Adventist Health and Rideout: charges and Medicare payments

Adventist Health and Rideout reported 3,114 Medicare inpatient stays across 81 DRGs in 2024. Across them it charged 6.33 times what it was paid — among the higher ratios in California, number 77 of 247 hospitals with at least 100 stays (state median 5.18×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 578 stays at an average charge of $136,132, 51% above the national average. It also billed 1,957 outpatient services, charging 9.05 times what Medicare paid.

1Medicare inpatient stays 3,114
2Charge ÷ paid, inpatient 6.33×
3Rank in CA (highest ratio = 1) 77 of 247
4CMS price-transparency actions 0

Average charge per stay at Adventist Health and Rideout, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 81 DRGs that can be compared with the national average, Adventist Health and Rideout charged more than the national average in 76 (94%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	578	$136,132	+51%	$21,964
291 Heart Failure and Shock with MCC	249	$104,093	+85%	$14,629
280 Acute Myocardial Infarction, Discharged Alive with MCC	122	$113,387	+50%	$17,203
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	105	$80,691	+65%	$11,638
193 Simple Pneumonia and Pleurisy with MCC	95	$118,481	+98%	$15,392
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	81	$103,404	+72%	$15,185
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	75	$65,573	+77%	$9,427
177 Respiratory Infections and Inflammations with MCC	65	$110,047	+56%	$18,019
682 Renal Failure with MCC	61	$94,883	+44%	$16,046
853 Infectious and Parasitic Diseases with O.R. Procedures with...	60	$356,572	+56%	$66,170
698 Other Kidney and Urinary Tract Diagnoses with MCC	59	$119,951	+63%	$19,185
481 Hip and Femur Procedures except Major Joint with CC	58	$116,203	+15%	$22,286
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	56	$72,862	+31%	$10,936
190 Chronic Obstructive Pulmonary Disease with MCC	50	$92,546	+83%	$11,899
683 Renal Failure with CC	50	$77,503	+90%	$9,677
189 Pulmonary Edema and Respiratory Failure	49	$98,747	+72%	$13,304
689 Kidney and Urinary Tract Infections with MCC	49	$90,485	+76%	$12,693
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	45	$132,959	+33%	$22,810
308 Cardiac Arrhythmia and Conduction Disorders with MCC	45	$84,601	+49%	$14,303
603 Cellulitis without MCC	42	$63,788	+71%	$9,493
690 Kidney and Urinary Tract Infections without MCC	40	$61,217	+62%	$8,683
281 Acute Myocardial Infarction, Discharged Alive with CC	39	$88,022	+74%	$12,043
378 Gastrointestinal Hemorrhage with CC	39	$69,912	+44%	$11,820
286 Circulatory Disorders except AMI, with Cardiac...	37	$174,949	+56%	$24,462
309 Cardiac Arrhythmia and Conduction Disorders with CC	37	$58,142	+61%	$8,015
377 Gastrointestinal Hemorrhage with MCC	32	$119,890	+40%	$19,373
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$56,874	+42%	$8,454
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	30	$142,556	+39%	$22,725
321 Percutaneous Cardiovascular Procedures with Intraluminal...	25	$257,090	+57%	$30,860
322 Percutaneous Cardiovascular Procedures with Intraluminal...	25	$190,886	+67%	$19,574
917 Poisoning and Toxic Effects of Drugs with MCC	25	$111,322	+49%	$18,004
194 Simple Pneumonia and Pleurisy with CC	23	$67,782	+77%	$8,854
389 Gastrointestinal Obstruction with CC	23	$61,882	+59%	$8,587
637 Diabetes with MCC	23	$79,538	+20%	$15,630
101 Seizures without MCC	22	$72,939	+50%	$9,867
274 Percutaneous and Other Intracardiac Procedures without MCC	22	$108,803	-31%	$34,517
312 Syncope and Collapse	22	$93,857	+106%	$9,366
208 Respiratory System Diagnosis with Ventilator Support <=96...	21	$234,346	+73%	$30,147
314 Other Circulatory System Diagnoses with MCC	21	$173,758	+83%	$24,390
467 Revision of Hip or Knee Replacement with CC	21	$191,650	+21%	$40,072
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	19	$47,449	+65%	$6,846
069 Transient Ischemia without Thrombolytic	18	$66,050	+31%	$8,634
252 Other Vascular Procedures with MCC	18	$225,572	+32%	$37,062
811 Red Blood Cell Disorders with MCC	18	$81,198	+19%	$15,029
870 Septicemia or Severe Sepsis with MV >96 Hours	18	$389,998	+21%	$85,995
091 Other Disorders of Nervous System with MCC	17	$135,985	+64%	$19,834
100 Seizures with MCC	17	$80,719	-14%	$21,400
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	17	$111,706	+71%	$15,075
233 Coronary Bypass with Cardiac Catheterization or Open...	17	$572,646	+49%	$88,879
480 Hip and Femur Procedures except Major Joint with MCC	17	$176,389	+27%	$31,730
617 Amputation of Lower Limb for Endocrine, Nutritional and...	17	$117,775	+36%	$22,184
283 Acute Myocardial Infarction, Expired with MCC	16	$248,147	+141%	$31,967
638 Diabetes with CC	16	$63,361	+52%	$9,693
287 Circulatory Disorders except AMI, with Cardiac...	15	$133,318	+109%	$11,639
854 Infectious and Parasitic Diseases with O.R. Procedures with...	15	$166,074	+69%	$21,775
092 Other Disorders of Nervous System with CC	13	$73,626	+43%	$11,075
300 Peripheral Vascular Disorders with CC	13	$81,037	+64%	$11,593
372 Major Gastrointestinal Disorders and Peritoneal Infections...	13	$89,058	+88%	$11,179
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	13	$84,385	+38%	$13,687
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	13	$153,075	+29%	$25,680

Showing the 60 most frequent of 81 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	717	$43,735	$3,596
Level 1 Endovascular Procedures	195	$73,175	$4,266
Level 5 Musculoskeletal Procedures	140	$97,283	$16,964
Level 2 Excision/ Biopsy/ Incision and Drainage	97	$12,066	$2,069
Level 3 Vascular Procedures	91	$34,869	$4,197
Level 3 Electrophysiologic Procedures	85	$132,639	$31,178
Level 1 Laparoscopy and Related Services	71	$51,370	$7,512
Level 5 Urology and Related Services	60	$42,391	$6,723
Level 3 Endovascular Procedures	54	$110,740	$14,459
Level 2 Vascular Procedures	50	$10,991	$2,088
Level 3 Urology and Related Services	49	$10,825	$2,463
Level 2 Endovascular Procedures	47	$55,290	$7,399
Level 3 Pacemaker and Similar Procedures	41	$57,123	$14,036
Level 3 Excision/ Biopsy/ Incision and Drainage	33	$20,202	$3,651
Level 4 Musculoskeletal Procedures	32	$54,701	$9,414
Level 2 Upper GI Procedures	32	$17,991	$2,466
Level 4 Urology and Related Services	32	$35,762	$4,590
Level 3 Musculoskeletal Procedures	28	$36,119	$4,262
Level 4 Vascular Procedures	25	$57,184	$7,236
Level 2 Musculoskeletal Procedures	21	$16,760	$2,066
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	20	$37,504	$4,555
Level 4 Endovascular Procedures	14	$130,543	$21,383
Level 3 Airway Endoscopy	12	$12,980	$2,235
Level 4 Airway Endoscopy	11	$26,451	$4,931

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventist Health and Rideout charged $136,132 on average, 5% less than the California average of $143,063, and was paid $21,964 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Adventist Health and Rideout charged $104,093 on average, 3% more than the California average of $100,739, and was paid $14,629 against a state average of $15,556. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Adventist Health and Rideout charged $113,387 on average, 8% less than the California average of $123,896, and was paid $17,203 against a state average of $19,122. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Adventist Health and Rideout charged $80,691 on average, 6% more than the California average of $76,120, and was paid $11,638 against a state average of $12,552. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $43,735 was 5% above the state average of $41,628. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $73,175 was 80% above the state average of $40,544. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $97,283 was 11% below the state average of $109,149. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,066 was 18% below the state average of $14,749.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.

Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.