Mercy Health - West Hospital
MERCY HEALTH - WEST HOSPITAL in Cincinnati, Ohio charges 6.0x the Medicare reimbursement rate across 62 analyzed procedures, representing a significant markup over the government benchmark.
Cincinnati, OH 45211 · Acute Care Hospitals · CMS Rating: 4/5
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
D
High
Avg markup vs Medicare
5.95x
Charge / Medicare rate
Max markup
9.17x
Worst procedure
Procedures analyzed
62
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 |
|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $30,184 | $15,092 | — | 9.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $47,703 | $23,851 | — | 8.7x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $112,999 | $56,499 | — | 8.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $41,058 | $20,529 | — | 7.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $86,320 | $43,160 | — | 7.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $80,638 | $40,319 | — | 7.6x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $29,793 | $14,897 | — | 7.6x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $186,318 | $93,159 | — | 7.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $31,307 | $15,654 | — | 7.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $30,059 | $15,030 | — | 7.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $30,741 | $15,371 | — | 7.1x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $27,487 | $13,743 | — | 7.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $37,294 | $18,647 | — | 6.9x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $36,130 | $18,065 | — | 6.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $50,050 | $25,025 | — | 6.7x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $70,959 | $35,479 | — | 6.7x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $73,389 | $36,694 | — | 6.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $27,667 | $13,834 | — | 6.6x |
| DIABETES WITH MCC | 637 | $54,570 | $27,285 | — | 6.5x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $35,864 | $17,932 | — | 6.4x |
| DYSEQUILIBRIUM | 149 | $27,455 | $13,728 | — | 6.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $26,423 | $13,212 | — | 6.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $66,346 | $33,173 | — | 6.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $76,949 | $38,475 | — | 6.2x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $80,331 | $40,165 | — | 6.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $60,206 | $30,103 | — | 6x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $38,704 | $19,352 | — | 6x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $34,144 | $17,072 | — | 6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $36,989 | $18,495 | — | 6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $34,285 | $17,142 | — | 5.9x |
| CHEST PAIN | 313 | $23,065 | $11,532 | — | 5.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $27,876 | $13,938 | — | 5.8x |
| DIABETES WITH CC | 638 | $29,787 | $14,893 | — | 5.8x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $99,618 | $49,809 | — | 5.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $42,576 | $21,288 | — | 5.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $72,288 | $36,144 | — | 5.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $43,008 | $21,504 | — | 5.6x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $53,371 | $26,686 | — | 5.6x |
| SEIZURES WITHOUT MCC | 101 | $27,242 | $13,621 | — | 5.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $25,136 | $12,568 | — | 5.5x |
| HYPERTENSION WITHOUT MCC | 305 | $22,517 | $11,258 | — | 5.5x |
| CELLULITIS WITHOUT MCC | 603 | $25,433 | $12,717 | — | 5.5x |
| SYNCOPE AND COLLAPSE | 312 | $26,028 | $13,014 | — | 5.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $59,997 | $29,999 | — | 5.3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $51,015 | $25,507 | — | 5.3x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $61,275 | $30,638 | — | 5.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $220,788 | $110,394 | — | 5.2x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $127,472 | $63,736 | — | 5.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $39,093 | $19,547 | — | 5.1x |
| RENAL FAILURE WITH CC | 683 | $24,357 | $12,178 | — | 5x |
Showing 50 of 62 procedures
How MERCY HEALTH - WEST 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