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Valley Regional Medical Center

Valley Regional Medical Center in Brownsville, TX charges 15.1x the Medicare reimbursement rate on average, with 96% of analyzed procedures showing significant price variations.

Brownsville, TX 78526 · Acute Care Hospitals · CMS Rating: 2/5

By Priya Iyengar , Senior Billing Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.

25 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 10.5x6.0x24.1x
15.1x
Medicare markup ratio
TX lowestValley Regional Medica...TX highest
15.1x
Avg markup ratio
14.0x
Median markup
25
Procedures
96%
Outlier procedures
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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

15.06x

Charge / Medicare rate

Max markup

23.58x

Worst procedure

Procedures analyzed

25

With pricing data

Outlier procedures

96%

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.

ProcedureCodeGross chargeCash priceMedicareMarkup
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$146,629$73,31423.6x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$136,773$68,38621.5x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC690$98,991$49,49520x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC699$106,548$53,27418.6x
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC689$123,774$61,88717.2x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$206,730$103,36516.5x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC280$171,969$85,98516.2x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$86,578$43,28915.8x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$106,679$53,34015.3x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC177$183,102$91,55115.2x
SIMPLE PNEUMONIA AND PLEURISY WITH MCC193$126,293$63,14614.4x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC393$159,012$79,50614.3x
GASTROINTESTINAL HEMORRHAGE WITH MCC377$177,600$88,80014x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC274$295,452$147,72614x
HYPERTENSION WITHOUT MCC305$63,799$31,90013.8x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC853$439,784$219,89213.7x
HEART FAILURE AND SHOCK WITH MCC291$121,429$60,71513.5x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC871$177,821$88,91113.3x
GASTROINTESTINAL OBSTRUCTION WITH CC389$75,828$37,91413.1x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC064$162,499$81,24913.1x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC698$140,930$70,46513x
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC314$176,189$88,09512.6x
RENAL FAILURE WITH CC683$71,148$35,57412.1x
RENAL FAILURE WITH MCC682$114,444$57,22211.7x
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC640$90,498$45,24910.1x

How VALLEY REGIONAL MEDICAL CENTER 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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?
Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.
Why do for-profit hospitals charge more than Medicare rates?
For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.
Does insurance typically pay the full hospital charge amount?
Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.
What should I know about billing differences between hospital types?
For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

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

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