SSM St Clare Health Center
SSM St Clare Health Center in Fenton, Missouri charges 4.0x the Medicare reimbursement rate across 48 analyzed procedures at this nonprofit-private hospital.
Fenton, MO 63026 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
C
Average
Avg markup vs Medicare
3.96x
Charge / Medicare rate
Max markup
7.66x
Worst procedure
Procedures analyzed
48
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 | $17,635 | $8,817 | — | 7.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $40,170 | $20,085 | — | 6.2x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $63,398 | $31,699 | — | 5.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $22,316 | $11,158 | — | 5.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $27,083 | $13,541 | — | 5.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $22,624 | $11,312 | — | 5.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $77,422 | $38,711 | — | 4.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $20,719 | $10,359 | — | 4.6x |
| SYNCOPE AND COLLAPSE | 312 | $21,401 | $10,701 | — | 4.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $36,647 | $18,324 | — | 4.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $19,948 | $9,974 | — | 4.4x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $51,101 | $25,551 | — | 4.4x |
| DIABETES WITH MCC | 637 | $38,274 | $19,137 | — | 4.4x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $31,538 | $15,769 | — | 4.4x |
| RENAL FAILURE WITH CC | 683 | $20,894 | $10,447 | — | 4.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $28,928 | $14,464 | — | 4.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $52,793 | $26,396 | — | 4.2x |
| DIABETES WITH CC | 638 | $21,354 | $10,677 | — | 4.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $39,548 | $19,774 | — | 4.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $49,259 | $24,630 | — | 4.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $23,374 | $11,687 | — | 4.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $18,802 | $9,401 | — | 4.1x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $32,038 | $16,019 | — | 4.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $23,377 | $11,689 | — | 4x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $55,443 | $27,721 | — | 3.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $45,837 | $22,919 | — | 3.7x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $36,703 | $18,352 | — | 3.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $47,918 | $23,959 | — | 3.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $24,745 | $12,372 | — | 3.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $29,280 | $14,640 | — | 3.6x |
| CELLULITIS WITH MCC | 602 | $32,626 | $16,313 | — | 3.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $76,520 | $38,260 | — | 3.5x |
| RENAL FAILURE WITH MCC | 682 | $29,209 | $14,604 | — | 3.5x |
| CELLULITIS WITHOUT MCC | 603 | $16,815 | $8,407 | — | 3.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $18,445 | $9,222 | — | 3.4x |
| SEIZURES WITH MCC | 100 | $40,063 | $20,032 | — | 3.3x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $48,596 | $24,298 | — | 3.2x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $34,794 | $17,397 | — | 3.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $38,615 | $19,307 | — | 3.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $24,531 | $12,266 | — | 3.1x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $87,354 | $43,677 | — | 3.1x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $57,808 | $28,904 | — | 3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $19,051 | $9,526 | — | 2.9x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $21,127 | $10,564 | — | 2.9x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $33,993 | $16,996 | — | 2.7x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $25,324 | $12,662 | — | 2.7x |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O | 023 | $85,053 | $42,527 | — | 2.7x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $32,005 | $16,003 | — | 2.5x |
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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