Providence Saint Joseph Medical Ctr: charges and Medicare payments

Providence Saint Joseph Medical Ctr reported 4,130 Medicare inpatient stays across 102 DRGs in 2024. Across them it charged 6.3 times what it was paid — among the higher ratios in California, number 80 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: 777 stays at an average charge of $128,488, 42% above the national average. It also billed 2,597 outpatient services, charging 8.06 times what Medicare paid.

1Medicare inpatient stays 4,130
2Charge ÷ paid, inpatient 6.3×
3Rank in CA (highest ratio = 1) 80 of 247
4CMS price-transparency actions 0

Average charge per stay at Providence Saint Joseph Medical Ctr, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 102 DRGs that can be compared with the national average, Providence Saint Joseph Medical Ctr charged more than the national average in 93 (91%). 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	777	$128,488	+42%	$20,297
291 Heart Failure and Shock with MCC	226	$96,035	+70%	$13,686
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	164	$64,301	+31%	$10,673
193 Simple Pneumonia and Pleurisy with MCC	114	$96,395	+61%	$13,088
177 Respiratory Infections and Inflammations with MCC	110	$126,754	+80%	$17,591
853 Infectious and Parasitic Diseases with O.R. Procedures with...	96	$266,233	+16%	$52,074
689 Kidney and Urinary Tract Infections with MCC	89	$84,097	+64%	$12,145
280 Acute Myocardial Infarction, Discharged Alive with MCC	85	$106,133	+40%	$15,973
698 Other Kidney and Urinary Tract Diagnoses with MCC	82	$89,806	+22%	$16,181
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	77	$181,079	+81%	$22,454
870 Septicemia or Severe Sepsis with MV >96 Hours	75	$510,984	+58%	$77,027
481 Hip and Femur Procedures except Major Joint with CC	69	$110,883	+10%	$20,251
682 Renal Failure with MCC	66	$92,088	+40%	$15,926
690 Kidney and Urinary Tract Infections without MCC	66	$51,414	+36%	$8,117
378 Gastrointestinal Hemorrhage with CC	63	$65,604	+35%	$10,962
189 Pulmonary Edema and Respiratory Failure	61	$102,194	+78%	$13,460
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	61	$56,990	+42%	$8,640
552 Medical Back Problems without MCC	61	$67,107	+37%	$10,803
377 Gastrointestinal Hemorrhage with MCC	54	$88,598	+4%	$17,880
603 Cellulitis without MCC	50	$59,278	+59%	$9,062
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	50	$81,301	+35%	$14,356
309 Cardiac Arrhythmia and Conduction Disorders with CC	43	$52,686	+46%	$7,830
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	42	$72,703	+30%	$10,179
470 Major Hip and Knee Joint Replacement or Reattachment of...	42	$102,542	+10%	$19,161
322 Percutaneous Cardiovascular Procedures with Intraluminal...	38	$102,564	-10%	$17,963
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	38	$54,303	+47%	$8,014
190 Chronic Obstructive Pulmonary Disease with MCC	36	$88,674	+75%	$11,824
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	36	$111,412	+9%	$20,859
683 Renal Failure with CC	35	$67,986	+67%	$9,447
194 Simple Pneumonia and Pleurisy with CC	33	$70,554	+84%	$8,546
308 Cardiac Arrhythmia and Conduction Disorders with MCC	32	$79,479	+40%	$12,463
208 Respiratory System Diagnosis with Ventilator Support <=96...	31	$276,940	+104%	$33,766
389 Gastrointestinal Obstruction with CC	30	$52,090	+34%	$8,282
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$72,682	+19%	$13,608
057 Degenerative Nervous System Disorders without MCC	28	$72,587	+28%	$11,794
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	28	$55,206	+30%	$10,627
023 Craniotomy with Major Device Implant or Acute Complex Cns...	26	$326,359	+16%	$57,576
025 Craniotomy and Endovascular Intracranial Procedures with MCC	26	$342,944	+48%	$54,243
330 Major Small and Large Bowel Procedures with CC	26	$169,680	+43%	$23,043
314 Other Circulatory System Diagnoses with MCC	25	$147,386	+55%	$22,597
329 Major Small and Large Bowel Procedures with MCC	25	$257,927	+20%	$46,094
321 Percutaneous Cardiovascular Procedures with Intraluminal...	24	$183,200	+12%	$28,944
812 Red Blood Cell Disorders without MCC	24	$55,011	+24%	$9,444
092 Other Disorders of Nervous System with CC	23	$75,934	+47%	$10,425
202 Bronchitis and Asthma with CC/MCC	23	$82,910	+80%	$10,087
390 Gastrointestinal Obstruction without CC/MCC	23	$39,498	+41%	$6,205
394 Other Digestive System Diagnoses with CC	23	$64,265	+37%	$10,456
480 Hip and Femur Procedures except Major Joint with MCC	23	$170,689	+23%	$28,908
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	23	$98,498	+46%	$13,569
312 Syncope and Collapse	22	$61,497	+35%	$9,026
482 Hip and Femur Procedures except Major Joint without CC/MCC	22	$93,004	+19%	$16,970
004 Tracheostomy with MV >96 Hours or Principal Diagnosis except...	21	$1,405,600	+129%	$211,496
100 Seizures with MCC	21	$114,773	+22%	$17,649
267 Endovascular Cardiac Valve Replacement and Supplement...	21	$227,659	+3%	$49,864
069 Transient Ischemia without Thrombolytic	20	$72,210	+43%	$8,380
418 Laparoscopic Cholecystectomy without C.D.E. with CC	20	$106,092	+14%	$17,233
699 Other Kidney and Urinary Tract Diagnoses with CC	20	$53,625	+13%	$9,709
638 Diabetes with CC	19	$71,321	+71%	$12,358
854 Infectious and Parasitic Diseases with O.R. Procedures with...	19	$136,807	+39%	$21,117
101 Seizures without MCC	18	$75,521	+55%	$9,112

Showing the 60 most frequent of 102 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	951	$34,339	$3,357
Level 5 Musculoskeletal Procedures	154	$75,197	$16,055
Level 2 Excision/ Biopsy/ Incision and Drainage	133	$10,354	$1,993
Level 1 Laparoscopy and Related Services	131	$40,426	$6,983
Level 5 Urology and Related Services	130	$50,273	$6,362
Level 2 Upper GI Procedures	121	$10,945	$2,339
Level 4 Musculoskeletal Procedures	75	$59,224	$8,602
Level 1 Endovascular Procedures	70	$28,162	$4,013
Level 2 Laparoscopy and Related Services	69	$90,313	$12,637
Level 4 Urology and Related Services	67	$34,150	$4,286
Level 2 Urology and Related Services	61	$4,311	$840
Level 3 Urology and Related Services	52	$17,941	$2,504
Level 4 Vascular Procedures	51	$40,846	$5,299
Level 3 Vascular Procedures	50	$28,327	$3,919
Level 3 Endovascular Procedures	47	$64,435	$13,250
Level 3 Excision/ Biopsy/ Incision and Drainage	45	$19,774	$3,416
Level 4 Gynecologic Procedures	39	$24,704	$3,844
Level 1 Breast/Lymphatic Surgery and Related Procedures	34	$31,071	$4,686
Level 6 Musculoskeletal Procedures	33	$129,353	$22,851
Level 3 Pacemaker and Similar Procedures	33	$35,371	$13,108
Level 5 Gynecologic Procedures	33	$34,449	$5,976
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	31	$33,219	$4,253
Level 3 Electrophysiologic Procedures	26	$110,105	$29,114
Level 2 Breast/Lymphatic Surgery and Related Procedures	24	$54,521	$7,783
Level 2 Musculoskeletal Procedures	24	$15,692	$1,976

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Providence Saint Joseph Medical Ctr charged $128,488 on average, 10% less than the California average of $143,063, and was paid $20,297 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Providence Saint Joseph Medical Ctr charged $96,035 on average, 5% less than the California average of $100,739, and was paid $13,686 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Providence Saint Joseph Medical Ctr charged $64,301 on average, 16% less than the California average of $76,120, and was paid $10,673 against a state average of $12,552. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Providence Saint Joseph Medical Ctr charged $96,395 on average, 7% less than the California average of $103,761, and was paid $13,088 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $34,339 was 18% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $75,197 was 31% below the state average of $109,149. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,354 was 30% below the state average of $14,749. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $40,426 was 37% below the state average of $64,351.

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.