Riddle Memorial Hospital: charges and Medicare payments

Riddle Memorial Hospital reported 2,847 Medicare inpatient stays across 75 DRGs in 2024. Across them it charged 7.11 times what it was paid — among the higher ratios in Pennsylvania, number 17 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 398 stays at an average charge of $96,132, 6% above the national average. It also billed 2,399 outpatient services, charging 4.68 times what Medicare paid.

1Medicare inpatient stays 2,847
2Charge ÷ paid, inpatient 7.11×
3Rank in PA (highest ratio = 1) 17 of 117
4CMS price-transparency actions 0

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

Inpatient stays

For the 75 DRGs that can be compared with the national average, Riddle Memorial Hospital charged more than the national average in 53 (71%). 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	398	$96,132	+6%	$13,690
291 Heart Failure and Shock with MCC	227	$68,752	+22%	$9,070
470 Major Hip and Knee Joint Replacement or Reattachment of...	146	$64,982	-30%	$13,653
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	98	$71,291	+45%	$7,782
378 Gastrointestinal Hemorrhage with CC	81	$74,266	+53%	$7,154
193 Simple Pneumonia and Pleurisy with MCC	76	$78,289	+31%	$9,422
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	75	$59,821	+49%	$6,022
683 Renal Failure with CC	71	$55,713	+37%	$6,515
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	66	$66,269	+19%	$7,210
177 Respiratory Infections and Inflammations with MCC	56	$84,446	+20%	$11,434
853 Infectious and Parasitic Diseases with O.R. Procedures with...	51	$199,712	-13%	$35,443
286 Circulatory Disorders except AMI, with Cardiac...	47	$135,902	+21%	$16,113
689 Kidney and Urinary Tract Infections with MCC	47	$75,770	+48%	$8,315
481 Hip and Femur Procedures except Major Joint with CC	45	$83,419	-17%	$14,432
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	45	$52,594	+42%	$5,510
698 Other Kidney and Urinary Tract Diagnoses with MCC	45	$98,535	+34%	$11,311
312 Syncope and Collapse	44	$50,955	+12%	$6,492
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	44	$62,660	+4%	$9,279
690 Kidney and Urinary Tract Infections without MCC	44	$57,102	+51%	$5,697
603 Cellulitis without MCC	42	$52,240	+40%	$6,320
189 Pulmonary Edema and Respiratory Failure	40	$64,051	+11%	$9,684
682 Renal Failure with MCC	39	$64,132	-3%	$11,065
194 Simple Pneumonia and Pleurisy with CC	38	$56,105	+46%	$6,091
322 Percutaneous Cardiovascular Procedures with Intraluminal...	38	$95,410	-17%	$14,400
190 Chronic Obstructive Pulmonary Disease with MCC	30	$69,307	+37%	$8,458
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	29	$83,939	-18%	$14,982
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	28	$85,810	-14%	$12,627
178 Respiratory Infections and Inflammations with CC	28	$71,117	+57%	$7,085
309 Cardiac Arrhythmia and Conduction Disorders with CC	28	$48,797	+35%	$5,786
330 Major Small and Large Bowel Procedures with CC	28	$121,808	+2%	$16,027
377 Gastrointestinal Hemorrhage with MCC	28	$107,517	+26%	$12,852
069 Transient Ischemia without Thrombolytic	27	$56,607	+12%	$5,729
812 Red Blood Cell Disorders without MCC	26	$63,467	+43%	$6,930
854 Infectious and Parasitic Diseases with O.R. Procedures with...	26	$123,888	+26%	$15,424
467 Revision of Hip or Knee Replacement with CC	25	$105,937	-33%	$25,137
811 Red Blood Cell Disorders with MCC	24	$71,322	+5%	$10,464
202 Bronchitis and Asthma with CC/MCC	23	$60,557	+31%	$6,891
321 Percutaneous Cardiovascular Procedures with Intraluminal...	23	$124,032	-24%	$22,814
394 Other Digestive System Diagnoses with CC	23	$49,590	+5%	$6,718
329 Major Small and Large Bowel Procedures with MCC	22	$221,419	+3%	$30,573
308 Cardiac Arrhythmia and Conduction Disorders with MCC	21	$77,040	+36%	$8,416
389 Gastrointestinal Obstruction with CC	21	$59,195	+52%	$5,839
638 Diabetes with CC	21	$47,310	+14%	$6,929
454 Combined Anterior and Posterior Spinal Fusion with CC	20	$113,375	-59%	$43,609
536 Fractures of Hip and Pelvis without MCC	20	$49,428	+31%	$5,683
066 Intracranial Hemorrhage or Cerebral Infarction without...	19	$54,447	+29%	$6,240
191 Chronic Obstructive Pulmonary Disease with CC	19	$52,822	+33%	$6,079
552 Medical Back Problems without MCC	19	$60,819	+24%	$6,799
699 Other Kidney and Urinary Tract Diagnoses with CC	19	$58,581	+23%	$7,284
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	17	$72,424	+19%	$9,136
460 Spinal Fusion except Cervical without MCC	17	$124,333	-27%	$28,392
314 Other Circulatory System Diagnoses with MCC	16	$87,265	-8%	$13,132
418 Laparoscopic Cholecystectomy without C.D.E. with CC	16	$97,483	+5%	$13,004
472 Cervical Spinal Fusion with CC	16	$106,540	-26%	$22,288
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	16	$61,111	-9%	$10,624
813 Coagulation Disorders	16	$93,805	+17%	$11,108
057 Degenerative Nervous System Disorders without MCC	15	$90,851	+60%	$9,703
101 Seizures without MCC	15	$48,461	-1%	$6,295
208 Respiratory System Diagnosis with Ventilator Support <=96...	14	$134,523	-1%	$19,248
281 Acute Myocardial Infarction, Discharged Alive with CC	14	$59,314	+17%	$6,471

Showing the 60 most frequent of 75 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	441	$40,196	$12,717
Level 2 Excision/ Biopsy/ Incision and Drainage	230	$7,240	$1,572
Level 1 Intraocular Procedures	203	$9,985	$2,255
Comprehensive Observation Services	129	$23,756	$2,626
Level 1 Endovascular Procedures	121	$23,955	$3,096
Level 1 Laparoscopy and Related Services	103	$26,741	$5,606
Level 5 Urology and Related Services	103	$19,852	$4,964
Level 4 Musculoskeletal Procedures	92	$29,211	$6,950
Level 3 Vascular Procedures	92	$11,234	$3,097
Level 3 Urology and Related Services	86	$9,450	$1,979
Level 6 Musculoskeletal Procedures	80	$53,686	$17,905
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	76	$14,846	$3,326
Level 3 Excision/ Biopsy/ Incision and Drainage	69	$12,840	$2,761
Level 4 Urology and Related Services	66	$17,004	$3,387
Level 3 Endovascular Procedures	58	$51,354	$10,677
Level 2 Upper GI Procedures	39	$10,565	$1,849
Level 2 Vascular Procedures	37	$4,885	$1,528
Level 1 Breast/Lymphatic Surgery and Related Procedures	35	$20,581	$3,703
Level 4 Airway Endoscopy	33	$20,578	$3,638
Level 2 Endovascular Procedures	31	$32,227	$5,553
Level 4 Gynecologic Procedures	31	$14,450	$2,894
Level 2 Laparoscopy and Related Services	27	$39,492	$9,683
Level 5 Gynecologic Procedures	26	$22,355	$4,684
Level 4 Vascular Procedures	22	$28,049	$4,660
Level 6 Urology and Related Services	21	$32,713	$8,946

Against the Pennsylvania average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Riddle Memorial Hospital charged $96,132 on average, 9% more than the Pennsylvania average of $88,167, and was paid $13,690 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Riddle Memorial Hospital charged $68,752 on average, 20% more than the Pennsylvania average of $57,362, and was paid $9,070 against a state average of $11,112. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Riddle Memorial Hospital charged $64,982 on average, 16% less than the Pennsylvania average of $77,050, and was paid $13,653 against a state average of $15,450. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Riddle Memorial Hospital charged $71,291 on average, 43% more than the Pennsylvania average of $49,758, and was paid $7,782 against a state average of $9,077. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $40,196 was 37% below the state average of $63,627. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,240 was 47% below the state average of $13,651. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,985 was 31% below the state average of $14,403. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,756 was 9% above the state average of $21,732.

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.