Providence St Joseph Hospital: charges and Medicare payments

Providence St Joseph Hospital reported 2,102 Medicare inpatient stays across 64 DRGs in 2024. Across them it charged 5.41 times what it was paid — mid-range in California, number 111 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: 390 stays at an average charge of $116,737, 29% above the national average. It also billed 2,497 outpatient services, charging 8.25 times what Medicare paid.

1Medicare inpatient stays 2,102
2Charge ÷ paid, inpatient 5.41×
3Rank in CA (highest ratio = 1) 111 of 247
4CMS price-transparency actions 0

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

Inpatient stays

For the 64 DRGs that can be compared with the national average, Providence St Joseph Hospital charged more than the national average in 58 (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	390	$116,737	+29%	$22,151
291 Heart Failure and Shock with MCC	137	$76,499	+36%	$14,298
177 Respiratory Infections and Inflammations with MCC	97	$104,920	+49%	$18,113
280 Acute Myocardial Infarction, Discharged Alive with MCC	81	$85,580	+13%	$17,092
853 Infectious and Parasitic Diseases with O.R. Procedures with...	76	$239,895	+5%	$52,686
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	72	$78,486	+60%	$11,509
193 Simple Pneumonia and Pleurisy with MCC	62	$69,292	+16%	$14,533
377 Gastrointestinal Hemorrhage with MCC	49	$119,547	+40%	$19,907
378 Gastrointestinal Hemorrhage with CC	46	$78,421	+62%	$10,942
039 Extracranial Procedures without CC/MCC	36	$84,578	+32%	$12,529
682 Renal Failure with MCC	36	$89,694	+36%	$16,191
698 Other Kidney and Urinary Tract Diagnoses with MCC	36	$90,695	+24%	$17,927
689 Kidney and Urinary Tract Infections with MCC	35	$76,169	+48%	$13,062
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	34	$99,754	0%	$23,754
189 Pulmonary Edema and Respiratory Failure	34	$91,163	+58%	$15,370
481 Hip and Femur Procedures except Major Joint with CC	33	$124,190	+23%	$23,336
281 Acute Myocardial Infarction, Discharged Alive with CC	32	$65,886	+30%	$10,036
308 Cardiac Arrhythmia and Conduction Disorders with MCC	32	$66,461	+17%	$13,395
603 Cellulitis without MCC	31	$58,495	+57%	$11,265
683 Renal Failure with CC	31	$56,217	+38%	$10,094
322 Percutaneous Cardiovascular Procedures with Intraluminal...	30	$121,908	+6%	$22,640
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	30	$84,951	+41%	$17,635
309 Cardiac Arrhythmia and Conduction Disorders with CC	26	$55,900	+55%	$8,452
896 Alcohol, Drug Abuse or Dependence without Rehabilitation...	26	$104,682	+34%	$19,215
480 Hip and Femur Procedures except Major Joint with MCC	25	$169,261	+22%	$30,677
163 Major Chest Procedures with MCC	23	$251,164	+19%	$52,272
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	22	$61,558	+10%	$10,805
271 Other Major Cardiovascular Procedures with CC	22	$192,551	+11%	$36,951
190 Chronic Obstructive Pulmonary Disease with MCC	21	$70,136	+39%	$12,077
329 Major Small and Large Bowel Procedures with MCC	21	$267,095	+24%	$52,426
330 Major Small and Large Bowel Procedures with CC	21	$180,363	+52%	$25,598
038 Extracranial Procedures with CC	20	$103,727	+19%	$17,419
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	18	$70,416	+75%	$9,455
208 Respiratory System Diagnosis with Ventilator Support <=96...	17	$184,070	+36%	$30,817
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	17	$133,106	+30%	$22,784
243 Permanent Cardiac Pacemaker Implant with CC	16	$87,557	-21%	$26,412
602 Cellulitis with MCC	16	$98,952	+65%	$16,346
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	16	$54,276	+46%	$8,825
321 Percutaneous Cardiovascular Procedures with Intraluminal...	15	$157,321	-4%	$33,245
493 Lower Extremity and Humerus Procedures except Hip, Foot and...	15	$150,367	+26%	$25,812
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	15	$66,341	+56%	$10,653
637 Diabetes with MCC	15	$102,986	+55%	$15,999
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	15	$113,179	+68%	$14,730
919 Complications of Treatment with MCC	15	$116,401	+32%	$19,611
460 Spinal Fusion except Cervical without MCC	14	$179,235	+5%	$39,207
690 Kidney and Urinary Tract Infections without MCC	14	$68,147	+80%	$9,171
951 Other Factors Influencing Health Status	14	$54,571	+113%	$6,809
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	13	$93,263	+43%	$15,451
269 Aortic and Heart Assist Procedures except Pulsation Balloon...	13	$211,963	+10%	$44,226
282 Acute Myocardial Infarction, Discharged Alive without CC/MCC	13	$62,052	+43%	$8,134
314 Other Circulatory System Diagnoses with MCC	13	$120,062	+27%	$22,025
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	13	$191,771	+42%	$31,216
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	13	$83,346	+125%	$9,522
242 Permanent Cardiac Pacemaker Implant with MCC	12	$141,075	-12%	$37,279
812 Red Blood Cell Disorders without MCC	12	$69,343	+56%	$10,381
854 Infectious and Parasitic Diseases with O.R. Procedures with...	12	$159,144	+62%	$21,795
917 Poisoning and Toxic Effects of Drugs with MCC	12	$87,641	+17%	$17,502
253 Other Vascular Procedures with CC	11	$213,054	+62%	$30,566
286 Circulatory Disorders except AMI, with Cardiac...	11	$96,620	-14%	$22,522
389 Gastrointestinal Obstruction with CC	11	$71,248	+83%	$9,927

Showing the 60 most frequent of 64 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	269	$39,936	$3,356
Level 2 Excision/ Biopsy/ Incision and Drainage	177	$17,432	$1,977
Level 5 Musculoskeletal Procedures	166	$94,768	$16,148
Level 1 Nerve Procedures	148	$21,857	$1,482
Level 1 Laparoscopy and Related Services	144	$56,275	$7,094
Level 3 Vascular Procedures	132	$36,826	$3,919
Level 4 Musculoskeletal Procedures	131	$68,620	$8,687
Level 1 Endovascular Procedures	121	$23,587	$4,013
Level 3 Excision/ Biopsy/ Incision and Drainage	103	$23,290	$3,466
Level 5 Urology and Related Services	93	$56,289	$6,362
Level 2 Upper GI Procedures	89	$21,614	$2,317
Level 3 Endovascular Procedures	87	$76,782	$13,503
Level 4 Urology and Related Services	83	$44,443	$4,286
Level 4 Endovascular Procedures	73	$113,353	$21,503
Level 3 Musculoskeletal Procedures	69	$40,203	$3,980
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	69	$44,112	$4,253
Level 3 Pacemaker and Similar Procedures	63	$39,303	$13,108
Level 2 Breast/Lymphatic Surgery and Related Procedures	59	$62,807	$8,017
Level 6 Musculoskeletal Procedures	57	$108,804	$22,852
Level 3 Urology and Related Services	48	$22,933	$2,504
Level 2 Musculoskeletal Procedures	38	$24,763	$1,976
Level 2 Endovascular Procedures	38	$32,919	$7,027
Level 2 Vascular Procedures	34	$18,945	$1,969
Level 2 Laparoscopy and Related Services	30	$99,617	$12,637
Level 3 Lower GI Procedures	29	$28,880	$3,452

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Providence St Joseph Hospital charged $116,737 on average, 18% less than the California average of $143,063, and was paid $22,151 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Providence St Joseph Hospital charged $76,499 on average, 24% less than the California average of $100,739, and was paid $14,298 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Providence St Joseph Hospital charged $104,920 on average, 16% less than the California average of $124,302, and was paid $18,113 against a state average of $18,986. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Providence St Joseph Hospital charged $85,580 on average, 31% less than the California average of $123,896, and was paid $17,092 against a state average of $19,122. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $39,936 was 4% below the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $17,432 was 18% above the state average of $14,749. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $94,768 was 13% below the state average of $109,149. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $21,857 was 13% above the state average of $19,391.

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.