Rhode Island / Rhode Island Hospital
CMS certification 410007 · Providence, RI · 3 entries in CMS's price-transparency list
Rhode Island Hospital: charges and Medicare payments
Rhode Island Hospital reported 4,986 Medicare inpatient stays across 155 DRGs in 2024. Across them it charged 2.6 times what it was paid — among the lower ratios in Rhode Island, number 8 of 9 hospitals with at least 100 stays (state median 2.81×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 291 stays at an average charge of $58,277, 35% below the national average. It also billed 3,259 outpatient services, charging 4.04 times what Medicare paid.
- 1Medicare inpatient stays 4,986
- 2Charge ÷ paid, inpatient 2.6×
- 3Rank in RI (highest ratio = 1) 8 of 9
- 4CMS price-transparency actions 3
Inpatient stays
For the 155 DRGs that can be compared with the national average, Rhode Island Hospital charged more than the national average in 6 (4%). 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 | 291 | $58,277 | -35% | $22,048 |
| 291 Heart Failure and Shock with MCC | 142 | $54,683 | -3% | $16,270 |
| 177 Respiratory Infections and Inflammations with MCC | 126 | $55,458 | -21% | $19,259 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 123 | $56,039 | -44% | $21,242 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 119 | $112,692 | -49% | $50,364 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 107 | $31,611 | -43% | $11,493 |
| 481 Hip and Femur Procedures except Major Joint with CC | 101 | $56,941 | -43% | $22,882 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 98 | $107,839 | -62% | $53,547 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 87 | $124,406 | -46% | $51,394 |
| 378 Gastrointestinal Hemorrhage with CC | 76 | $33,750 | -30% | $12,077 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 75 | $74,460 | -52% | $32,648 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 72 | $70,973 | -6% | $20,781 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 68 | $34,548 | -30% | $12,214 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 64 | $51,890 | -14% | $17,658 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 64 | $48,787 | -34% | $18,831 |
| 689 Kidney and Urinary Tract Infections with MCC | 61 | $41,725 | -19% | $13,517 |
| 193 Simple Pneumonia and Pleurisy with MCC | 60 | $41,309 | -31% | $15,726 |
| 184 Major Chest Trauma with CC | 59 | $32,369 | -42% | $12,539 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 59 | $38,579 | -24% | $14,299 |
| 312 Syncope and Collapse | 57 | $30,602 | -33% | $10,445 |
| 377 Gastrointestinal Hemorrhage with MCC | 57 | $68,346 | -20% | $21,247 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 56 | $158,629 | -44% | $64,097 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 53 | $31,445 | -13% | $8,974 |
| 460 Spinal Fusion except Cervical without MCC | 49 | $83,239 | -51% | $40,804 |
| 884 Organic Disturbances and Intellectual Disability | 49 | $54,528 | -13% | $18,522 |
| 036 Carotid Artery Stent Procedures without CC/MCC | 48 | $43,662 | -51% | $18,893 |
| 057 Degenerative Nervous System Disorders without MCC | 45 | $38,156 | -33% | $14,729 |
| 101 Seizures without MCC | 45 | $29,217 | -40% | $10,985 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 44 | $73,845 | -36% | $23,159 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 44 | $31,997 | -20% | $10,806 |
| 200 Pneumothorax with CC | 43 | $34,198 | -36% | $13,871 |
| 542 Pathological Fractures and Musculoskeletal and Connective... | 43 | $47,285 | -41% | $19,241 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 42 | $36,119 | -26% | $13,362 |
| 082 Traumatic Stupor and Coma >1 Hour with MCC | 40 | $51,099 | -56% | $25,221 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 40 | $86,576 | -38% | $31,982 |
| 164 Major Chest Procedures with CC | 39 | $45,683 | -64% | $27,300 |
| 189 Pulmonary Edema and Respiratory Failure | 38 | $57,160 | -1% | $17,521 |
| 683 Renal Failure with CC | 38 | $32,445 | -20% | $11,899 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 38 | $33,114 | -30% | $12,838 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 37 | $191,066 | -17% | $60,104 |
| 235 Coronary Bypass without Cardiac Catheterization with MCC | 36 | $181,299 | -38% | $67,798 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 36 | $27,676 | -25% | $9,259 |
| 552 Medical Back Problems without MCC | 35 | $29,495 | -40% | $11,354 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 34 | $37,687 | -25% | $10,891 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 34 | $99,781 | -39% | $32,084 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 34 | $43,303 | -29% | $17,470 |
| 638 Diabetes with CC | 34 | $30,654 | -26% | $12,495 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 33 | $59,010 | -50% | $25,355 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 32 | $196,990 | -51% | $84,305 |
| 603 Cellulitis without MCC | 32 | $35,781 | -4% | $10,942 |
| 812 Red Blood Cell Disorders without MCC | 32 | $32,901 | -26% | $11,408 |
| 029 Spinal Procedures with CC or Spinal Neurostimulators | 31 | $54,035 | -68% | $36,079 |
| 178 Respiratory Infections and Inflammations with CC | 30 | $38,618 | -15% | $15,417 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 30 | $107,093 | -5% | $26,741 |
| 690 Kidney and Urinary Tract Infections without MCC | 30 | $34,004 | -10% | $10,106 |
| 682 Renal Failure with MCC | 29 | $50,499 | -23% | $19,744 |
| 813 Coagulation Disorders | 29 | $45,562 | -43% | $18,054 |
| 024 Craniotomy with Major Device Implant or Acute Complex Cns... | 28 | $83,352 | -57% | $39,093 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 28 | $30,050 | -29% | $8,416 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 28 | $53,123 | -6% | $14,375 |
Showing the 60 most frequent of 155 DRGs.
Outpatient services
Against the Rhode Island average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Rhode Island Hospital charged $58,277 on average, 4% more than the Rhode Island average of $56,063, and was paid $22,048 against a state average of $18,474. For Heart Failure and Shock with MCC (DRG 291), Rhode Island Hospital charged $54,683 on average, 46% more than the Rhode Island average of $37,534, and was paid $16,270 against a state average of $12,554. For Respiratory Infections and Inflammations with MCC (DRG 177), Rhode Island Hospital charged $55,458 on average, 18% more than the Rhode Island average of $46,857, and was paid $19,259 against a state average of $15,760. For Intracranial Hemorrhage or Cerebral Infarction with MCC (DRG 064), Rhode Island Hospital charged $56,039 on average, 10% more than the Rhode Island average of $51,084, and was paid $21,242 against a state average of $19,443. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,887 was 4% above the state average of $17,131. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,908 was 6% above the state average of $7,430. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $5,449 was 24% below the state average of $7,186. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $9,977 was 19% above the state average of $8,355.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Rhode Island Hospital in Providence, RI, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-02-08 (CMS case 457)
- Closure Notice — 2024-06-04 (CMS case 457)
- Met Requirements — 2025-03-20 (CMS case 3291)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
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.