Providence Mission Hospital: charges and Medicare payments

Providence Mission Hospital reported 4,143 Medicare inpatient stays across 118 DRGs in 2024. Across them it charged 5.25 times what it was paid — mid-range in California, number 121 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: 694 stays at an average charge of $101,956, 13% above the national average. It also billed 3,841 outpatient services, charging 6.23 times what Medicare paid.

1Medicare inpatient stays 4,143
2Charge ÷ paid, inpatient 5.25×
3Rank in CA (highest ratio = 1) 121 of 247
4CMS price-transparency actions 0

Average charge per stay at Providence Mission Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 118 DRGs that can be compared with the national average, Providence Mission Hospital charged more than the national average in 91 (77%). 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	694	$101,956	+13%	$19,048
177 Respiratory Infections and Inflammations with MCC	193	$99,806	+41%	$16,293
291 Heart Failure and Shock with MCC	143	$74,898	+33%	$12,173
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	128	$56,801	+16%	$10,187
193 Simple Pneumonia and Pleurisy with MCC	105	$92,762	+55%	$13,576
698 Other Kidney and Urinary Tract Diagnoses with MCC	92	$71,552	-3%	$15,442
853 Infectious and Parasitic Diseases with O.R. Procedures with...	79	$280,275	+22%	$54,101
481 Hip and Femur Procedures except Major Joint with CC	76	$107,127	+6%	$19,919
378 Gastrointestinal Hemorrhage with CC	71	$49,894	+3%	$9,612
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	68	$73,165	+31%	$9,784
274 Percutaneous and Other Intracardiac Procedures without MCC	63	$122,582	-22%	$31,432
682 Renal Failure with MCC	63	$75,587	+15%	$14,235
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	61	$109,166	+9%	$18,262
690 Kidney and Urinary Tract Infections without MCC	59	$46,602	+23%	$8,572
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	52	$44,898	+12%	$8,360
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	51	$118,191	+16%	$23,230
689 Kidney and Urinary Tract Infections with MCC	51	$49,673	-3%	$11,178
552 Medical Back Problems without MCC	49	$59,165	+21%	$11,073
603 Cellulitis without MCC	49	$38,262	+3%	$8,699
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	49	$62,188	+3%	$13,729
377 Gastrointestinal Hemorrhage with MCC	48	$81,331	-5%	$17,151
280 Acute Myocardial Infarction, Discharged Alive with MCC	47	$78,278	+3%	$14,560
389 Gastrointestinal Obstruction with CC	46	$41,133	+6%	$8,296
322 Percutaneous Cardiovascular Procedures with Intraluminal...	44	$96,016	-16%	$18,800
683 Renal Failure with CC	44	$47,718	+17%	$8,737
189 Pulmonary Edema and Respiratory Failure	42	$82,297	+43%	$14,080
025 Craniotomy and Endovascular Intracranial Procedures with MCC	41	$258,516	+12%	$51,233
330 Major Small and Large Bowel Procedures with CC	38	$130,855	+10%	$23,443
163 Major Chest Procedures with MCC	36	$271,644	+29%	$47,310
454 Combined Anterior and Posterior Spinal Fusion with CC	35	$267,206	-4%	$61,745
086 Traumatic Stupor and Coma <1 Hour with CC	34	$94,068	+38%	$12,772
308 Cardiac Arrhythmia and Conduction Disorders with MCC	34	$74,238	+31%	$12,991
309 Cardiac Arrhythmia and Conduction Disorders with CC	34	$43,587	+21%	$7,905
321 Percutaneous Cardiovascular Procedures with Intraluminal...	32	$149,323	-9%	$31,406
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	32	$49,086	+32%	$8,078
480 Hip and Femur Procedures except Major Joint with MCC	31	$145,971	+5%	$28,969
536 Fractures of Hip and Pelvis without MCC	30	$50,285	+33%	$7,996
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	28	$31,648	+10%	$6,900
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	27	$46,500	+9%	$9,004
699 Other Kidney and Urinary Tract Diagnoses with CC	27	$55,846	+18%	$9,975
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	24	$127,812	+7%	$32,171
870 Septicemia or Severe Sepsis with MV >96 Hours	24	$437,885	+35%	$78,774
281 Acute Myocardial Infarction, Discharged Alive with CC	23	$64,809	+28%	$9,955
184 Major Chest Trauma with CC	22	$90,748	+64%	$10,720
393 Other Digestive System Diagnoses with MCC	22	$87,993	+15%	$15,930
394 Other Digestive System Diagnoses with CC	22	$49,114	+4%	$9,445
083 Traumatic Stupor and Coma >1 Hour with CC	21	$108,882	+49%	$13,788
164 Major Chest Procedures with CC	21	$159,270	+25%	$26,531
178 Respiratory Infections and Inflammations with CC	21	$62,648	+38%	$10,719
243 Permanent Cardiac Pacemaker Implant with CC	21	$75,501	-32%	$21,376
331 Major Small and Large Bowel Procedures without CC/MCC	21	$114,750	+34%	$17,608
390 Gastrointestinal Obstruction without CC/MCC	21	$29,196	+5%	$7,088
208 Respiratory System Diagnosis with Ventilator Support <=96...	20	$130,537	-4%	$26,113
470 Major Hip and Knee Joint Replacement or Reattachment of...	20	$115,641	+24%	$18,347
551 Medical Back Problems with MCC	20	$91,175	+16%	$15,761
854 Infectious and Parasitic Diseases with O.R. Procedures with...	20	$106,950	+9%	$18,752
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	19	$66,132	+2%	$12,682
194 Simple Pneumonia and Pleurisy with CC	19	$50,128	+31%	$8,618
266 Endovascular Cardiac Valve Replacement and Supplement...	19	$158,479	-44%	$58,364
813 Coagulation Disorders	19	$127,203	+59%	$19,087

Showing the 60 most frequent of 118 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	868	$28,208	$3,365
Level 2 Upper GI Procedures	431	$6,815	$2,328
Level 5 Musculoskeletal Procedures	365	$95,295	$16,148
Level 2 Excision/ Biopsy/ Incision and Drainage	325	$9,819	$1,979
Level 3 Electrophysiologic Procedures	316	$130,691	$29,031
Level 1 Laparoscopy and Related Services	150	$62,688	$7,094
Level 1 Endovascular Procedures	120	$22,237	$3,989
Level 3 Pacemaker and Similar Procedures	96	$40,603	$13,108
Level 4 Musculoskeletal Procedures	87	$68,974	$8,792
Level 3 Vascular Procedures	85	$21,964	$3,919
Level 6 Musculoskeletal Procedures	83	$120,758	$22,852
Level 3 Endovascular Procedures	79	$64,324	$13,503
Level 3 Lower GI Procedures	73	$8,631	$3,449
Level 5 Urology and Related Services	73	$41,301	$6,362
Level 4 Urology and Related Services	68	$29,975	$4,286
Level 3 Airway Endoscopy	61	$9,798	$2,087
Level 2 Musculoskeletal Procedures	54	$24,749	$1,976
Level 2 Vascular Procedures	51	$11,837	$1,969
Level 2 Laparoscopy and Related Services	46	$84,589	$12,637
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	44	$29,288	$4,253
Level 5 Airway Endoscopy	41	$43,793	$8,413
Level 4 Vascular Procedures	36	$51,676	$6,612
Level 3 Musculoskeletal Procedures	35	$37,060	$3,980
Level 3 Excision/ Biopsy/ Incision and Drainage	31	$23,130	$3,493
Level 1 Breast/Lymphatic Surgery and Related Procedures	24	$45,470	$4,686

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Providence Mission Hospital charged $101,956 on average, 29% less than the California average of $143,063, and was paid $19,048 against a state average of $23,020. For Respiratory Infections and Inflammations with MCC (DRG 177), Providence Mission Hospital charged $99,806 on average, 20% less than the California average of $124,302, and was paid $16,293 against a state average of $18,986. For Heart Failure and Shock with MCC (DRG 291), Providence Mission Hospital charged $74,898 on average, 26% less than the California average of $100,739, and was paid $12,173 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Providence Mission Hospital charged $56,801 on average, 25% less than the California average of $76,120, and was paid $10,187 against a state average of $12,552. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $28,208 was 32% below the state average of $41,628. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $6,815 was 64% below the state average of $19,034. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $95,295 was 13% below the state average of $109,149. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $9,819 was 33% 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.