California / Mad River Community Hospital
CMS certification 050028 · Arcata, CA
Mad River Community Hospital: charges and Medicare payments
Mad River Community Hospital reported 33 Medicare inpatient stays across 1 DRGs in 2024. Across them it charged 3.63 times what it was paid. Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 33 stays at an average charge of $70,451, 22% below the national average. It also billed 628 outpatient services, charging 7.4 times what Medicare paid.
- 1Medicare inpatient stays 33
- 2Charge ÷ paid, inpatient 3.63×
- 3Rank in CA (highest ratio = 1) –
- 4CMS price-transparency actions 0
Inpatient stays
For the 1 DRGs that can be compared with the national average, Mad River Community Hospital charged more than the national average in 0 (0%). 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 | 33 | $70,451 | -22% | $19,426 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 378 | $16,722 | $2,859 |
| Comprehensive Observation Services | 67 | $29,611 | $3,315 |
| Level 3 Musculoskeletal Procedures | 35 | $19,028 | $3,980 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 21 | $9,641 | $1,993 |
| Level 4 Musculoskeletal Procedures | 21 | $34,139 | $8,793 |
| Level 5 Gynecologic Procedures | 21 | $29,619 | $5,883 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 18 | $26,236 | $4,254 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 17 | $15,105 | $3,083 |
| Level 1 Laparoscopy and Related Services | 15 | $28,161 | $7,093 |
| Level 3 Vascular Procedures | 12 | $41,177 | $3,919 |
| Level 3 Lower GI Procedures | 12 | $22,218 | $3,452 |
| Level 2 Musculoskeletal Procedures | 11 | $16,734 | $1,976 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mad River Community Hospital charged $70,451 on average, 51% less than the California average of $143,063, and was paid $19,426 against a state average of $23,020. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $16,722 was 20% below the state average of $20,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $29,611 was 29% below the state average of $41,628. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $19,028 was 47% below the state average of $36,238. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,641 was 35% 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.