Northeast Georgia Medical Center, Inc
Northeast Georgia Medical Center, Inc in Gainesville charges 7.1x the Medicare reimbursement rate across 191 analyzed procedures, reflecting this government-owned hospital's pricing structure compared to federal benchmarks.
Gainesville, GA 30501 · Acute Care Hospitals · CMS Rating: 2/5
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.
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Billing patterns — government
Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.
Pricing grade
D
High
Avg markup vs Medicare
7.09x
Charge / Medicare rate
Max markup
11.06x
Worst procedure
Procedures analyzed
191
With pricing data
Outlier procedures
0.5%
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 |
|---|---|---|---|---|---|
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $78,938 | $39,469 | — | 11.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $141,336 | $70,668 | — | 10.9x |
| CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC | 036 | $142,281 | $71,141 | — | 10.8x |
| O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC | 621 | $102,372 | $51,186 | — | 10.1x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | 419 | $89,863 | $44,931 | — | 9.9x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | 438 | $107,512 | $53,756 | — | 9.8x |
| SEIZURES WITHOUT MCC | 101 | $65,760 | $32,880 | — | 9.8x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $55,360 | $27,680 | — | 9.7x |
| PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | 337 | $95,480 | $47,740 | — | 9.5x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | 236 | $254,607 | $127,303 | — | 9.5x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | 494 | $119,446 | $59,723 | — | 9.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $43,381 | $21,691 | — | 9.2x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $251,697 | $125,849 | — | 9.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $42,099 | $21,049 | — | 9.2x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $214,323 | $107,162 | — | 9.1x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $121,041 | $60,521 | — | 9.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $94,041 | $47,021 | — | 9x |
| AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | 269 | $253,260 | $126,630 | — | 9x |
| BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | 477 | $176,668 | $88,334 | — | 9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $119,203 | $59,602 | — | 8.8x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 220 | $325,775 | $162,888 | — | 8.8x |
| CAROTID ARTERY STENT PROCEDURES WITH CC | 035 | $150,055 | $75,028 | — | 8.8x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $68,303 | $34,152 | — | 8.8x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $65,403 | $32,701 | — | 8.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $58,989 | $29,495 | — | 8.7x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $100,079 | $50,040 | — | 8.7x |
| CERVICAL SPINAL FUSION WITH CC | 472 | $188,284 | $94,142 | — | 8.6x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $44,817 | $22,409 | — | 8.6x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $146,996 | $73,498 | — | 8.6x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $330,560 | $165,280 | — | 8.6x |
| BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | 478 | $121,813 | $60,907 | — | 8.5x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $107,592 | $53,796 | — | 8.5x |
| FRACTURES OF HIP AND PELVIS WITH MCC | 535 | $77,286 | $38,643 | — | 8.5x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $428,586 | $214,293 | — | 8.5x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | 267 | $291,097 | $145,549 | — | 8.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $183,491 | $91,745 | — | 8.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $53,077 | $26,538 | — | 8.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $53,278 | $26,639 | — | 8.4x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $141,388 | $70,694 | — | 8.4x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $45,218 | $22,609 | — | 8.3x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $96,829 | $48,415 | — | 8.3x |
| CHEST PAIN | 313 | $35,797 | $17,898 | — | 8.3x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | 234 | $285,884 | $142,942 | — | 8.2x |
| BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | 519 | $111,677 | $55,839 | — | 8.2x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $195,960 | $97,980 | — | 8.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $130,251 | $65,126 | — | 8.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $89,704 | $44,852 | — | 8.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | 195 | $34,472 | $17,236 | — | 8x |
| TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | 558 | $48,773 | $24,386 | — | 8x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $55,681 | $27,840 | — | 8x |
Showing 50 of 191 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.
FAQ — government hospital billing
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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