Texas / Rio Grande Regional Hospital
CMS certification 450711 · Mcallen, TX · 3 entries in CMS's price-transparency list
Rio Grande Regional Hospital: charges and Medicare payments
Rio Grande Regional Hospital reported 514 Medicare inpatient stays across 22 DRGs in 2024. Across them it charged 9.34 times what it was paid — among the higher ratios in Texas, number 43 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 136 stays at an average charge of $152,492, 69% above the national average. It also billed 434 outpatient services, charging 25.74 times what Medicare paid.
- 1Medicare inpatient stays 514
- 2Charge ÷ paid, inpatient 9.34×
- 3Rank in TX (highest ratio = 1) 43 of 190
- 4CMS price-transparency actions 3
Inpatient stays
For the 22 DRGs that can be compared with the national average, Rio Grande Regional Hospital charged more than the national average in 21 (95%). 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 | 136 | $152,492 | +69% | $16,859 |
| 291 Heart Failure and Shock with MCC | 43 | $124,370 | +121% | $12,317 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 28 | $81,665 | +66% | $10,235 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 27 | $69,939 | +16% | $12,334 |
| 682 Renal Failure with MCC | 26 | $109,911 | +67% | $13,680 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 21 | $381,114 | +66% | $44,026 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 20 | $319,331 | +104% | $25,850 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 20 | $82,292 | +105% | $8,904 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 20 | $136,884 | +86% | $14,767 |
| 683 Renal Failure with CC | 18 | $79,519 | +95% | $9,233 |
| 193 Simple Pneumonia and Pleurisy with MCC | 17 | $163,291 | +173% | $12,769 |
| 690 Kidney and Urinary Tract Infections without MCC | 16 | $77,163 | +104% | $8,776 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 14 | $187,524 | +147% | $23,541 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $75,124 | +103% | $8,602 |
| 252 Other Vascular Procedures with MCC | 13 | $158,584 | -7% | $26,895 |
| 552 Medical Back Problems without MCC | 13 | $105,105 | +115% | $9,988 |
| 330 Major Small and Large Bowel Procedures with CC | 12 | $254,161 | +114% | $19,574 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 12 | $279,239 | +184% | $17,969 |
| 177 Respiratory Infections and Inflammations with MCC | 11 | $139,569 | +98% | $14,894 |
| 312 Syncope and Collapse | 11 | $91,877 | +102% | $9,210 |
| 377 Gastrointestinal Hemorrhage with MCC | 11 | $178,920 | +110% | $16,675 |
| 811 Red Blood Cell Disorders with MCC | 11 | $126,561 | +86% | $13,532 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 85 | $22,360 | $2,003 |
| Comprehensive Observation Services | 50 | $41,880 | $2,375 |
| Level 1 Endovascular Procedures | 38 | $100,223 | $2,832 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 30 | $25,812 | $1,407 |
| Level 3 Vascular Procedures | 28 | $43,780 | $2,766 |
| Level 3 Extraocular, Repair, and Plastic Eye Procedures | 27 | $19,577 | $2,028 |
| Level 4 Vascular Procedures | 25 | $98,133 | $4,768 |
| Level 2 Upper GI Procedures | 23 | $73,960 | $1,651 |
| Level 1 Laparoscopy and Related Services | 20 | $120,936 | $5,006 |
| Level 4 Urology and Related Services | 20 | $71,696 | $3,025 |
| Level 3 Endovascular Procedures | 15 | $187,130 | $9,539 |
| Level 4 Musculoskeletal Procedures | 13 | $149,618 | $6,207 |
| Level 3 Urology and Related Services | 13 | $45,229 | $1,767 |
| Level 2 Intraocular Procedures | 13 | $37,314 | $3,528 |
| Level 3 Musculoskeletal Procedures | 12 | $66,743 | $2,809 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 11 | $42,635 | $2,466 |
| Level 2 Endovascular Procedures | 11 | $92,938 | $4,959 |
Against the Texas average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Rio Grande Regional Hospital charged $152,492 on average, 37% more than the Texas average of $111,133, and was paid $16,859 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), Rio Grande Regional Hospital charged $124,370 on average, 83% more than the Texas average of $67,944, and was paid $12,317 against a state average of $11,820. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Rio Grande Regional Hospital charged $81,665 on average, 40% more than the Texas average of $58,253, and was paid $10,235 against a state average of $10,103. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC (DRG 640), Rio Grande Regional Hospital charged $69,939 on average, 3% more than the Texas average of $68,203, and was paid $12,334 against a state average of $12,119. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $22,360 was 36% above the state average of $16,442. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $41,880 was 50% above the state average of $27,955. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $100,223 was 177% above the state average of $36,220. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $25,812 was 83% above the state average of $14,089.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Rio Grande Regional Hospital in Mcallen, TX, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-06-28 (CMS case 365)
- Closure Notice — 2023-10-03 (CMS case 365)
- Met Requirements — 2025-04-30 (CMS case 4233)
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.