Infirmary Health System · Bay Minette, AL
3 of 5
CMS star rating
53
Beds
1,545
Inpatient discharges a year
$196.8M
Net patient revenue a year
31
In-network payers
North Baldwin Infirmary is a 53-bed voluntary non-profit - private hospital in Bay Minette, AL, affiliated with Infirmary Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 31 in-network payers and 380 disclosed rate categories.
The 24 services North Baldwin Infirmary most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Childbirth · Inpatient
MS-DRG 807
$7,240
negotiated rate
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$9,890
negotiated rate
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Medicine & Surgery
CPT 47562
$2,892 - $7,586
from 3 insurers · median $5,814
14 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 49650
$5,837 - $7,586
from 2 insurers · median $6,712
14 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74177
$501 - $2,228
from 4 insurers · median $600
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$191 - $1,541
from 4 insurers · median $526
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 29881
$3,546 - $4,644
from 2 insurers · median $4,095
22 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
Digestive procedures
CPT 47563
$5,814 - $7,586
from 2 insurers · median $6,700
14 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 470
$16,058 - $21,245
from 2 insurers · median $18,652
Hospital reports orthopedic surgery services to CMS
Cardiology and vascular testing
CPT 93306
$259 - $985
from 4 insurers · median $870
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$1,517 - $1,640
from 2 insurers · median $1,578
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$7,240
negotiated rate
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74176
$396 - $3,023
from 4 insurers · median $526
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45378
$262 - $1,640
from 3 insurers · median $1,540
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$7,586 - $9,725
from 2 insurers · median $8,656
Typical for a hospital with this service line
Mammography
CPT 77067
$84 - $170
from 4 insurers · median $131
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$310 - $1,831
from 4 insurers · median $582
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$24,632
negotiated rate
Hospital reports orthopedic surgery services to CMS
MRI imaging
CPT 70553
$649 - $3,403
from 4 insurers · median $713
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 64721
$532 - $3,304
from 3 insurers · median $2,224
25 Medicare claims in Level 1 Nerve Procedures (CMS 2024)
Medicine & Surgery
CPT 66984
$2,709 - $3,304
from 2 insurers · median $3,006
Typical for a hospital with this service line
Orthopedics and pain
CPT 29880
$3,579 - $4,644
from 2 insurers · median $4,112
22 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
X-ray and bone density
CPT 71046
$36 - $263
from 4 insurers · median $113
Common here, based on CMS Medicare volume
Lung function and sleep
CPT 95810
$769 - $2,440
from 4 insurers · median $1,488
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 10 | 460% | 2 | 2 |
| Insurer B* | 24 | 166% | 12 | 9 |
| Insurer C* | 11 | 154% | 4 | 7 |
| Insurer D* | 20 | 115% | 2 | 15 |
How we chose these services: 6 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 7 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for North Baldwin Infirmary, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
3 of 5 stars
Doctors and services
No Medicare-funded residents
Finances
$196.8M net patient revenue
Ownership and leadership
Owned by Infirmary Health System
The employer identification numbers (EINs) health plans and networks list for North Baldwin Infirmary in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 63-0891904Thomas Hospital | 54Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 49 more | 1134164924 Gulf Health Hospitals Inc.1447303227 Gulf Health Hospitals Inc1679347561 Gulf Health Hospitals Inc.and 15 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
1815 Hand Avenue, Bay Minette, AL 36507
(251) 937-5521
How North Baldwin Infirmary compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
3 of 5
Lower than 42% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 3 measures
0 better, 3 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
No different on 7 measures
0 better, 7 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
5 of 5
The top rating, shared by 7% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
80%
Higher than 79% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Penalized
Among the worst-performing 25% of US hospitals
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.99
Higher than 62% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
180 min
Higher than 70% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
72%
Higher than 66% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 3 of 5 | |
| Death rates | No different on 3 measures | |
| Safety | No different on 2 measures | |
| Readmissions | No different on 7 measures | |
| Patient survey ratingCMS: Summary star rating | 5 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 80% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.99 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 180 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 72% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts North Baldwin Infirmary's inpatient payments for its readmissions, quality and cost results.
-0.17% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+0.79% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for North Baldwin Infirmary, beside the US median and the average of AL hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.469 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 356 cases | 4.8 | 3.9 | 4.658 | Worse than 85% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 12.46 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.7 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.869 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 35 cases | 13.9 | 11 | 11.65 | Worse than 91% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 56 cases | 15.9 | 15.2 | 16.81 | Worse than 60% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 14.25 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 430 cases | 0.54 | 0.51 | 0.6234 | No Different Than the National Rate | Worse than 54% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 184 | |||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 581 cases | 0.21 | 0.2 | 0.2114 | No Different Than the National Rate | Worse than 54% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 556 cases | 0.27 | 0.27 | 0.2777 | No Different Than the National Rate | Worse than 46% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 75 cases | 2.31 | 2.29 | 2.258 | No Different Than the National Rate | Worse than 55% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.702 | Number of Cases Too Small | ||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 10.91 | Number of Cases Too Small | ||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 77 cases | 3.38 | 3.4 | 3.831 | No Different Than the National Rate | Better than 51% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.911 | Number of Cases Too Small | ||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 28 cases | 1.76 | 1.72 | 1.803 | No Different Than the National Rate | Worse than 71% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 63 cases | 1.04 | 1.02 | 1.058 | No Different Than the National Rate | Worse than 57% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 2.616 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 38 cases | 17.8 | 1.25 | 11.68 | Worse than 72% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 55 cases | 7.3 | 3.85 | 12.55 | Worse than 55% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 · 127 cases | 12.3 | 12.9 | 12.93 | No Different Than the National Rate | Better than 83% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 99 cases | 10.2 | 10.7 | 10.28 | No Different Than the National Rate | Better than 64% of US hospitals |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 99 cases | 5.3 | 5.3 | 5.113 | No Different Than the National Rate | Better than 48% of US hospitals |
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 50 cases | 1 | 1 | 0.986 | No Different than expected | Worse than 32% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.31 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.67 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 57 cases | 20.2 | 19.8 | 19.89 | Worse than 66% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 92 cases | 21.4 | 21.3 | 21.29 | Worse than 51% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.979 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 117 cases | 17 | 17.2 | 17.3 | Better than 59% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3169 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.803 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 317 | 1,370 | 3,994 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.191 | 0.9835 | 4.09 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.932 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.6373 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1812 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.656 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 746 | 1,799 | 5,240 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.41 | 1.377 | 6.563 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.286 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5151 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2584 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.032 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 24 | 61 | 115 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.743 | 1.591 | 3.302 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 1 | 1 | 2.222 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.6198 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3223 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.058 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 65 | 38 | 169 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.702 | 0.328 | 1.547 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 3 | 0 | 1.1 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.6612 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3413 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.26 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 6,719 | 14,451 | 38,119 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.18 | 0.567 | 2.905 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.295 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.8121 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.113 | 0.127 | 0.2104 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.218 | 0.747 | 1.307 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 6,295 | 13,646 | 35,794 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 2.979 | 5.683 | 20 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 2 | 2 | 8.833 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.671 | 0.279 | 0.3683 | No Different than National Benchmark | Worse than 86% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 227 cases | 87 | 73 | 70.64 | Better than 93% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 227 cases | 1 | 8 | 10.56 | Better than 95% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 227 cases | 12 | 18 | 18.79 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 95 | 87 | 83.69 | Better than 98% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 4 | 2.759 | The top rating, shared by 12% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 227 cases | 87 | 80 | 79.88 | Better than 87% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 95 | 91 | 91.09 | Better than 91% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 227 cases | 2 | 4 | 4.699 | Better than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 3 | 3.315 | The top rating, shared by 18% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 227 cases | 11 | 16 | 15.42 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 227 cases | 91 | 79 | 81.51 | Better than 95% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 96 | 91 | 91.22 | Better than 97% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 227 cases | 1 | 5 | 5.027 | Better than 94% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 3 | 3.278 | The top rating, shared by 6% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 227 cases | 8 | 16 | 13.47 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 227 cases | 69 | 61 | 62.21 | Better than 81% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 83 | 77 | 77.09 | Better than 88% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 227 cases | 13 | 19 | 19.6 | Better than 83% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 227 cases | 4 | 3 | 2.685 | Better than 79% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 227 cases | 18 | 19 | 18.19 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 90 | 86 | 84.46 | Better than 86% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 227 cases | 10 | 13 | 14.63 | Better than 78% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 227 cases | 4 | 3 | 3.056 | Better than 55% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 227 cases | 90 | 87 | 85.37 | Better than 78% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 227 cases | 12 | 14 | 16.42 | Better than 68% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 227 cases | 88 | 86 | 83.58 | Better than 68% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 87 | 74 | 76.38 | Better than 96% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 1 | 7 | 6.297 | Better than 97% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 12 | 19 | 17.33 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 89 | 77 | 79.28 | Better than 96% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 1 | 6 | 5.516 | Better than 96% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 10 | 17 | 15.2 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 96 | 85 | 86.14 | Better than 98% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 1 | 3 | 3.688 | Better than 91% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 3 | 11 | 10.17 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 227 cases | 4 | 8 | 8.753 | Better than 82% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 227 cases | 14 | 20 | 20.79 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 227 cases | 82 | 72 | 70.45 | Better than 85% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 93 | 88 | 87.57 | Better than 92% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 3 | 3.222 | The top rating, shared by 8% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 227 cases | 79 | 74 | 74.89 | Better than 76% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 227 cases | 6 | 9 | 9.938 | Better than 79% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 227 cases | 15 | 16 | 15.17 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 81 | 75 | 75.05 | Better than 84% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 2 | 5 | 6 | Better than 90% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 227 cases | 17 | 20 | 18.95 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 86 | 77 | 76.77 | Better than 91% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 2 | 4 | 5.703 | Better than 80% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 227 cases | 12 | 19 | 17.53 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 94 | 86 | 84.83 | Better than 94% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 1 | 3 | 3.531 | Better than 77% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 227 cases | 5 | 11 | 11.64 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 227 cases | 73 | 59 | 66.56 | Better than 88% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 227 cases | 4 | 9 | 6.575 | Better than 83% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 227 cases | 23 | 31 | 26.86 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 90 | 82 | 84.96 | Better than 95% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 3 | 4 | The top rating, shared by 11% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 227 cases | 2 | 5 | 6.466 | Better than 83% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 227 cases | 80 | 71 | 70.55 | Better than 79% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 227 cases | 93 | 87 | 86.26 | Better than 90% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 227 cases | 18 | 23 | 22.99 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 4 | 3.389 | The top rating, shared by 24% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 227 cases | 60 | 47 | 48.08 | Better than 91% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 227 cases | 20 | 30 | 30.03 | Better than 89% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 227 cases | 20 | 22 | 21.89 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 227 cases | 5 | 3 | 3.241 | The top rating, shared by 7% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 227 cases | 7 | 12 | 13 | Better than 92% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 227 cases | 93 | 88 | 87 | Better than 92% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 · 1,277 cases | 10 | 8 | 10 | Worse than 62% of US hospitals | |
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 · 376 cases | 1 | 1 | 1.7 | Worse than 34% of US hospitals | |
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.5 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 548 cases | 47 | 79 | 62.92 | Worse than 88% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 404 cases | 188 | 154 | 158 | Worse than 71% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 372 cases | 180 | 148 | 153 | Worse than 70% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 255 | |||
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 25 cases | 302 | 293 | 311 | Worse than 54% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 16,857 cases | 4 | 1 | 2.342 | Worse than 88% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 67.37 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 28 cases | 79 | 97 | 90.8 | Worse than 91% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 100 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 46.43 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 623 cases | 12 | 15 | 14.5 | Better than 69% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 94 cases | 72 | 65 | 62.47 | Better than 66% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 30 cases | 70 | 73 | 70.8 | Worse than 56% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 17 cases | 76 | 88 | 87.48 | Worse than 79% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 94 cases | 91 | 82 | 79.9 | Better than 85% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 61 cases | 92 | 94 | 90.95 | Worse than 61% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 95.75 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 77.67 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 91.83 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 75.44 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 89.85 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 1.2 | 5 | 7.666 | Better than 91% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 9.1 | 6.6 | 6.484 | Worse than 76% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.91 | 0.99 | 0.9828 | Better than 84% of US hospitals |
Measures CMS reports for the hospital's psychiatric unit or for a psychiatric hospital.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Follow-up care within 30 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 54.63 | |||
| Follow-up care within 7 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 30.65 | |||
| Hours of physical-restraint use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 27,482 cases | 0 | 0.05 | 0.06205 | The worst result, shared by 22% of US hospitals | |
| Hours of seclusion use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 27,482 cases | 0 | 0.03 | 0.8569 | The worst result, shared by 39% of US hospitals | |
| Psychiatric patients screened for and given the flu vaccine2024-10-01 to 2025-03-31 · 117 cases | 97 | 87 | 83.44 | Better than 78% of US hospitals | |
| Medication continuation after psychiatric discharge2022-07-01 to 2024-06-30 | Not Available | 83.08 | |||
| Readmitted to any hospital within 30 days of psychiatric discharge2022-07-01 to 2024-06-30 · 140 cases | 17.9 | 19.1 | 19.31 | No Different Than the National Rate | Better than 69% of US hospitals |
| Psychiatric patients screened for metabolic disorders2024-01-01 to 2024-12-31 · 243 cases | 92 | 92 | 85.49 | Better than 49% of US hospitals | |
| Alcohol use brief intervention provided or offered2024-01-01 to 2024-12-31 · 15 cases | 13 | 74 | 71.35 | Worse than 88% of US hospitals | |
| Alcohol use brief intervention provided2024-01-01 to 2024-12-31 | Not Available | 84.76 | |||
| Alcohol and other drug use disorder treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 14 cases | 64 | 77 | 65.14 | Worse than 63% of US hospitals | |
| Alcohol and other drug use disorder treatment provided at discharge2024-01-01 to 2024-12-31 · 14 cases | 50 | 56 | 59.52 | Worse than 55% of US hospitals | |
| Tobacco use treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 20 cases | 25 | 64 | 62.52 | Worse than 76% of US hospitals | |
| Tobacco use treatment provided at discharge2024-01-01 to 2024-12-31 · 20 cases | 5 | 4 | 37.24 | Better than 51% of US hospitals | |
| Discharged patients who received a transition record with the specified elements2024-01-01 to 2024-12-31 · 325 cases | 16 | 77 | 70.82 | Worse than 80% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 10 | 20 | 12.82 | Worse than 70% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 2.5 | 5 | 3.268 | Worse than 70% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 50 | 10 | 19.17 | Better than 84% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 12.5 | 2.5 | 5.035 | Better than 83% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 87 | 34 | 41.4 | Better than 98% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 21.75 | 8.75 | 10.89 | Better than 97% of US hospitals | |
| VBP safety domain scoreFY 2026 | 15 | 40 | 40.62 | Worse than 90% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 3.75 | 10 | 10.27 | Worse than 91% of US hospitals | |
| VBP total performance scoreFY 2026 | 40.5 | 29.5 | 28.52 | Better than 81% of US hospitals |
| By fiscal year | FY 2021 | FY 2023 | FY 2025 | FY 2026 |
|---|---|---|---|---|
| VBP clinical outcomes domain score | 25 | Not Available | 5 | 10 |
| VBP clinical outcomes weighted domain score | 8.333 | Not Available | 1.667 | 2.5 |
| VBP efficiency and cost reduction domain score | 30 | 0 | 70 | 50 |
| VBP efficiency and cost reduction weighted domain score | 10 | 0 | 23.33 | 12.5 |
| VBP person and community engagement domain score | 66 | Not Available | 62 | 87 |
| VBP person and community engagement weighted domain score | 22 | Not Available | 20.67 | 21.75 |
| VBP safety domain score | Not Available | Not Available | Not Available | 15 |
| VBP safety weighted domain score | Not Available | Not Available | Not Available | 3.75 |
| VBP total performance score | 40.33 | Not Available | 45.67 | 40.5 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.029 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 1.045 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | N/A | 0.996 | |||
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 0.9843 | 0.9983 | 1.009 | Better than 60% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 1.039 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 | 1.032 | 0.9955 | 1.003 | Worse than 71% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9959 | 0.9936 | N/A | N/A | N/A | N/A |
| READM-30-HF-HRRP | 1.019 | 1.013 | 0.9637 | 0.9806 | 0.9521 | 0.9843 |
| READM-30-HIP-KNEE-HRRP | 1.052 | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.053 | 0.9802 | 1.053 | 1.047 | 1.107 | 1.032 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | North Baldwin Infirmary | US median | AL average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.5999 | |||
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.4007 | |||
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8784 | |||
| HAC Reduction Program payment reductionFY 2026 | Yes | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8744 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9876 | 0.9628 | 1.049 | Worse than 62% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.5688 | |||
| Total HAC scoreFY 2026 | 1.646 | -0.0453 | 0.09962 | Worse than 98% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | No | No | Yes |
| Total HAC score | -0.2772 | 0.1228 | 0 | -0.5365 | -0.5765 | 1.646 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
Not accredited
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
78
Medicare-certified beds
122
Registered nurses (full-time equivalent)
1970
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What North Baldwin Infirmary reported to Medicare in its latest cost report, covering Apr 1, 2025 to Mar 31, 2026.
1,545
Inpatient discharges
Medicare 11%, Medicaid 17%
5,256
Inpatient days
48% of available bed days used
263
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 843265). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges North Baldwin Infirmary reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 623 | 1,050 | 3,583 | 5,256 |
| Discharges | 172 | 268 | 1,105 | 1,545 |
| Average length of stay | 3.6 days | 3.9 days | 3.2 days | 3.4 days |
| Average daily census | 1.7 | 2.9 | 9.8 | 14.4 |
1,350
Medicare Advantage days
403 discharges
149
Medicaid managed care days
62 discharges
1,527
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 25 | 4,089 | 515 | 45% |
| Intensive care unit | 5 | 717 | 108 | 39% |
| Nursery | 450 | |||
| Subprovider - ipf | 23 | 5,932 | 2,067 | 71% |
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What North Baldwin Infirmary treats Medicare patients for most often, in 2024. 47 Medicare discharges in 3 published DRGs; 0% surgical; 100% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 20 | $35,647 | $12,905 | $12,761 | 1.98 |
| Heart failure and shock with MCCMS-DRG 291, medical | 16 | $18,062 | $9,283 | $6,466 | 1.28 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 11 | $22,509 | $10,308 | $8,058 | 1.33 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) North Baldwin Infirmary billed Medicare for most in 2024: 206 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 98 | 83 | $11,621 | $1,725 | $2,090 |
| Level 1 Nerve ProceduresAPC 5431 | 25 | 22 | $5,052 | $1,277 | $1,407 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 22 | 21 | $6,977 | $1,946 | $2,373 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 14 | 14 | $13,040 | $3,002 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 12 | 12 | $11,701 | $4,731 | $5,339 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 12 | $19,606 | $9,281 | $10,772 | |
| Level 2 Upper GI ProceduresAPC 5302 | 12 | $4,614 | $1,067 | $1,445 | |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 11 | 11 | $5,397 | $1,066 | $1,220 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at North Baldwin Infirmary in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 823 in 2020 to 566 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 36507 | 337 | 60% | 1,207 | $10.1M | 30% | 37% |
| 36502 | 127 | 22% | 409 | $3.5M | 16% | 15% |
| 36562 | 34 | 6% | 112 | $880,094 | 41% | 43% |
| 36579 | 25 | 4% | 85 | $663,728 | 30% | 36% |
| 36578 | 18 | 3% | 69 | $515,365 | 14% | 16% |
| 36532 | 14 | 2% | 47 | $401,147 | 1% | 2% |
| 36526 | 11 | 2% | 32 | $270,013 | 1% | 2% |
Source: CMS Hospital Service Area file. Shares are of the 566 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units North Baldwin Infirmary reported at its latest Medicare certification survey (2025). Counts are people, not full-time equivalents.
3
Operating rooms
2
Endoscopy rooms
23
Psychiatric unit beds
7
Off-site locations
122
Registered nurses
3
Licensed practical nurses
9
Pharmacists
14
Respiratory therapists
21
Radiology technicians
1
Nuclear medicine technicians
1
Social workers
102
Other personnel
Source: CMS Provider of Services file.
248 clinicians who bill Medicare list North Baldwin Infirmary as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Ray Mclaughlin, M.D.
Rheumatology Physician
NPI 1720215049
See commercial rates for Ray Mclaughlin, M.D.William Mcevoy, M.D.
Hematology & Oncology Physician
NPI 1821222761
See commercial rates for William Mcevoy, M.D.Carmel Verrier, MD
Hematology & Oncology Physician
NPI 1518165729
See commercial rates for Carmel Verrier, MDBrittany Case, M.D.
Medical Oncology Physician
NPI 1033537154
See commercial rates for Brittany Case, M.D.Joseph Jones, M.D.
Hematology & Oncology Physician
NPI 1316092109
See commercial rates for Joseph Jones, M.D.William Sullivan, MD
Rheumatology Physician
NPI 1144311663
See commercial rates for William Sullivan, MDDavid Thomason, M.D.
Physical Medicine & Rehabilitation Physician
NPI 1770878373
See commercial rates for David Thomason, M.D.Vanna Eslava
Family Nurse Practitioner
NPI 1235794819
See commercial rates for Vanna EslavaRalph Buckley, MD
Cardiovascular Disease Physician
NPI 1043266281
See commercial rates for Ralph Buckley, MDSherri Arledge, MD
Medical Oncology Physician
NPI 1881805406
See commercial rates for Sherri Arledge, MDMichael Meshad, MD
Hematology & Oncology Physician
NPI 1538112701
See commercial rates for Michael Meshad, MDKendall Douglass, MD
Cardiovascular Disease Physician
NPI 1316334634
See commercial rates for Kendall Douglass, MDCharles Markle, M.D.
Neurology Physician
NPI 1194774927
See commercial rates for Charles Markle, M.D.Amy Stanley, CRNP
Primary Care Nurse Practitioner
NPI 1972250652
See commercial rates for Amy Stanley, CRNPJason Cole, MD
Cardiovascular Disease Physician
NPI 1083666705
See commercial rates for Jason Cole, MDRichard Friedman, M.D.
Neurology Physician
NPI 1770920365
See commercial rates for Richard Friedman, M.D.Sarah Goode, CRNP
Family Nurse Practitioner
NPI 1447794862
See commercial rates for Sarah Goode, CRNPStanley Thornton, M.D.
Interventional Cardiology Physician
NPI 1588870224
See commercial rates for Stanley Thornton, M.D.George Fahy, M.D.
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
NPI 1578586798
See commercial rates for George Fahy, M.D.Christopher Gamard, M.D.
Internal Medicine Physician
NPI 1215984786
See commercial rates for Christopher Gamard, M.D.Jacob Webster, M.D.
Internal Medicine Physician
NPI 1164453957
See commercial rates for Jacob Webster, M.D.Frank Lester, M.D.
Cardiovascular Disease Physician
NPI 1871541482
See commercial rates for Frank Lester, M.D.K Varden, M.D.
Internal Medicine Physician
NPI 1417903113
See commercial rates for K Varden, M.D.Thomas Mcgee, M.D.
Rheumatology Physician
NPI 1942253737
See commercial rates for Thomas Mcgee, M.D.Source: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income North Baldwin Infirmary reported to Medicare for Apr 1, 2025 to Mar 31, 2026. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $576.2M | 292.7% |
| Inpatient | $60.7M | 30.8% |
| Outpatient | $515.6M | 261.9% |
| Contractual allowances and discounts | -$379.4M | -192.7% |
| Net patient revenue | $196.8M | 100.0% |
| Operating expenses | -$171.5M | -87.1% |
| Operating income from patient care | $25.4M | 12.9% |
| Other income | $24.3M | 12.4% |
| Contributions and donations | $766,796 | 0.4% |
| Other | $23.6M | 12.0% |
| Net income | $49.7M | 25.2% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $52.8M | 10.3% |
| Medicaid (including managed care) | $31.8M | 6.2% |
| Other payers and self-pay | $427.3M | 83.5% |
| Total charges | $511.8M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from North Baldwin Infirmary's latest cost report.
12.9%
Operating margin
Operating income from patient care / net patient revenue
22.5%
Total margin
Net income / net patient revenue plus other income
24.2%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
17% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$41.99
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
75.4%
Return on assets
Net income for a year / total assets
154.1%
Return on equity
Net income for a year / fund balance
0.67
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
4.86
Current ratio
Current assets / current liabilities
3.68
Quick ratio
Cash, temporary investments and net receivables / current liabilities
44 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
32 days
Days in patient receivables
Net patient receivables / daily net patient revenue
22 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
3.36
Asset turnover
Total revenue for a year / total assets
16.9 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements.
What North Baldwin Infirmary owned and owed at the end of its reporting period (Mar 2026), across all fund types: $65.9M in total assets and a $32.2M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $20.4M | 31.0% |
| Patient receivables, net | $17.5M | 26.6% |
| Inventory | $10.1M | 15.3% |
| Total current assets | $50.2M | 76.2% |
| Property and equipment, net of depreciation | $14.5M | 22.0% |
| Investments and other assets | $1.2M | 1.9% |
| Total assets | $65.9M | 100.0% |
| Current liabilities | $10.3M | 15.7% |
| Long-term debt | $21.6M | 32.8% |
| Total liabilities | $33.6M | 51.0% |
| Fund balance (net assets) | $32.2M | 49.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements.
Care North Baldwin Infirmary provided without full payment, as reported on Worksheet S-10 of its cost report.
$2.9M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$3.7M
Bad debt
Patient bills written off as uncollectible, at charges
$2.9M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$3.8M
Total unreimbursed and uncompensated care
2.2% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements.
North Baldwin Infirmary's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Mar 2021 | Mar 2022 | Mar 2023 | Mar 2024 | Mar 2025 | Mar 2026 |
|---|---|---|---|---|---|---|
| Net patient revenue | $33.9M | $33.9M | $55.3M | $74.7M | $121M | $196.8M |
| Operating expenses | $45.9M | $53.8M | $57.1M | $76.4M | $108.8M | $171.5M |
| Operating margin | -35.4% | -58.6% | -3.3% | -2.3% | 10.1% | 12.9% |
| Net income | -$12.3M | -$20.2M | $1.5M | $2.3M | $27.8M | $49.7M |
| Total assets | -$21.7M | -$21.7M | $24.2M | $35.7M | $11.6M | $65.9M |
| Discharges | 1,783 | 2,069 | 2,476 | 2,166 | 1,453 | 1,545 |
| Inpatient days | 6,001 | 6,255 | 5,282 | 6,000 | 4,561 | 5,256 |
| Medicare Advantage days | 1,993 | 2,425 | 2,334 | 2,124 | 1,587 | 1,350 |
| Beds | 48 | 48 | 58 | 81 | 53 | 53 |
| Employees (FTE) | 177 | 177 | 140 | 226 | 218 | 263 |
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center North Baldwin Infirmary reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Drugs charged to patients | $65.9M | $311.3M | 0.21 | ||
| Operating room | $2.2M | $6.3M | $8.7M | 0.72 | 18,899 |
| Medical supplies charged to patient | $5.3M | $12.6M | 0.42 | ||
| Emergency | $2.4M | $5.3M | $36.9M | 0.14 | 12,053 |
| Radiology-diagnostic | $2M | $4.8M | $52.7M | 0.09 | 9,510 |
| Nbi infusion - mobile | $1.7M | $4.7M | $6.4M | 0.73 | |
| Laboratory | $3.3M | $33.1M | 0.10 | 2,787 | |
| Nbi infusion - malbis | $874,426 | $2.3M | $3.3M | 0.71 | |
| Observation beds (non-distinct part | $2M | $2.4M | 0.84 | ||
| Respiratory therapy | $1.1M | $1.9M | $6.4M | 0.30 | 2,406 |
| Impl. dev. charged to patients | $1.7M | $3.2M | 0.53 | ||
| Nbi infusion - bay minette | $599,477 | $1.7M | $2.9M | 0.58 | |
| Delivery room & labor room | $1.4M | $1.4M | $963,625 | 1.46 | 7,584 |
| Physical therapy | $371,543 | $981,488 | $2.6M | 0.37 | 800 |
| Nbi infusion - fairhope | $427,706 | $943,294 | $1.7M | 0.55 | |
| Intravenous therapy | $103,128 | $665,050 | $3.1M | 0.21 | 1,511 |
| Renal dialysis | $213,112 | $240,386 | 0.89 | 275 | |
| Occupational therapy | $172,306 | $382,573 | 0.45 | 800 | |
| Speech pathology | $48,287 | $152,800 | 0.32 | ||
| Anesthesiology | $31,446 | $301,898 | 0.10 | 330 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $2.6M | $7.3M | $8M | 0.92 | 16,681 |
| Subprovider - ipf | $2.7M | $7.1M | $9.8M | 0.72 | 15,229 |
| Intensive care unit | $879,625 | $2.1M | $3.7M | 0.56 | 4,823 |
| Nursery | $589,144 | $930,732 | 0.63 | 499 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $426,925 | $11.1M | 20,513 | $20.81 | 7,054 |
| Employee benefits department | $9.6M | ||||
| Pharmacy | $3.2M | $3.4M | 56,729 | $55.64 | 1,289 |
| Operation of plant | $575,285 | $2.7M | 20,371 | $28.24 | 11,632 |
| Cap rel costs-bldg & fixt | $2.3M | 177,363 | |||
| Cap rel costs-mvble equip | $1.6M | ||||
| Nursing administration | $1.2M | $1.2M | 22,800 | $50.76 | 1,185 |
| Dietary | $1.1M | 3,568 | |||
| Housekeeping | $97,644 | $1M | 6,474 | $15.08 | 2,719 |
| Medical records & library | $934,815 | 1,340 | |||
| Social service | $185,663 | $829,960 | 4,985 | $37.25 | 128 |
| Central services & supply | $130,428 | $395,858 | 6,931 | $18.82 | 2,522 |
| Laundry & linen service | $202,158 |
Source: CMS cost report (HCRIS, Form 2552-10), report 843265, amended. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays North Baldwin Infirmary for an inpatient stay.
1.33
Case mix index
Higher than 12% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
34.8%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
210
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.29 | 1.29 | 1.47 | 1.36 | 1.38 | 1.37 | 1.33 |
| Wage index | 0.789 | 0.789 | 0.788 | 0.809 | 0.914 | 0.881 | 0.868 |
| Readmissions adjustment | -0.88% | -0.80% | -0.08% | 0.00% | -0.18% | -0.43% | -0.17% |
| Value-based purchasing adjustment | +0.61% | +0.59% | +0.59% | +0.74% | 0.00% | +2.09% | +0.79% |
| Medicare inpatient stays | 369 | 369 | 334 | 319 | 317 | 218 | 210 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations North Baldwin Infirmary reports to Medicare as owners or with operational control.
Infirmary Health System
Operational/managerial control, since 2001
Infirmary Health System
5% or greater direct ownership interest, since 2001
Sources: CMS Hospital All Owners.
The officers and board members on North Baldwin Infirmary's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 6 of 11 are shown.
Gulf Health Hospitals Inc Dba files the Form 990 for the tax ID insurers list for North Baldwin Infirmary, so these people may lead the wider organization rather than North Baldwin Infirmary alone.
| Name | Title |
|---|---|
| D Mark Nix | Pres/ceo |
| Furhan Yunas | Director |
| Joe T Stough III | Vice Preside |
| Joseph Denton | Assistanttre |
| Scott A Browning | Secretary |
| Kerry Tolleson | Treasurer |
| Paul Glisson | Physician |
| X | Asst Treasur |
| Leeann Cain | Vice Preside |
| Arthur Johnson | Vice Preside |
| Joann Nix | Vice Preside |
| John Baker III | Chairman |
Board members: Jason M Badgett, Laura Morrissette Clark, Michael Holberg, Frank Lott III, Michael Pierce.
Source: IRS Form 990 Part VII filed by Gulf Health Hospitals Inc Dba (EIN 63-0891904), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2005
340B ID DSH010129, registered as a disproportionate share hospital; 4 registered outpatient sites; 23 active contract pharmacies. Authorizing official: Kenny H Breal, President.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
North baldwin psych unit
CCN 01S129, certified 2012, Medicare prospective payment
Source: Worksheet S-2 Part I of North Baldwin Infirmary's latest Medicare cost report (HCRIS).
About North Baldwin Infirmary's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at North Baldwin Infirmary range from $649 to $3,403 across 4 insurers. UnitedHealthcare's rate is $649. The median at nearby comparable hospitals is $974. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at North Baldwin Infirmary range from $501 to $2,228 across 4 insurers. Aetna's rate is $550. The median at nearby comparable hospitals is $639. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Diagnostic colonoscopy (CPT 45378), published negotiated rates at North Baldwin Infirmary range from $262 to $1,640 across 3 insurers. Blue Cross Blue Shield's rate is $1,540. The median at nearby comparable hospitals is $1,259. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at North Baldwin Infirmary range from $7,240 to $7,240 across 1 insurers. UnitedHealthcare's rate is $7,240. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at North Baldwin Infirmary range from $84 to $170 across 4 insurers. Aetna's rate is $138. The median at nearby comparable hospitals is $166. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at North Baldwin Infirmary range from $16,058 to $21,245 across 2 insurers. UnitedHealthcare's rate is $16,058. The median at nearby comparable hospitals is $22,071. What a patient pays depends on their plan's deductible, coinsurance and network status.
North Baldwin Infirmary has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.
CMS reports no Medicare-funded interns or residents at North Baldwin Infirmary for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts North Baldwin Infirmary's base inpatient payments by an estimated 0.17% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (20 discharges), heart failure and shock with mcc (16 discharges), simple pneumonia and pleurisy with mcc (11 discharges).
North Baldwin Infirmary's Medicare case mix index is 1.33 for fiscal year 2027, higher than 12% of hospitals paid under the inpatient prospective payment system.
North Baldwin Infirmary reported 1,545 inpatient discharges and 5,256 inpatient days from Apr 1, 2025 to Mar 31, 2026.
North Baldwin Infirmary reported 263 full-time-equivalent employees on payroll from Apr 1, 2025 to Mar 31, 2026.
North Baldwin Infirmary reported $196.8M in net patient revenue on $576.2M of gross charges for Apr 1, 2025 to Mar 31, 2026, an operating margin of 12.9%, and net income of $49.7M.
North Baldwin Infirmary reported $3.8M of unreimbursed and uncompensated care for Apr 1, 2025 to Mar 31, 2026, including $2.9M of charity care at cost.
North Baldwin Infirmary's Medicare enrollment lists Douglas Mark Nix as Vice Chair/vice President since 2009.
Insurers' price transparency files list North Baldwin Infirmary under employer identification number 63-0891904 (Thomas Hospital). 54 health plans and networks list 63-0891904 for it.
Yes. HRSA's 340B database lists North Baldwin Infirmary (340B ID DSH010129) as a participating disproportionate share hospital since 2005, with 23 active contract pharmacies.
248 clinicians who bill Medicare list North Baldwin Infirmary as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are internal medicine physician (24), family medicine physician (23), diagnostic radiology physician (21).
CMS's Provider of Services file lists no accrediting organization for North Baldwin Infirmary; it is certified for Medicare through state survey.
In its Medicare enrollment, North Baldwin Infirmary reports Infirmary Health System as 5% or greater direct ownership interest.
CMS lists 28 services at North Baldwin Infirmary, including Anesthesia, Chemotherapy, Clinical Laboratory, CT Scan, Dental Care, Diagnostic Radiology.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at North Baldwin Infirmary came from ZIP codes 36507 (337), 36502 (127), 36562 (34).
North Baldwin Infirmary has 53 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 78 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
North Baldwin Infirmary is located at 1815 Hand Avenue, Bay Minette, AL 36507. Its main phone number is (251) 937-5521.
North Baldwin Infirmary's CMS Certification Number (CCN), also called its Medicare provider number, is 010129.
The National Provider Identifier (NPI) on file for North Baldwin Infirmary is 1134164924.
North Baldwin Infirmary is affiliated with Infirmary Health System.
North Baldwin Infirmary lists 31 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
380 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers