Prisma Health Tuomey Hospital
PRISMA HEALTH TUOMEY HOSPITAL in Sumter, SC charges 4.6x the Medicare reimbursement rate across 49 analyzed procedures, reflecting this nonprofit facility's pricing structure compared to federal benchmarks.
Sumter, SC 29150 · Acute Care Hospitals · CMS Rating: 2/5
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
C
Average
Avg markup vs Medicare
4.64x
Charge / Medicare rate
Max markup
8.22x
Worst procedure
Procedures analyzed
49
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 |
|---|---|---|---|---|---|
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $40,635 | $20,318 | — | 8.2x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $84,992 | $42,496 | — | 6.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $81,848 | $40,924 | — | 6.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $16,161 | $8,080 | — | 5.7x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $26,589 | $13,295 | — | 5.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $28,670 | $14,335 | — | 5.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $30,188 | $15,094 | — | 5.5x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $35,064 | $17,532 | — | 5.3x |
| RENAL FAILURE WITH CC | 683 | $27,284 | $13,642 | — | 5.2x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $28,193 | $14,097 | — | 5.2x |
| DIABETES WITH CC | 638 | $27,070 | $13,535 | — | 5.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $54,078 | $27,039 | — | 5.1x |
| HYPERTENSION WITHOUT MCC | 305 | $22,501 | $11,251 | — | 5.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $38,597 | $19,298 | — | 5.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $22,105 | $11,052 | — | 5.1x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $40,310 | $20,155 | — | 4.9x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $48,779 | $24,390 | — | 4.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $36,205 | $18,102 | — | 4.9x |
| SEIZURES WITHOUT MCC | 101 | $25,023 | $12,512 | — | 4.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $59,824 | $29,912 | — | 4.7x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $48,156 | $24,078 | — | 4.6x |
| CELLULITIS WITHOUT MCC | 603 | $25,010 | $12,505 | — | 4.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $24,980 | $12,490 | — | 4.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $25,560 | $12,780 | — | 4.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $33,671 | $16,835 | — | 4.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $30,994 | $15,497 | — | 4.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $34,122 | $17,061 | — | 4.5x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $40,693 | $20,346 | — | 4.4x |
| SYNCOPE AND COLLAPSE | 312 | $23,724 | $11,862 | — | 4.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $20,689 | $10,344 | — | 4.4x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $20,823 | $10,411 | — | 4.4x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $25,439 | $12,719 | — | 4.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $39,024 | $19,512 | — | 4.2x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $23,060 | $11,530 | — | 4.2x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $17,899 | $8,950 | — | 4.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $18,699 | $9,350 | — | 4.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $19,356 | $9,678 | — | 4.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $32,086 | $16,043 | — | 4x |
| RENAL FAILURE WITH MCC | 682 | $33,689 | $16,845 | — | 4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $22,579 | $11,290 | — | 4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $48,384 | $24,192 | — | 3.9x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $18,407 | $9,204 | — | 3.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $30,564 | $15,282 | — | 3.7x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $35,633 | $17,817 | — | 3.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $18,726 | $9,363 | — | 3.5x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $57,101 | $28,551 | — | 3.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $88,529 | $44,264 | — | 3.4x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $37,624 | $18,812 | — | 3.4x |
| DIABETES WITH MCC | 637 | $28,152 | $14,076 | — | 3.2x |
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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