BJC Healthcare · O Fallon, MO
4 of 5
CMS star rating
77
Beds
4,858
Inpatient discharges a year
$128.4M
Net patient revenue a year
34
In-network payers
Progress West Hospital is a 77-bed voluntary non-profit - private hospital in O Fallon, MO, affiliated with BJC Healthcare. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 398 disclosed rate categories.
The 24 services Progress West Hospital 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
$6,947 - $8,240
from 4 insurers · median $7,267
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 obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 788
$8,213 - $11,832
from 4 insurers · median $10,198
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 obstetrics / child birth services to CMS
Gynecology
CPT 58558
$2,581 - $6,463
from 4 insurers · median $4,771
11 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 470
$10,469 - $33,677
from 4 insurers · median $27,633
12 Medicare discharges for this DRG in CMS hospital data
CT imaging
CPT 74177
$278 - $1,701
from 4 insurers · median $916
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$937 - $4,123
from 4 insurers · median $2,541
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$4,821 - $12,017
from 4 insurers · median $8,409
19 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 29881
$2,609 - $9,135
from 4 insurers · median $8,672
35 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
Mammography
CPT 77067
$87 - $665
from 4 insurers · median $277
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$14,293 - $64,611
from 4 insurers · median $52,932
Hospital reports orthopedic surgery services to CMS
Childbirth · Inpatient
MS-DRG 807
$6,947 - $8,240
from 4 insurers · median $7,267
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 obstetrics / child birth services to CMS
Digestive procedures
CPT 49650
$4,821 - $10,492
from 4 insurers · median $8,590
19 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 70450
$83 - $912
from 4 insurers · median $361
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$1,840 - $5,891
from 4 insurers · median $5,164
Typical for a hospital with this service line
Digestive procedures
CPT 47563
$4,821 - $11,345
from 4 insurers · median $9,723
19 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 71275
$140 - $1,269
from 4 insurers · median $908
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$190 - $773
from 4 insurers · median $660
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$8,859 - $9,622
from 3 insurers · median $9,611
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$723 - $3,767
from 4 insurers · median $2,055
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$278 - $2,218
from 4 insurers · median $1,155
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$954 - $3,983
from 4 insurers · median $2,021
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 20610
$245 - $5,685
from 4 insurers · median $2,039
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 29880
$2,609 - $9,938
from 4 insurers · median $8,767
35 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
Gynecology
CPT 58661
$4,821 - $10,510
from 4 insurers · median $9,612
Typical for a hospital with this service line
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* | 23 | 270% | 4 | 7 |
| Insurer B* | 24 | 241% | 21 | 0 |
| Insurer C* | 24 | 168% | 16 | 1 |
| Insurer D* | 24 | 78% | 6 | 12 |
How we chose these services: 7 appear in this hospital's own Medicare claims, 10 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 Progress West Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
4 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$128.4M net patient revenue
Ownership and leadership
Owned by BJC Health System
The employer identification numbers (EINs) health plans and networks list for Progress West Hospital 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 |
|---|---|---|
| 41-2140764Progress West Healthcare Center | 57Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 52 more | 1508938044 Progress West Healthcare Center1124166434 Progress West Healthcare Center1225367360 Progress West Healthcare Centerand 2 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.
Two Progress Point Parkway, O Fallon, MO 63368
(636) 344-1000
How Progress West Hospital compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
4 of 5
Higher than 58% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
Better on 1 of 6 measures
1 better, 5 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 4 measures
0 better, 4 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Better on 1 of 7 measures
1 better, 6 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
4 of 5
Higher than 60% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
82%
Higher than 85% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
1.03
Higher than 70% 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
203 min
Higher than 82% 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
56%
Lower than 71% 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 | 4 of 5 | |
| Death rates | Better on 1 of 6 measures | |
| Safety | No different on 4 measures | |
| Readmissions | Better on 1 of 7 measures | |
| Patient survey ratingCMS: Summary star rating | 4 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 82% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 1.03 | 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 | 203 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 56% | 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 Progress West Hospital's inpatient payments for its readmissions, quality and cost results.
No penalty
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
-0.10% 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 Progress West Hospital, beside the US median and the average of MO 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 | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 · 89 cases | 3.3 | 4.1 | 4.203 | Better than 85% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 1,298 cases | 3.4 | 3.9 | 3.991 | Better than 79% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 · 57 cases | 11.9 | 11.8 | 11.96 | Worse than 53% of US hospitals | |
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.622 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 48 cases | 6.8 | 8.5 | 8.708 | Better than 91% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 125 cases | 9.9 | 11 | 11.68 | Better than 71% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 191 cases | 11.3 | 15.2 | 15.5 | Better than 95% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 102 cases | 11.6 | 11.6 | 12.03 | Better than 50% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 1,467 cases | 0.83 | 0.51 | 0.5582 | No Different Than the National Rate | Worse than 82% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 181 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 1,790 cases | 0.19 | 0.2 | 0.2094 | No Different Than the National Rate | Better than 66% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 1,766 cases | 0.25 | 0.27 | 0.2774 | No Different Than the National Rate | Better than 71% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 274 cases | 2.23 | 2.29 | 2.312 | No Different Than the National Rate | Better than 61% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 88 cases | 1.66 | 1.63 | 1.619 | No Different Than the National Rate | Worse than 64% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 91 cases | 8.63 | 8.88 | 9.849 | No Different Than the National Rate | Better than 57% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 296 cases | 3.56 | 3.4 | 3.388 | No Different Than the National Rate | Worse than 64% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 87 cases | 5.14 | 5.105 | 5.071 | No Different Than the National Rate | Worse than 53% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 64 cases | 1.72 | 1.72 | 1.763 | No Different Than the National Rate | Better than 48% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 275 cases | 1.01 | 1.02 | 1.029 | No Different Than the National Rate | Better than 53% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 5.15 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 140 cases | -4.8 | 1.25 | 2.001 | Better than 59% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 195 cases | -15.8 | 3.85 | 0.788 | Better than 76% 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 · 780 cases | 12.9 | 12.9 | 13.12 | No Different Than the National Rate | Better than 50% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.22 | Number of Cases Too Small | ||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.318 | Number of Cases Too Small | ||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 253 cases | 0.9 | 1 | 0.9815 | No Different than expected | Better than 68% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 73 cases | 13.8 | 14.4 | 14.32 | Better than 77% of US hospitals | |
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.43 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 100 cases | 19.2 | 19.8 | 20.11 | Better than 77% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 264 cases | 21 | 21.3 | 21.62 | Better than 60% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 · 79 cases | 6 | 5.8 | 6.12 | Worse than 61% of US hospitals | |
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 324 cases | 16.4 | 17.2 | 17.28 | Better than 83% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.28 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.027 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 1,105 | 1,370 | 4,135 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.782 | 0.9835 | 4.122 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.604 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.6608 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2046 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.947 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 1,447 | 1,799 | 3,878 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.88 | 1.377 | 4.807 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 2.413 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5467 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3088 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.21 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 35 | 61 | 126 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.792 | 1.591 | 3.466 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 1 | 1 | 2.877 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.8248 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2664 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.522 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 13 | 38 | 93.8 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.11 | 0.328 | 0.829 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.8929 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 1.061 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2979 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.478 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 20,392 | 14,451 | 41,352 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.515 | 0.567 | 2.861 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 1.978 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.8703 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.052 | 0.127 | 0.1657 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 1.034 | 0.747 | 1.229 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 18,592 | 13,646 | 38,342 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 6.388 | 5.683 | 24.41 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 2 | 2 | 8.022 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.313 | 0.279 | 0.3843 | No Different than National Benchmark | Worse than 55% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 587 cases | 66 | 73 | 72.59 | Worse than 79% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 587 cases | 12 | 8 | 9.344 | Worse than 76% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 587 cases | 22 | 18 | 18.06 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 84 | 87 | 85.78 | Worse than 71% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 587 cases | 3 | 4 | 3.297 | Worse than 53% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 587 cases | 82 | 80 | 79.3 | Better than 63% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 94 | 91 | 91.27 | Better than 82% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 587 cases | 2 | 4 | 3.882 | Better than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 587 cases | 5 | 3 | 3.392 | The top rating, shared by 18% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 587 cases | 16 | 16 | 16.82 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 587 cases | 79 | 79 | 79.32 | Worse than 47% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 92 | 91 | 90.65 | Better than 63% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 587 cases | 3 | 5 | 5.032 | Better than 77% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 3.095 | Better than 63% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 587 cases | 18 | 16 | 15.65 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 587 cases | 64 | 61 | 60.96 | Better than 64% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 81 | 77 | 76.66 | Better than 79% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 587 cases | 16 | 19 | 18.89 | Better than 69% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 2.689 | Better than 79% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 587 cases | 20 | 19 | 20.15 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 90 | 86 | 86.27 | Better than 86% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 587 cases | 10 | 13 | 13.38 | Better than 78% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 3.432 | Better than 55% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 587 cases | 90 | 87 | 86.62 | Better than 78% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 587 cases | 11 | 14 | 14.94 | Better than 77% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 587 cases | 89 | 86 | 85.06 | Better than 77% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 74 | 74 | 73.49 | Better than 48% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 4 | 7 | 6.488 | Better than 81% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 22 | 19 | 20.02 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 78 | 77 | 77.34 | Better than 51% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 4 | 6 | 5.549 | Better than 70% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 18 | 17 | 17.11 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 85 | 85 | 85.12 | Worse than 47% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 2 | 3 | 3.463 | Better than 75% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 13 | 11 | 11.41 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 587 cases | 4 | 8 | 7.366 | Better than 82% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 587 cases | 20 | 20 | 20.41 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 587 cases | 76 | 72 | 72.23 | Better than 66% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 92 | 88 | 88.41 | Better than 86% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 3.405 | Better than 55% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 587 cases | 80 | 74 | 73.17 | Better than 80% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 587 cases | 8 | 9 | 9.915 | Better than 60% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 587 cases | 12 | 16 | 16.91 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 79 | 75 | 73.79 | Better than 75% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 3 | 5 | 5.598 | Better than 81% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 587 cases | 18 | 20 | 20.61 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 79 | 77 | 75.55 | Better than 63% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 3 | 4 | 4.585 | Better than 64% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 587 cases | 18 | 19 | 19.87 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 87 | 86 | 85.67 | Better than 53% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 0 | 3 | 2.427 | The best result, shared by 7% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 587 cases | 13 | 11 | 11.9 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 587 cases | 64 | 59 | 60.98 | Better than 65% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 587 cases | 5 | 9 | 8.344 | Better than 77% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 587 cases | 31 | 31 | 30.68 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 87 | 82 | 82.92 | Better than 85% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 3.568 | Better than 56% 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 · 587 cases | 3 | 5 | 5.892 | Better than 70% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 587 cases | 82 | 71 | 70.75 | Better than 85% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 587 cases | 93 | 87 | 87.14 | Better than 90% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 587 cases | 15 | 23 | 23.35 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 587 cases | 5 | 4 | 3.662 | The top rating, shared by 24% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 587 cases | 49 | 47 | 45.78 | Better than 58% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 587 cases | 25 | 30 | 29.67 | Better than 74% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 587 cases | 26 | 22 | 24.55 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 587 cases | 4 | 3 | 3.311 | Better than 60% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 587 cases | 9 | 12 | 12.12 | Better than 80% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 587 cases | 91 | 88 | 87.88 | Better than 80% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | medium | ||||
| 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 · 5,170 cases | 5 | 8 | 6.941 | Better than 70% of US hospitals | |
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.026 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.2857 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 2,128 cases | 96 | 79 | 81.12 | Better than 90% 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 · 402 cases | 206 | 154 | 167 | Worse than 81% 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 · 389 cases | 203 | 148 | 161 | Worse than 82% 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 | 273 | |||
| 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 | Not Available | 288 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 26,981 cases | 3 | 1 | 2.18 | Worse than 78% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 · 14 cases | 86 | 74 | 72.93 | Better than 78% of US hospitals | |
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 159 cases | 100 | 97 | 95.34 | The best result, shared by 27% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 98 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 55.38 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 1,456 cases | 16 | 15 | 17.13 | Worse than 57% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 207 cases | 56 | 65 | 61.69 | Worse than 71% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 59 cases | 51 | 73 | 66.69 | Worse than 89% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 23 cases | 91 | 88 | 82.85 | Better than 57% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 208 cases | 74 | 82 | 78.59 | Worse than 76% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 119 cases | 98 | 94 | 92.68 | Better than 77% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 · 68 cases | 100 | 98 | 96.61 | The best result, shared by 14% of US hospitals | |
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 69.14 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 · 55 cases | 100 | 94 | 95.06 | The best result, shared by 6% of US hospitals | |
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 83.25 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 95.05 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 2.3 | 5 | 5.293 | Better than 82% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 9.1 | 6.6 | 6.538 | Worse than 76% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.95 | 0.99 | 0.981 | Better than 68% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 32 | 20 | 20.74 | Better than 72% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 8 | 5 | 5.208 | Better than 72% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 30 | 10 | 24.07 | Better than 68% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 7.5 | 2.5 | 6.186 | Better than 68% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 48 | 34 | 35.83 | Better than 72% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 12 | 8.75 | 9.052 | Better than 72% of US hospitals | |
| VBP safety domain scoreFY 2026 | 0 | 40 | 39.11 | The worst result, shared by 1% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 0 | 10 | 9.878 | The worst result, shared by 1% of US hospitals | |
| VBP total performance scoreFY 2026 | 27.5 | 29.5 | 30.07 | Worse than 57% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 36 | 46 | 32.5 | 14 | 12 | 32 |
| VBP clinical outcomes weighted domain score | 12 | 11.5 | 8.125 | 3.5 | 4 | 8 |
| VBP efficiency and cost reduction domain score | 20 | Not Available | 10 | 0 | 10 | 30 |
| VBP efficiency and cost reduction weighted domain score | 6.667 | Not Available | 2.5 | 0 | 3.333 | 7.5 |
| VBP person and community engagement domain score | 40 | Not Available | Not Available | 20 | 16 | 48 |
| VBP person and community engagement weighted domain score | 13.33 | Not Available | Not Available | 5 | 5.333 | 12 |
| VBP safety domain score | Not Available | Not Available | Not Available | 65 | Not Available | 0 |
| VBP safety weighted domain score | Not Available | Not Available | Not Available | 16.25 | Not Available | 0 |
| VBP total performance score | 32 | Not Available | Not Available | 24.75 | 12.67 | 27.5 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | 0.9575 | 0.9995 | 1.004 | Better than 77% of US hospitals | |
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9855 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | 0.9739 | 0.9969 | 1.004 | Better than 72% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 124 cases | 0.948 | 0.9983 | 1 | Better than 81% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | 0.9713 | 0.9916 | 1.018 | Better than 56% of US hospitals | |
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 180 cases | 0.9475 | 0.9955 | 0.9936 | Better than 81% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | 0.9576 | N/A | 0.9327 | 0.9592 | 0.9561 | 0.9575 |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9562 | 0.9664 | 0.9879 | 0.968 | 0.9825 | 0.9739 |
| READM-30-HF-HRRP | 1.116 | 1.108 | 1.05 | 0.957 | 0.9743 | 0.948 |
| READM-30-HIP-KNEE-HRRP | 1.143 | 1.122 | 0.964 | 0.8735 | 0.9184 | 0.9713 |
| READM-30-PN-HRRP | 0.9709 | 0.9637 | 0.9544 | 0.9198 | 0.952 | 0.9475 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | Progress West Hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.531 | 0.489 | 0.5555 | Worse than 54% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.59 | 0.346 | 0.3878 | Worse than 81% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.559 | 0.5837 | The best result, shared by 14% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | 0.947 | 0.6405 | 0.8346 | Worse than 74% of US hospitals | |
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 1.029 | 0.9628 | 0.9777 | Worse than 70% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 1.119 | 0.7945 | 0.777 | Worse than 70% of US hospitals | |
| Total HAC scoreFY 2026 | 0.1064 | -0.0453 | -0.03378 | Worse than 60% 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 | No |
| Total HAC score | -0.6953 | -0.8605 | 0 | -0.7916 | -0.627 | 0.1064 |
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.
The Joint Commission (since 2018)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
76
Medicare-certified beds
90
Registered nurses (full-time equivalent)
2007
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Progress West Hospital reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
4,858
Inpatient discharges
Medicare 20%, Medicaid 3%
18,736
Inpatient days
67% of available bed days used
443
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 836730). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Progress West Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 3,971 | 585 | 14,180 | 18,736 |
| Discharges | 960 | 150 | 3,748 | 4,858 |
| Average length of stay | 4.1 days | 3.9 days | 3.8 days | 3.9 days |
| Average daily census | 10.9 | 1.6 | 38.8 | 51.3 |
6,716
Medicare Advantage days
1,540 discharges
1,938
Medicaid managed care days
345 discharges
992
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 77 | 16,958 | 3,971 | 60% |
| Nursery | 1,778 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Progress West Hospital treats Medicare patients for most often, in 2024. 430 Medicare discharges in 17 published DRGs; 9% surgical; 65% 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 | 102 | $46,207 | $11,715 | $15,433 | 1.98 |
| Heart failure and shock with MCCMS-DRG 291, medical | 40 | $37,437 | $7,900 | $12,504 | 1.28 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 29 | $33,820 | $4,681 | $11,296 | 0.79 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 28 | $27,910 | $4,487 | $9,322 | 0.81 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 27 | $42,737 | $10,130 | $14,274 | 1.70 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 27 | $31,107 | $5,814 | $10,390 | 1.03 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 24 | $42,804 | $8,758 | $14,296 | 1.33 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 22 | $69,823 | $12,505 | $23,321 | 2.07 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 21 | $32,849 | $5,879 | $10,971 | 0.98 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 20 | $34,096 | $7,621 | $11,388 | 1.17 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 16 | $53,173 | $10,299 | $17,760 | 1.88 |
| Cellulitis without MCCMS-DRG 603, medical | 14 | $24,150 | $4,497 | $8,066 | 0.88 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 13 | $31,027 | $7,681 | $10,363 | 1.23 |
| Syncope and collapseMS-DRG 312, medical | 12 | $32,797 | $5,572 | $10,954 | 0.86 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 12 | $34,020 | $3,873 | $11,363 | 0.80 |
| Renal failure with MCCMS-DRG 682, medical | 12 | $54,837 | $10,700 | $18,316 | 1.50 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 11 | $28,372 | $4,482 | $9,476 | 0.78 |
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) Progress West Hospital billed Medicare for most in 2024: 467 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 5 Musculoskeletal ProceduresAPC 5115 | 140 | 136 | $40,348 | $9,922 | $10,772 |
| Level 2 Upper GI ProceduresAPC 5302 | 44 | 40 | $6,775 | $1,362 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 42 | 41 | $17,007 | $1,890 | $2,090 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 35 | 35 | $16,343 | $2,033 | $2,373 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 34 | 22 | $7,109 | $1,048 | $1,220 |
| Level 1 Nerve ProceduresAPC 5431 | 34 | 31 | $9,981 | $1,369 | $1,407 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 30 | 30 | $30,567 | $4,923 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 30 | 30 | $11,066 | $2,085 | $2,208 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 25 | 22 | $8,631 | $1,140 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 23 | 23 | $58,844 | $14,919 | $15,763 |
See all 12 Medicare outpatient services at Progress West Hospital
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 Progress West Hospital 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 1,405 in 2020 to 2,331 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 63368 | 563 | 24% | 2,194 | $23.4M | 28% | 27% |
| 63304 | 350 | 15% | 1,406 | $14.9M | 16% | 15% |
| 63366 | 335 | 14% | 1,478 | $14.2M | 10% | 9% |
| 63385 | 260 | 11% | 1,078 | $12M | 11% | 7% |
| 63376 | 206 | 9% | 830 | $9.1M | 5% | 5% |
| 63367 | 178 | 8% | 737 | $8.1M | 12% | 13% |
| 63379 | 82 | 4% | 363 | $3.6M | 5% | 3% |
| 63383 | 73 | 3% | 305 | $3.4M | 7% | 4% |
| 63390 | 65 | 3% | 287 | $2.9M | 9% | 9% |
| 63303 | 51 | 2% | 274 | $3M | 2% | 2% |
| 63341 | 45 | 2% | 173 | $2M | 30% | 27% |
| 63362 | 36 | 2% | 139 | $1.5M | 8% | |
| 63348 | 33 | 1% | 158 | $1.6M | 10% | 5% |
| 63301 | 32 | 1% | 140 | $1.5M | 1% | 1% |
| 63031 | 11 | 0% | 57 | $542,726 | 0% | |
| 63389 | 11 | 0% | 38 | $355,002 | 3% | 4% |
Source: CMS Hospital Service Area file. Shares are of the 2,331 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 Progress West Hospital reported at its latest Medicare certification survey (2011). Counts are people, not full-time equivalents.
2
Off-site locations
90
Registered nurses
3
Physicians
4
Pharmacists
5
Respiratory therapists
1
Physical therapists
1
Occupational therapists
15
Radiology technicians
1
Nuclear medicine technicians
1
Laboratory technicians
7
Medical technologists
2
Dietitians
1
Social workers
164
Other personnel
Source: CMS Provider of Services file.
327 clinicians who bill Medicare list Progress West Hospital 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.
Peter Oppelt, MD
Medical Oncology Physician
NPI 1639332968
See commercial rates for Peter Oppelt, MDAshley Frith, MD
Medical Oncology Physician
NPI 1730352014
See commercial rates for Ashley Frith, MDCarolyn Jachna, MD
Endocrinology, Diabetes & Metabolism Physician
NPI 1558378216
See commercial rates for Carolyn Jachna, MDCaron Rigden, MD
Medical Oncology Physician
NPI 1407903826
See commercial rates for Caron Rigden, MDMia Weiss, MD
Medical Oncology Physician
NPI 1033525332
See commercial rates for Mia Weiss, MDDane Glueck, MD
Orthopaedic Surgery Physician
NPI 1811075757
See commercial rates for Dane Glueck, MDJohn Mcallister, MD
Orthopaedic Surgery Physician
NPI 1497857965
See commercial rates for John Mcallister, MDBrad White, MD
Urology Physician
NPI 1205810512
See commercial rates for Brad White, MDChristopher Jaeger, MD
Urology Physician
NPI 1457672446
See commercial rates for Christopher Jaeger, MDJohn Mccarthy, MD
Urology Physician
NPI 1477662179
See commercial rates for John Mccarthy, MDSteven Schneider, MD
Urology Physician
NPI 1598997439
See commercial rates for Steven Schneider, MDZachary Fallon, M.D.
Physical Medicine & Rehabilitation Physician
NPI 1225491004
See commercial rates for Zachary Fallon, M.D.Brian Meek, MD
Pain Medicine Physician
NPI 1730342023
See commercial rates for Brian Meek, MDDouglas Curry, MD
Diagnostic Radiology Physician
NPI 1508974379
See commercial rates for Douglas Curry, MDMoh'D Khushman, MD
Medical Oncology Physician
NPI 1750546735
See commercial rates for Moh'D Khushman, MDRyan Nunley, MD
Adult Reconstructive Orthopaedic Surgery Physician
NPI 1164568887
See commercial rates for Ryan Nunley, MDAndrew Krainik, MD
Clinical Cardiac Electrophysiology Physician
NPI 1821010968
See commercial rates for Andrew Krainik, MDStanley Mathew, MD
Endocrinology, Diabetes & Metabolism Physician
NPI 1376644484
See commercial rates for Stanley Mathew, MDChristopher Thornton, MD
Diagnostic Radiology Physician
NPI 1093829970
See commercial rates for Christopher Thornton, MDNicholas Wilson, M.D.
Orthopaedic Surgery Physician
NPI 1902225766
See commercial rates for Nicholas Wilson, M.D.Hui Hua Shu, MD
Diagnostic Radiology Physician
NPI 1831139286
See commercial rates for Hui Hua Shu, MDMarie Morris, MD
Surgery of the Hand (Surgery) Physician
NPI 1235589342
See commercial rates for Marie Morris, MDWilliam Frisella, MD
Orthopaedic Surgery Physician
NPI 1851427066
See commercial rates for William Frisella, MDKimberly Berni, MD
Urology Physician
NPI 1245289677
See commercial rates for Kimberly Berni, MDSource: 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 Progress West Hospital reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $506.9M | 394.8% |
| Inpatient | $182.8M | 142.3% |
| Outpatient | $324.1M | 252.4% |
| Contractual allowances and discounts | -$378.5M | -294.8% |
| Net patient revenue | $128.4M | 100.0% |
| Operating expenses | -$118.7M | -92.5% |
| Operating income from patient care | $9.7M | 7.5% |
| Other income | $1.4M | 1.1% |
| Investment income | $104,348 | 0.1% |
| Other | $1.3M | 1.0% |
| Other expenses | -$16.9M | -13.1% |
| Net income | -$5.8M | -4.5% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $75.4M | 14.9% |
| Medicaid (including managed care) | $43.7M | 8.6% |
| Other payers and self-pay | $386.9M | 76.5% |
| Total charges | $506M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. 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 Progress West Hospital's latest cost report.
7.5%
Operating margin
Operating income from patient care / net patient revenue
-4.5%
Total margin
Net income / net patient revenue plus other income
1.4%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
49% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$49.69
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-8.8%
Return on assets
Net income for a year / total assets
-11.3%
Return on equity
Net income for a year / fund balance
1.41
Current ratio
Current assets / current liabilities
1.24
Quick ratio
Cash, temporary investments and net receivables / current liabilities
3 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
45 days
Days in patient receivables
Net patient receivables / daily net patient revenue
45 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.97
Asset turnover
Total revenue for a year / total assets
15.3 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Progress West Hospital owned and owed at the end of its reporting period (Dec 2025), across all fund types: $65.9M in total assets and a $51.3M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $1.1M | 1.6% |
| Patient receivables, net | $16M | 24.2% |
| Inventory | $2.1M | 3.2% |
| Total current assets | $19.5M | 29.6% |
| Property and equipment, net of depreciation | $45.5M | 69.0% |
| Investments and other assets | $926,544 | 1.4% |
| Total assets | $65.9M | 100.0% |
| Current liabilities | $13.8M | 20.9% |
| Total liabilities | $14.5M | 22.1% |
| Fund balance (net assets) | $51.3M | 77.9% |
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Progress West Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$1.9M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$8.1M
Bad debt
Patient bills written off as uncollectible, at charges
$413,204
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$4.1M
Total unreimbursed and uncompensated care
3.5% 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 836730, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Progress West Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Dec 2020 | Dec 2021 | Dec 2022 | Dec 2023 | Dec 2024 | Dec 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $82.1M | $102M | $112M | $119.2M | $121.3M | $128.4M |
| Operating expenses | $76.5M | $86.6M | $98.8M | $105M | $111.2M | $118.7M |
| Operating margin | 6.9% | 15.1% | 11.7% | 11.9% | 8.3% | 7.5% |
| Net income | -$2.1M | $9.8M | $9M | $5M | -$1.2M | -$5.8M |
| Total assets | $64.3M | $66.3M | $66.1M | $65.9M | $65.1M | $65.9M |
| Discharges | 3,559 | 4,554 | 4,307 | 4,829 | 4,863 | 4,858 |
| Inpatient days | 15,169 | 16,236 | 18,879 | 18,079 | 18,325 | 18,736 |
| Medicare Advantage days | 3,393 | 3,718 | 5,644 | 6,216 | 6,728 | 6,716 |
| Beds | 68 | 68 | 69 | 69 | 69 | 77 |
| Employees (FTE) | 344 | 445 | 373 | 445 | 453 | 443 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Progress West Hospital 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 |
|---|---|---|---|---|---|
| Operating room | $4.9M | $14.4M | $77.3M | 0.19 | 11,630 |
| Emergency | $4.9M | $12.1M | $98.9M | 0.12 | 7,279 |
| Radiology-diagnostic | $4.3M | $11.5M | $77.6M | 0.15 | 7,970 |
| Drugs charged to patients | $8M | $25.1M | 0.32 | ||
| Impl. dev. charged to patients | $6.9M | $17M | 0.41 | ||
| Laboratory | $1.6M | $6.6M | $47M | 0.14 | 2,301 |
| Medical supplies charged to patient | $4.3M | $10.3M | 0.42 | ||
| Wound care | $827,536 | $2.6M | $11.4M | 0.23 | |
| Respiratory therapy | $1.2M | $2.4M | $6.6M | 0.37 | 451 |
| Ct scan | $1.1M | $2.2M | $48.2M | 0.05 | 943 |
| Physical therapy | $1.1M | $2.1M | $4.6M | 0.45 | 408 |
| Observation beds (non-distinct part | $1.8M | $3.3M | 0.55 | ||
| Delivery room & labor room | $1.7M | $2.1M | 0.81 | 2,433 | |
| Mri | $642,927 | $1.3M | $13.9M | 0.09 | 842 |
| Hyperbaric oxygen therapy | $812,391 | $3.2M | 0.25 | ||
| Renal dialysis | $179,855 | $538,920 | 0.33 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $15.7M | $32.6M | $53M | 0.61 | 25,272 |
| Nursery | $506,682 | $2.7M | $5.9M | 0.46 | 427 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.8M | $26.9M | 39,134 | $72.73 | 39,491 |
| Operation of plant | $1.3M | $4.1M | 42,293 | $31.65 | 17,453 |
| Cap rel costs-mvble equip | $3.7M | ||||
| Cap rel costs-bldg & fixt | $3.1M | 128,439 | |||
| Pharmacy | $1.9M | $2.6M | 32,502 | $58.15 | 1,318 |
| Dietary | $1.4M | $2.1M | 48,540 | $28.65 | 5,743 |
| Housekeeping | $703,249 | $2.1M | 33,897 | $20.78 | 400 |
| Cap rel - pob i bldg & mme | $646,810 | ||||
| Central services & supply | $327,381 | $640,436 | 10,458 | $31.30 | 735 |
| Pob i - other expenses | $614,293 | ||||
| Nursing administration | $423,367 | $589,959 | 8,487 | $50.03 | 421 |
| Laundry & linen service | $509,929 | 2,194 | |||
| Employee benefits department | $43,232 | $273,542 | 1,331 | $16.32 | 291 |
| Cap rel - annex bldg & mme | $250,789 | ||||
| Medical records & library | $265 | 437 |
Source: CMS cost report (HCRIS, Form 2552-10), report 836730, as submitted. 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 Progress West Hospital for an inpatient stay.
1.48
Case mix index
Higher than 25% 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).
14.9%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
949
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 | 1.47 | 1.47 | 1.57 | 1.54 | 1.48 | 1.50 | 1.48 |
| Wage index | 0.915 | 0.942 | 0.934 | 0.915 | 0.912 | 0.967 | 0.951 |
| Readmissions adjustment | -1.84% | -2.11% | -2.04% | -0.25% | 0.00% | 0.00% | 0.00% |
| Value-based purchasing adjustment | -0.10% | +0.05% | +0.05% | +0.22% | +0.35% | -0.87% | -0.10% |
| Medicare inpatient stays | 792 | 792 | 717 | 795 | 912 | 897 | 949 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Progress West Hospital reports to Medicare as owners or with operational control. 7 individuals also hold ownership interests; they are not listed here.
BJC Health System
Operational/managerial control, since 2004
Progress West Healthcare Center
Operational/managerial control, since 2004
Sources: CMS Hospital All Owners.
The officers and board members on Progress West Hospital'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 10 of 22 are shown.
Accountable care organization (Medicare Shared Savings Program)
BJC HealthCare ACO, LLC
ACO A1204, current agreement since 2025. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on Progress West Hospital's legal name.
About Progress West Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Progress West Hospital range from $278 to $2,218 across 4 insurers. Aetna's rate is $675. The median at nearby comparable hospitals is $683. 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 Progress West Hospital range from $278 to $1,701 across 4 insurers. Blue Cross Blue Shield's rate is $1,701. The median at nearby comparable hospitals is $500. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Progress West Hospital range from $954 to $3,983 across 4 insurers. Cigna's rate is $2,231. The median at nearby comparable hospitals is $1,229. 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 Progress West Hospital range from $6,947 to $8,240 across 4 insurers. UnitedHealthcare's rate is $8,240. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Progress West Hospital range from $87 to $665 across 4 insurers. UnitedHealthcare's rate is $87. The median at nearby comparable hospitals is $191. 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 Progress West Hospital range from $10,469 to $33,677 across 4 insurers. Aetna's rate is $26,557. The median at nearby comparable hospitals is $20,046. What a patient pays depends on their plan's deductible, coinsurance and network status.
Progress West Hospital has a CMS overall hospital star rating of 4 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is higher than 58% of US hospitals.
CMS reports no Medicare-funded interns or residents at Progress West Hospital for fiscal year 2027.
No. Progress West Hospital has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (102 discharges), heart failure and shock with mcc (40 discharges), esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc (29 discharges).
Progress West Hospital's Medicare case mix index is 1.48 for fiscal year 2027, higher than 25% of hospitals paid under the inpatient prospective payment system.
Progress West Hospital reported 4,858 inpatient discharges and 18,736 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Progress West Hospital reported 443 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Progress West Hospital reported $128.4M in net patient revenue on $506.9M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of 7.5%, and net income of -$5.8M.
Progress West Hospital reported $4.1M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $1.9M of charity care at cost.
Progress West Hospital's Medicare enrollment lists Scott Hawig as Vice President, Finance since 2026.
Insurers' price transparency files list Progress West Hospital under employer identification number 41-2140764 (Progress West Healthcare Center). 57 health plans and networks list 41-2140764 for it.
327 clinicians who bill Medicare list Progress West Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family medicine physician (29), diagnostic radiology physician (25), emergency medicine physician (23).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Progress West Hospital, effective 2018.
In its Medicare enrollment, Progress West Hospital reports BJC Health System as Operational/managerial control.
CMS lists 25 services at Progress West Hospital, including Acute Renal Dialysis, Anesthesia, Cardiac Catheterization Lab, Clinical Laboratory, CT Scan, Diagnostic Radiology.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Progress West Hospital came from ZIP codes 63368 (563), 63304 (350), 63366 (335).
Progress West Hospital has 77 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 76 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Progress West Hospital is located at Two Progress Point Parkway, O Fallon, MO 63368. Its main phone number is (636) 344-1000.
Progress West Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 260219.
The National Provider Identifier (NPI) on file for Progress West Hospital is 1508938044.
Progress West Hospital is affiliated with BJC Healthcare.
Progress West Hospital lists 34 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
398 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