Northside Hospital Forsyth
NORTHSIDE HOSPITAL FORSYTH in Cumming, GA charges 8.1x the Medicare reimbursement rate across 99 analyzed procedures, placing this nonprofit-private facility significantly above standard Medicare benchmarks.
Cumming, GA 30041 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
F
Very high
Avg markup vs Medicare
8.1x
Charge / Medicare rate
Max markup
13.27x
Worst procedure
Procedures analyzed
99
With pricing data
Outlier procedures
1%
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 |
|---|---|---|---|---|---|
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $83,288 | $41,644 | — | 13.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $163,484 | $81,742 | — | 12.9x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $76,137 | $38,069 | — | 11.7x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $158,918 | $79,459 | — | 11.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $71,459 | $35,730 | — | 11.3x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $38,199 | $19,100 | — | 10.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $36,962 | $18,481 | — | 10.8x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $105,896 | $52,948 | — | 10.4x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $103,714 | $51,857 | — | 9.9x |
| DIABETES WITH CC | 638 | $56,210 | $28,105 | — | 9.8x |
| HYPERTENSION WITHOUT MCC | 305 | $47,684 | $23,842 | — | 9.7x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $50,455 | $25,228 | — | 9.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $215,459 | $107,729 | — | 9.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $81,282 | $40,641 | — | 9.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $63,624 | $31,812 | — | 9.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $107,914 | $53,957 | — | 9.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $50,042 | $25,021 | — | 9.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $75,848 | $37,924 | — | 9.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $136,750 | $68,375 | — | 9.1x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $59,266 | $29,633 | — | 9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $91,582 | $45,791 | — | 8.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $45,846 | $22,923 | — | 8.9x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $119,838 | $59,919 | — | 8.8x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $112,525 | $56,263 | — | 8.8x |
| CELLULITIS WITH MCC | 602 | $86,694 | $43,347 | — | 8.7x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $76,160 | $38,080 | — | 8.7x |
| CHEST PAIN | 313 | $42,685 | $21,343 | — | 8.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $45,018 | $22,509 | — | 8.6x |
| SEIZURES WITHOUT MCC | 101 | $53,227 | $26,613 | — | 8.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $227,399 | $113,699 | — | 8.5x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $45,602 | $22,801 | — | 8.5x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $106,552 | $53,276 | — | 8.5x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $59,499 | $29,750 | — | 8.5x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $58,355 | $29,177 | — | 8.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $77,516 | $38,758 | — | 8.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $48,129 | $24,065 | — | 8.3x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $41,112 | $20,556 | — | 8.3x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $46,097 | $23,049 | — | 8.3x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $158,713 | $79,357 | — | 8.3x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $117,362 | $58,681 | — | 8.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $44,236 | $22,118 | — | 8.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $56,976 | $28,488 | — | 8.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $64,797 | $32,399 | — | 8.2x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $61,037 | $30,518 | — | 8.2x |
| CERVICAL SPINAL FUSION WITHOUT CC/MCC | 473 | $134,001 | $67,000 | — | 8.2x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $49,159 | $24,579 | — | 8.1x |
| BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | 519 | $106,113 | $53,056 | — | 8.1x |
| SEIZURES WITH MCC | 100 | $136,809 | $68,404 | — | 8.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $98,034 | $49,017 | — | 8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $47,076 | $23,538 | — | 8x |
Showing 50 of 99 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.
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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