Community Memorial Hospital
1755 North Mecklenburg Avenue, South Hill, VA 23970 · 52 Priced Procedures · 70% Patient Recommendation
Typical commercial prices here are +45% above the fair benchmark (1.45×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.45× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Community Memorial Hospital prices routine shoppable procedures at 1.5× Medicare (median 1.30× Fair BaseRate) while upper-quartile commercial rates jump +50% to 1.95× 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 0.94× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- 4-Star CMS clinical rating with 70% patient recommendation (74/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.9× markup over Medicare rates
- Commercial insurance median sits at 1.30× Fair BaseRate (1.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.95×) jump +50% above the median procedure ratio (Q50 1.30×)
- Unnegotiated chargemaster list prices average 3.8× Medicare (26¢ true HCRIS cost per $1 gross)
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 Community Memorial Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 52 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $27,101 | 1.4× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $15,687 | 0.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $14,512 | 0.8× |
| Total hip replacement CPT Code: 27130 | $12,900 | 1.0× |
| Total knee replacement CPT Code: 27447 | $12,900 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,727 | 0.8× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,571 | 0.9× |
| C-section delivery (full package) CPT Code: 59510 | $3,990 | 1.3× |
| Breast lump removal CPT Code: 19120 | $3,656 | 0.9× |
| Vaginal delivery (full package) CPT Code: 59400 | $3,608 | 1.3× |
| Inguinal hernia repair CPT Code: 49505 | $3,538 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $3,253 | 0.9× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,287 | 0.9× |
| Trauma team activation HCPCS Code: G0390 | $1,270 | 0.9× |
| Residential mental health treatment HCPCS Code: H2036 | $792 | unverified |
| Behavioral health day program HCPCS Code: H2012 | $721 | unverified |
| Psychological testing by technician CPT Code: 96138 | $400 | 1.0× |
| Behavioral health counseling (per session) HCPCS Code: H0008 | $341 | 1.3× |
| Behavioral health counseling (group) HCPCS Code: H0009 | $341 | 1.3× |
| Behavioral health day treatment HCPCS Code: H0010 | $341 | 1.0× |
| Behavioral health residential care HCPCS Code: H0011 | $341 | 0.9× |
| Behavioral health assessment HCPCS Code: H0001 | $361 | unverified |
| Mental health services (assessment) HCPCS Code: H0031 | $361 | unverified |
| Neurobehavioral status check CPT Code: 96116 | $312 | 1.4× |
| Care planning with family CPT Code: 90887 | $233 | 2.2× |
Audit a Bill or Quote at Community Memorial Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $23,584
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $23,584).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Community Memorial Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)
Your bill ($65,042) is $45,610 above the denoised Fair BaseRate ($19,432) and 4.6× the $14,044 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Illustrative National Nonprofit Peer Median (36.3% of gross — request this hospital's exact FAP Look-Back AGB percentage)
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. Hospital-specific AGB look-back percentages are published in each facility’s written Financial Assistance Policy (FAP). This figure reflects the national nonprofit peer median benchmark.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (420 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 Community Memorial Hospital.
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.