SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE
JANESVILLE, WI 53546 · Acute Care Hospitals
17 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
17
With CMS pricing data
Avg Charge-to-Medicare Ratio
5.5x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Other
Above 90th Percentile
0%
Compared to WI hospitals
Understanding Your Costs
When you receive a bill from SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE lists chargemaster rates that average 5.5x the corresponding Medicare reimbursement amount across 17 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in WI has a chargemaster-to-Medicare ratio of 4.1x, with ratios across the state ranging from 1.4x to 7.3x. At 5.5x, this facility’s average ratio is above the state median. 63 hospitals in WI report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE is INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS (DRG 065). The listed chargemaster rate is $44,618, while Medicare reimburses $5,501 for the same procedure — a ratio of 8.1x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE is a voluntary non-profit - other acute care hospitals facility with a CMS quality rating of 4/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $44,618 | $5,501 | 8.1x | 1th | Compare your bill |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $43,116 | $6,024 | 7.2x | 1th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $40,111 | $6,097 | 6.6x | 1th | Compare your bill |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $50,128 | $7,787 | 6.4x | 1th | Compare your bill |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $44,006 | $7,246 | 6.1x | 1th | Compare your bill |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $27,035 | $4,482 | 6.0x | 0th | Compare your bill |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $31,338 | $5,516 | 5.7x | 0th | Compare your bill |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $34,482 | $6,134 | 5.6x | 0th | Compare your bill |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $41,991 | $7,579 | 5.5x | 1th | Compare your bill |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $35,798 | $6,973 | 5.1x | 1th | Compare your bill |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $31,199 | $6,391 | 4.9x | 0th | Compare your bill |
| RENAL FAILURE WITH CC | 683 | $26,442 | $5,440 | 4.9x | 0th | Compare your bill |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $47,950 | $10,268 | 4.7x | 0th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $53,890 | $11,921 | 4.5x | 0th | Compare your bill |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $48,971 | $11,619 | 4.2x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $33,229 | $8,524 | 3.9x | 0th | Compare your bill |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $41,067 | $12,549 | 3.3x | 0th | Compare your bill |
Showing 17 of 17 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across WI hospitals
63 hospitals in WI report pricing data to CMS. This facility's average ratio of 5.5x places it at the upper-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE
How much does SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE charge compared to Medicare?
According to CMS IPPS data, SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE's listed chargemaster rates average 5.5x the Medicare reimbursement amount across 17 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE?
The procedure with the highest chargemaster-to-Medicare ratio at SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE is INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS (DRG 065), with a listed charge of $44,618 compared to Medicare reimbursement of $5,501 — a ratio of 8.1x. Source: CMS IPPS Provider Summary.
Is SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE expensive compared to other WI hospitals?
SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE's average chargemaster-to-Medicare ratio is 5.5x. Ratios vary significantly across WI hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE in JANESVILLE, WI accept Medicare?
SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.