Portsmouth Regional Hospital
Portsmouth Regional Hospital, a for-profit facility in Portsmouth, NH, charges 9.2x the Medicare reimbursement rate across 87 analyzed procedures.
Portsmouth, NH 03801 · Acute Care Hospitals · CMS Rating: 3/5
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 — 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
F
Very high
Avg markup vs Medicare
9.16x
Charge / Medicare rate
Max markup
19x
Worst procedure
Procedures analyzed
87
With pricing data
Outlier procedures
9.2%
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 |
|---|---|---|---|---|---|
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $102,539 | $51,270 | — | 19x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $41,213 | $20,606 | — | 13.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $149,510 | $74,755 | — | 13.2x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | 267 | $527,778 | $263,889 | — | 12.8x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $169,242 | $84,621 | — | 12.2x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $63,556 | $31,778 | — | 11.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $176,833 | $88,416 | — | 11.8x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $59,267 | $29,634 | — | 11.7x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | 516 | $161,416 | $80,708 | — | 11.2x |
| PNEUMOTHORAX WITH CC | 200 | $86,230 | $43,115 | — | 11.2x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | 235 | $374,592 | $187,296 | — | 11.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $77,341 | $38,670 | — | 11x |
| SEIZURES WITHOUT MCC | 101 | $67,119 | $33,559 | — | 11x |
| HYPERTENSION WITHOUT MCC | 305 | $59,345 | $29,672 | — | 10.8x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $82,757 | $41,378 | — | 10.8x |
| TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | 605 | $63,102 | $31,551 | — | 10.7x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $275,047 | $137,524 | — | 10.6x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $121,894 | $60,947 | — | 10.6x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $239,951 | $119,976 | — | 10.5x |
| DYSEQUILIBRIUM | 149 | $49,991 | $24,995 | — | 10.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $50,464 | $25,232 | — | 10.3x |
| SEIZURES WITH MCC | 100 | $156,486 | $78,243 | — | 10.2x |
| CHEST PAIN | 313 | $45,717 | $22,859 | — | 10.2x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $557,469 | $278,734 | — | 10.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $35,059 | $17,530 | — | 10x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $57,005 | $28,502 | — | 10x |
| SYNCOPE AND COLLAPSE | 312 | $58,196 | $29,098 | — | 10x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $161,986 | $80,993 | — | 9.8x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $66,702 | $33,351 | — | 9.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $50,872 | $25,436 | — | 9.6x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $145,418 | $72,709 | — | 9.5x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 219 | $558,825 | $279,413 | — | 9.5x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $50,518 | $25,259 | — | 9.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $127,500 | $63,750 | — | 9.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $59,614 | $29,807 | — | 9.5x |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O | 023 | $414,554 | $207,277 | — | 9.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $143,301 | $71,650 | — | 9.4x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $104,211 | $52,105 | — | 9.4x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | 086 | $83,563 | $41,781 | — | 9.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $46,208 | $23,104 | — | 9.4x |
| REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | 468 | $186,908 | $93,454 | — | 9.4x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $54,055 | $27,028 | — | 9.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $51,656 | $25,828 | — | 9.3x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $166,409 | $83,205 | — | 9.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $70,802 | $35,401 | — | 9.1x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC | 084 | $58,679 | $29,340 | — | 9.1x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $162,726 | $81,363 | — | 9x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $236,924 | $118,462 | — | 8.9x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $262,201 | $131,100 | — | 8.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $69,823 | $34,911 | — | 8.9x |
Showing 50 of 87 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