricing data
Outlier procedures
4%
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 |
|---|---|---|---|---|---|
| MAJOR CHEST PROCEDURES WITHOUT CC/MCC | 165 | $147,507 | $73,754 | — | 11.4x |
| KIDNEY TRANSPLANT | 652 | $245,986 | $122,993 | — | 10.8x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $64,005 | $32,002 | — | 10.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $57,320 | $28,660 | — | 8.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $48,996 | $24,498 | — | 8.7x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 809 | $105,963 | $52,981 | — | 8.7x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $137,824 | $68,912 | — | 8.6x |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $125,191 | $62,595 | — | 8.4x |
| COMPLICATIONS OF TREATMENT WITH CC | 920 | $68,587 | $34,294 | — | 8.1x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | 442 | $72,971 | $36,486 | — | 8.1x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $122,351 | $61,176 | — | 7.9x |
| POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | 857 | $174,711 | $87,356 | — | 7.7x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $152,413 | $76,206 | — | 7.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $49,255 | $24,627 | — | 7.6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $61,228 | $30,614 | — | 7.5x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $160,488 | $80,244 | — | 7.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $61,344 | $30,672 | — | 7.2x |
| KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC | 650 | $306,123 | $153,062 | — | 7.2x |
| OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | 907 | $204,432 | $102,216 | — | 7.1x |
| WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE D | 464 | $205,301 | $102,651 | — | 7.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $84,332 | $42,166 | — | 7x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $152,035 | $76,017 | — | 7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $60,776 | $30,388 | — | 6.9x |
| RENAL FAILURE WITH MCC | 682 | $127,202 | $63,601 | — | 6.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $124,126 | $62,063 | — | 6.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $53,132 | $26,566 | — | 6.9x |
| POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | 862 | $166,137 | $83,068 | — | 6.8x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $141,438 | $70,719 | — | 6.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $79,790 | $39,895 | — | 6.8x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $125,205 | $62,602 | — | 6.8x |
| DIABETES WITH CC | 638 | $54,490 | $27,245 | — | 6.7x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $128,800 | $64,400 | — | 6.7x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $138,957 | $69,479 | — | 6.7x |
| CELLULITIS WITHOUT MCC | 603 | $54,297 | $27,149 | — | 6.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $43,505 | $21,753 | — | 6.6x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $85,391 | $42,696 | — | 6.6x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $329,211 | $164,606 | — | 6.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $46,654 | $23,327 | — | 6.5x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $177,072 | $88,536 | — | 6.5x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | 026 | $152,176 | $76,088 | — | 6.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $76,606 | $38,303 | — | 6.4x |
| BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR | 518 | $183,444 | $91,722 | — | 6.4x |
| LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT | 005 | $811,803 | $405,902 | — | 6.3x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $56,862 | $28,431 | — | 6.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $84,793 | $42,396 | — | 6.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $84,308 | $42,154 | — | 6.3x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $117,402 | $58,701 | — | 6.2x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $47,473 | $23,737 | — | 6.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $350,865 | $175,433 | — | 6.2x |
| DIABETES WITH MCC | 637 | $66,801 | $33,401 | — | 6.1x |
Showing 50 of 126 procedures
How MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL 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.
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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