Wellmont Bristol Regional Medical Center
Wellmont Bristol Regional Medical Center, a government-owned hospital in Bristol, TN, charges 5.6x the Medicare reimbursement rate across 73 analyzed procedures.
Bristol, TN 37620 · Acute Care Hospitals · CMS Rating: 1/5
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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Billing patterns — government
Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.
Pricing grade
D
High
Avg markup vs Medicare
5.64x
Charge / Medicare rate
Max markup
9.41x
Worst procedure
Procedures analyzed
73
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 |
|---|---|---|---|---|---|
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $87,204 | $43,602 | — | 9.4x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $124,452 | $62,226 | — | 9.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $95,202 | $47,601 | — | 8.7x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $127,141 | $63,570 | — | 8.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $28,111 | $14,055 | — | 8.6x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $44,660 | $22,330 | — | 8.4x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $34,605 | $17,302 | — | 8.2x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $138,050 | $69,025 | — | 7.5x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/ | 321 | $126,208 | $63,104 | — | 7.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $44,108 | $22,054 | — | 7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $38,615 | $19,307 | — | 6.9x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $78,406 | $39,203 | — | 6.9x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $39,063 | $19,532 | — | 6.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $80,540 | $40,270 | — | 6.7x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $65,187 | $32,593 | — | 6.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $25,867 | $12,934 | — | 6.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $32,597 | $16,299 | — | 6.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $23,987 | $11,993 | — | 6.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $31,671 | $15,836 | — | 6.1x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | 236 | $142,507 | $71,254 | — | 6x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $58,663 | $29,332 | — | 6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $40,440 | $20,220 | — | 6x |
| HYPERTENSION WITHOUT MCC | 305 | $23,240 | $11,620 | — | 5.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $38,460 | $19,230 | — | 5.9x |
| DIABETES WITH MCC | 637 | $46,177 | $23,088 | — | 5.8x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $71,820 | $35,910 | — | 5.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $22,572 | $11,286 | — | 5.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $39,537 | $19,769 | — | 5.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $32,107 | $16,054 | — | 5.6x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $26,026 | $13,013 | — | 5.6x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $44,127 | $22,064 | — | 5.5x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $81,139 | $40,569 | — | 5.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $37,968 | $18,984 | — | 5.4x |
| CHEST PAIN | 313 | $20,349 | $10,174 | — | 5.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $24,459 | $12,230 | — | 5.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $48,382 | $24,191 | — | 5.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $39,656 | $19,828 | — | 5.3x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $25,306 | $12,653 | — | 5.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $30,278 | $15,139 | — | 5.2x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $59,809 | $29,905 | — | 5.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $15,355 | $7,677 | — | 5.1x |
| RENAL FAILURE WITH MCC | 682 | $43,814 | $21,907 | — | 5.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $146,588 | $73,294 | — | 5.1x |
| CELLULITIS WITHOUT MCC | 603 | $23,474 | $11,737 | — | 5.1x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $26,740 | $13,370 | — | 5x |
| SYNCOPE AND COLLAPSE | 312 | $22,691 | $11,345 | — | 5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $20,527 | $10,264 | — | 4.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $22,418 | $11,209 | — | 4.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $55,680 | $27,840 | — | 4.9x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $61,053 | $30,526 | — | 4.9x |
Showing 50 of 73 procedures
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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