South Texas Health System
South Texas Health System in Edinburg, TX charges 14.1x the Medicare reimbursement rate on average, with 92% of analyzed procedures showing significant price variations.
Edinburg, TX 78539 · Acute Care Hospitals · CMS Rating: 4/5
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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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
14.11x
Charge / Medicare rate
Max markup
22.68x
Worst procedure
Procedures analyzed
51
With pricing data
Outlier procedures
92.2%
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 |
|---|---|---|---|---|---|
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $563,554 | $281,777 | — | 22.7x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $1,184,179 | $592,089 | — | 21.3x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $313,318 | $156,659 | — | 20.9x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $289,405 | $144,702 | — | 20.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $293,894 | $146,947 | — | 19.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $243,204 | $121,602 | — | 18.4x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $607,929 | $303,965 | — | 17.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $116,076 | $58,038 | — | 17.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $140,949 | $70,475 | — | 17.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $357,299 | $178,650 | — | 16.7x |
| CELLULITIS WITHOUT MCC | 603 | $116,589 | $58,294 | — | 16.2x |
| SYNCOPE AND COLLAPSE | 312 | $119,251 | $59,626 | — | 16.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $711,169 | $355,585 | — | 16.1x |
| CHEST PAIN | 313 | $89,443 | $44,722 | — | 16.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $242,598 | $121,299 | — | 16x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $138,207 | $69,104 | — | 15.8x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $125,788 | $62,894 | — | 15.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $150,519 | $75,259 | — | 15.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $123,420 | $61,710 | — | 15x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $113,389 | $56,694 | — | 14.9x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $488,285 | $244,142 | — | 14.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $105,980 | $52,990 | — | 14.5x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $102,415 | $51,207 | — | 14.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $131,592 | $65,796 | — | 14.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $163,327 | $81,663 | — | 14.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $86,648 | $43,324 | — | 14.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $205,977 | $102,988 | — | 13.8x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $173,358 | $86,679 | — | 13.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $135,410 | $67,705 | — | 13.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $103,465 | $51,733 | — | 13.5x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $108,660 | $54,330 | — | 13x |
| RENAL FAILURE WITH CC | 683 | $93,283 | $46,641 | — | 12.8x |
| RENAL FAILURE WITH MCC | 682 | $147,696 | $73,848 | — | 12.6x |
| HYPERTENSION WITHOUT MCC | 305 | $79,132 | $39,566 | — | 12.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $130,553 | $65,276 | — | 12.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $86,042 | $43,021 | — | 12.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $176,327 | $88,164 | — | 12.1x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $287,052 | $143,526 | — | 12.1x |
| DIABETES WITH MCC | 637 | $123,054 | $61,527 | — | 12x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $149,688 | $74,844 | — | 11.9x |
| DIABETES WITH CC | 638 | $92,459 | $46,229 | — | 11.5x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $268,308 | $134,154 | — | 11.1x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $151,506 | $75,753 | — | 10.8x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $470,523 | $235,261 | — | 10.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $72,593 | $36,297 | — | 10.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $102,192 | $51,096 | — | 10.1x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $152,680 | $76,340 | — | 9.7x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $142,840 | $71,420 | — | 9.6x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $82,202 | $41,101 | — | 9.5x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $80,425 | $40,213 | — | 7x |
Showing 50 of 51 procedures
How SOUTH TEXAS HEALTH SYSTEM compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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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 — for-profit 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