Pikeville Medical Center
Pikeville Medical Center, a nonprofit hospital in Pikeville, Kentucky, charges 5.8x the Medicare reimbursement rate across 63 analyzed procedures.
Pikeville, KY 41501 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Pricing grade
D
High
Avg markup vs Medicare
5.75x
Charge / Medicare rate
Max markup
10.22x
Worst procedure
Procedures analyzed
63
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 |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $34,289 | $17,145 | — | 10.2x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $70,713 | $35,357 | — | 8.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $95,374 | $47,687 | — | 7.1x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | 433 | $54,735 | $27,367 | — | 7x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $110,490 | $55,245 | — | 7x |
| CELLULITIS WITHOUT MCC | 603 | $42,192 | $21,096 | — | 6.9x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | 207 | $406,250 | $203,125 | — | 6.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $179,739 | $89,869 | — | 6.9x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $130,735 | $65,367 | — | 6.9x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $50,261 | $25,130 | — | 6.8x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $81,138 | $40,569 | — | 6.8x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $37,640 | $18,820 | — | 6.7x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $145,440 | $72,720 | — | 6.7x |
| CHEST PAIN | 313 | $33,784 | $16,892 | — | 6.6x |
| PNEUMOTHORAX WITH CC | 200 | $51,540 | $25,770 | — | 6.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $80,973 | $40,486 | — | 6.5x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $70,390 | $35,195 | — | 6.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $35,377 | $17,688 | — | 6.4x |
| DIABETES WITH CC | 638 | $34,998 | $17,499 | — | 6.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $31,695 | $15,847 | — | 6.2x |
| DIABETES WITH MCC | 637 | $66,745 | $33,372 | — | 6.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $36,378 | $18,189 | — | 6.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $168,992 | $84,496 | — | 6.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $36,264 | $18,132 | — | 6x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $280,991 | $140,496 | — | 6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $44,280 | $22,140 | — | 6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $99,073 | $49,537 | — | 5.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $33,825 | $16,913 | — | 5.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $54,355 | $27,178 | — | 5.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $347,879 | $173,939 | — | 5.9x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $223,703 | $111,851 | — | 5.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $46,564 | $23,282 | — | 5.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $34,732 | $17,366 | — | 5.6x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $104,725 | $52,363 | — | 5.6x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $90,810 | $45,405 | — | 5.5x |
| RENAL FAILURE WITH MCC | 682 | $66,050 | $33,025 | — | 5.5x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $33,588 | $16,794 | — | 5.4x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $38,903 | $19,452 | — | 5.4x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $29,442 | $14,721 | — | 5.4x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $85,081 | $42,540 | — | 5.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $56,763 | $28,381 | — | 5.4x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $54,848 | $27,424 | — | 5.4x |
| RENAL FAILURE WITH CC | 683 | $36,310 | $18,155 | — | 5.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $52,220 | $26,110 | — | 5.3x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $111,275 | $55,637 | — | 5.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $82,705 | $41,352 | — | 5.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $38,646 | $19,323 | — | 5.1x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | 271 | $131,250 | $65,625 | — | 4.9x |
| SYNCOPE AND COLLAPSE | 312 | $29,866 | $14,933 | — | 4.9x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 521 | $122,720 | $61,360 | — | 4.9x |
Showing 50 of 63 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