What hospitals bill, and what Medicare actually pays
Two things are unusually hard to find in one place, and both matter if you are staring at a medical bill: how far a hospital's charges sit above what Medicare pays for the same care, and whether that hospital is legally required to offer you financial assistance. These are ours to give away — built entirely from U.S. government data, free to download, free to cite.
US hospital charges vs. Medicare payments
~2,900 hospitalsOne row per hospital: ownership, whether IRS §501(r) financial-assistance rules bind it, and total Medicare charges against total Medicare payments across all reported MS-DRGs.
| Column | What it is |
|---|---|
name, city, state, zip | Hospital identity, from the CMS Hospital General Information dataset. |
ownership, ownership_class | The verbatim CMS ownership string, and our normalised class (nonprofit / for-profit / government). |
bound_by_501r | Whether IRS §501(r) — the financial-assistance-policy requirement — legally binds this hospital. Yes for nonprofits, no for for-profits, not-applicable for government facilities. This is the field almost nothing else publishes. |
total_medicare_charges, total_medicare_payments | Summed across reported MS-DRGs, weighted by discharges. Charges are what the hospital billed; payments are what Medicare actually paid. |
charge_to_payment_ratio | How many dollars billed per dollar paid — usually several-fold. |
MS-DRG national charges vs. payments
772 MS-DRGsOne row per Medicare Severity Diagnosis-Related Group: national discharge counts, average charge, and average Medicare payment.
| Column | What it is |
|---|---|
ms_drg, title | The MS-DRG code and its official description. |
mdc, type | Major Diagnostic Category and whether the group is medical or surgical. |
national_discharges | Total Medicare discharges nationally for this group. |
avg_charge, avg_medicare_payment | Average billed amount and average Medicare payment. |
charge_to_payment_ratio | Dollars billed per dollar paid. |
Sources & terms
Every figure is derived from public datasets published by the U.S. Centers for Medicare & Medicaid Services — hospital identity and ownership from the Hospital General Information dataset, charges and payments from Medicare Inpatient Hospitals by Provider and Service, and the MS-DRG groupings from the FY 2026 IPPS Final Rule. The full pipeline is described on our methodology page.
The underlying government data is in the public domain. You are welcome to use and republish these files, with or without attribution; a link back to billstand.com/data is appreciated but not required. Where the government does not publish a hospital's income thresholds, we do not guess them — those fields are simply absent rather than estimated.