Understanding Legacy's charge lists
In compliance with new federal rules going into effect on January 1, 2019, we have published all Legacy Health chargemasters, as well as our standard charges per Diagnosis Related Group (DRG) code.
We are here to help
A chargemaster is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital. It is not a helpful tool for patients to comparison shop between hospitals or to estimate what health care services are going to cost them out of their own pocket.
For more information about the cost of your care, please contact our Customer Service Team between 8 a.m. and 5:30 p.m., Monday through Friday at 503-413-4048, 360-487-4048 or 800-495-7076.
It’s important to note, a chargemaster reflects standard charges billed to payors, whether commercial, government, or self-pay – not your out-of-pocket costs. This is because your out-of-pocket costs are ultimately based on your:
- Individual health plan benefits
- Medical situation
- Unique treatment plan
- Financial situation – Uninsured or self-pay patients receive a 35 percent discount off Legacy’s standard charges for hospital services. In addition, Legacy has one of the most generous financial assistance programs in our region.
More robust, meaningful options
We are committed to providing price information to our patients. Legacy Customer Service provides individualized cost estimates for all services, upon request.
In addition, we have made charge information available to the public for years through the Oregon Hospital Guide, a website that compares hospital pricing data based on your unique health needs on a user-friendly platform. To learn more, visit OregonHospitalGuide.org.
Legacy Health Chargemaster and DRG
Frequently Asked Questions
Legacy Health has published its hospitals’ chargemasters and standard charges per Diagnosis Related Group (DRG) code. We did this to comply with new Centers for Medicare & Medicaid Services (CMS) rules, which will go into effect on January 1, 2019, requiring all hospitals in the United States to publish their standard list of charges.
What is a chargemaster?
A chargemaster is a comprehensive listing of charges for services and items billable to a hospital patient and/or a patient’s health insurance provider. Given the many services provided by hospitals 24 hours a day, seven days a week, a chargemaster contains thousands of services and related charges.
What is a DRG?
A DRG is a system of categorizing patient encounters (primarily inpatient) for payment by many payors including Medicare, which is determined by the patient’s diagnosis, length of hospital stay and treatments provided.
Are all my charges listed in the chargemaster?
Legacy’s chargemaster includes all items and services billed by the hospital. Not included are professional charges billed by physicians and other providers, such as emergency physicians, anesthesiologists, radiologists, etc. Also, not included are non-hospital services provided by Legacy Health, such as Legacy Medical Group Clinic and Legacy-Go Health charges.
Do the charges listed reflect what my out-of-pocket costs will be?
Because your out-of-pocket costs are based on your individual health plan benefits, medical situation, treatment plan and financial situation, the chargemaster is not a useful tool for estimating your out-of-pocket costs.
For individual hospital pricing estimates, please contact Legacy Customer Service Team at 503-413-4048, 360-487-4048 or 800-495-7076.
How are charges determined?
Charges are determined by what it costs Legacy to provide the service, local market conditions, payor and regulatory requirements, as well as Legacy’s costs to operate the hospital.
Why do charges vary from hospital to hospital?
Each hospital system has its own chargemaster with its own unique pricing. Charges may vary between health systems and hospitals – even within the same local markets – because each has its own factors that influence pricing including staffing, equipment and maintenance costs.
Moreover, hospital systems may structure their charges differently, so it isn’t always possible to make a direct price comparison based on chargemasters.
What other resources are there for me to use to estimate pricing?
To see the national average price for procedures for outpatient care, please see Medicare's Procedure Price Lookup. For more information on procedure costs in the state of Oregon, visit Oregon Association of Hospitals and Health Systems (OAHHS). It is always prudent to gather as much information from your provider about the anticipated care plan to use as a reference for these tools.
Who do I contact with questions?
Legacy Health is ready to help you and your family understand your financial obligation at any time during your treatment process. We encourage you to reach out and ask our financial counselors detailed questions – especially before scheduled services.
Please contact our Customer Service Team between 8 a.m. and 5:30 p.m., Monday through Friday at 503-413-4048, 360-487-4048 or 800-495-7076.
For more information on Medicare updates please visit our Medicare Information page.
For information on Financial Assistance please visit our What if I cannot pay? page.