Piedmont Augusta Hospital
1350 Walton Way, Augusta, GA 30901 · 100 Priced Procedures · 67% Patient Recommendation
Typical commercial prices here are +31% above the fair benchmark (1.31×) even after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 1.31× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Piedmont Augusta Hospital prices routine shoppable procedures at 2.0× Medicare (median 1.24× Fair BaseRate) while upper-quartile commercial rates jump +49% to 1.85× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.00× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 70% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 67% patient recommendation (56/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (26.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
- Commercial insurance median sits at 1.24× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.85×) jump +49% above the median procedure ratio (Q50 1.24×)
- Consolidated metro market (HHI 2,534) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Piedmont Augusta Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 100 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $43,210 | 1.4× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $28,045 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $25,893 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $24,140 | 1.3× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $9,374 | 1.1× |
| Colonoscopy with biopsy CPT Code: 45380 | $3,127 | 2.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $3,031 | 3.1× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,279 | 2.2× |
| Blood transfusion CPT Code: 36430 | $1,510 | 3.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,135 | 2.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $964 | 1.7× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $916 | 2.0× |
| MRI, lower back (no contrast) CPT Code: 72148 | $725 | 2.1× |
| MRI, brain (no contrast) CPT Code: 70551 | $666 | 1.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $666 | 1.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $584 | 1.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $522 | 2.0× |
| CT scan, head (with contrast) CPT Code: 70460 | $523 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $489 | 1.8× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $432 | 2.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $450 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $424 | unverified |
| CT scan, pelvis CPT Code: 72192 | $433 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $360 | unverified |
| CT scan, sinuses CPT Code: 70486 | $332 | 2.0× |
Audit a Bill or Quote at Piedmont Augusta Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $34,990
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (26.1% of gross = $34,990).
Self-Pay Cash Rate ($40,249) Beats Your Bill
Piedmont Augusta Hospital's published 45 CFR § 180 self-pay cash rate is $40,249 (vs. $43,210 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($134,164) is $103,389 above the denoised Fair BaseRate ($30,775) and 5.7× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (26.1% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Piedmont Augusta Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-11-21·administrative_or_closure
Closure Notice
Recorded - 2025-08-22·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (1,544 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Piedmont Augusta Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.