California / Riverside Community Hospital

CMS certification 050022 · Riverside, CA · 4 entries in CMS's price-transparency list

Riverside Community Hospital: charges and Medicare payments

Riverside Community Hospital reported 3,409 Medicare inpatient stays across 101 DRGs in 2024. Across them it charged 10.6 times what it was paid — among the higher ratios in California, number 18 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: 614 stays at an average charge of $276,017, 206% above the national average. It also billed 1,043 outpatient services, charging 18.04 times what Medicare paid.

1Medicare inpatient stays 3,409
2Charge ÷ paid, inpatient 10.6×
3Rank in CA (highest ratio = 1) 18 of 247
4CMS price-transparency actions 4

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

Inpatient stays

For the 101 DRGs that can be compared with the national average, Riverside Community Hospital charged more than the national average in 101 (100%). 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	614	$276,017	+206%	$25,680
280 Acute Myocardial Infarction, Discharged Alive with MCC	119	$181,630	+140%	$20,974
291 Heart Failure and Shock with MCC	114	$153,920	+173%	$16,918
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	98	$136,963	+179%	$13,526
698 Other Kidney and Urinary Tract Diagnoses with MCC	97	$164,141	+124%	$20,052
853 Infectious and Parasitic Diseases with O.R. Procedures with...	92	$815,153	+256%	$62,810
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	81	$347,106	+248%	$24,941
193 Simple Pneumonia and Pleurisy with MCC	65	$190,283	+218%	$18,062
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	64	$149,529	+148%	$17,015
312 Syncope and Collapse	54	$123,724	+172%	$11,555
683 Renal Failure with CC	53	$105,473	+159%	$11,930
177 Respiratory Infections and Inflammations with MCC	52	$244,828	+247%	$20,781
870 Septicemia or Severe Sepsis with MV >96 Hours	52	$1,129,427	+249%	$88,449
682 Renal Failure with MCC	51	$175,504	+166%	$17,624
690 Kidney and Urinary Tract Infections without MCC	50	$93,514	+147%	$10,741
281 Acute Myocardial Infarction, Discharged Alive with CC	47	$123,778	+145%	$14,617
552 Medical Back Problems without MCC	43	$122,404	+151%	$13,264
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	43	$88,550	+139%	$10,598
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	41	$205,599	+269%	$12,542
689 Kidney and Urinary Tract Infections with MCC	40	$105,565	+106%	$14,778
699 Other Kidney and Urinary Tract Diagnoses with CC	40	$116,503	+145%	$13,677
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	37	$107,535	+168%	$10,978
069 Transient Ischemia without Thrombolytic	36	$156,453	+210%	$10,430
100 Seizures with MCC	36	$242,474	+157%	$23,820
101 Seizures without MCC	36	$136,278	+179%	$11,844
057 Degenerative Nervous System Disorders without MCC	34	$134,613	+138%	$18,393
322 Percutaneous Cardiovascular Procedures with Intraluminal...	33	$363,125	+217%	$51,871
481 Hip and Femur Procedures except Major Joint with CC	32	$248,669	+147%	$23,701
638 Diabetes with CC	31	$110,173	+164%	$13,358
189 Pulmonary Edema and Respiratory Failure	29	$151,255	+163%	$15,651
321 Percutaneous Cardiovascular Procedures with Intraluminal...	29	$458,991	+180%	$36,860
884 Organic Disturbances and Intellectual Disability	28	$90,342	+45%	$19,443
208 Respiratory System Diagnosis with Ventilator Support <=96...	27	$385,072	+184%	$30,629
252 Other Vascular Procedures with MCC	27	$394,309	+131%	$41,313
300 Peripheral Vascular Disorders with CC	26	$106,242	+115%	$13,690
092 Other Disorders of Nervous System with CC	25	$137,335	+166%	$13,378
389 Gastrointestinal Obstruction with CC	25	$93,990	+141%	$11,084
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	25	$88,864	+109%	$12,012
023 Craniotomy with Major Device Implant or Acute Complex Cns...	24	$758,930	+170%	$63,029
074 Cranial and Peripheral Nerve Disorders without MCC	24	$115,127	+115%	$13,684
282 Acute Myocardial Infarction, Discharged Alive without CC/MCC	24	$87,872	+103%	$9,670
004 Tracheostomy with MV >96 Hours or Principal Diagnosis except...	23	$1,916,302	+212%	$145,392
025 Craniotomy and Endovascular Intracranial Procedures with MCC	23	$759,494	+228%	$58,913
330 Major Small and Large Bowel Procedures with CC	23	$382,135	+221%	$31,998
299 Peripheral Vascular Disorders with MCC	22	$202,046	+169%	$20,089
314 Other Circulatory System Diagnoses with MCC	22	$235,449	+148%	$25,345
673 Other Kidney and Urinary Tract Procedures with MCC	22	$436,996	+152%	$49,850
091 Other Disorders of Nervous System with MCC	21	$232,977	+182%	$21,532
309 Cardiac Arrhythmia and Conduction Disorders with CC	21	$110,245	+205%	$10,324
811 Red Blood Cell Disorders with MCC	21	$162,091	+138%	$18,490
377 Gastrointestinal Hemorrhage with MCC	20	$194,598	+128%	$21,346
470 Major Hip and Knee Joint Replacement or Reattachment of...	20	$228,991	+146%	$23,816
287 Circulatory Disorders except AMI, with Cardiac...	19	$166,775	+161%	$15,107
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	19	$141,758	+132%	$15,931
551 Medical Back Problems with MCC	19	$160,737	+104%	$18,844
432 Cirrhosis and Alcoholic Hepatitis with MCC	18	$213,515	+123%	$24,788
637 Diabetes with MCC	18	$150,324	+126%	$17,287
308 Cardiac Arrhythmia and Conduction Disorders with MCC	17	$210,643	+272%	$15,779
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	17	$261,636	+156%	$23,134
603 Cellulitis without MCC	17	$98,177	+163%	$11,735

Showing the 60 most frequent of 101 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	281	$65,523	$3,365
Level 1 Endovascular Procedures	134	$72,482	$3,991
Level 5 Musculoskeletal Procedures	79	$199,678	$16,148
Level 3 Vascular Procedures	47	$71,687	$3,919
Level 1 Laparoscopy and Related Services	47	$113,820	$7,094
Level 2 Upper GI Procedures	43	$20,993	$2,339
Level 3 Endovascular Procedures	41	$221,900	$13,503
Level 2 Excision/ Biopsy/ Incision and Drainage	32	$38,764	$1,993
Level 2 Endovascular Procedures	30	$141,706	$6,843
Level 4 Musculoskeletal Procedures	29	$156,688	$8,566
Level 4 Endovascular Procedures	28	$357,945	$21,504
Level 4 Vascular Procedures	27	$111,913	$6,756
Level 3 Pacemaker and Similar Procedures	27	$85,324	$13,108
Level 3 Excision/ Biopsy/ Incision and Drainage	25	$38,943	$3,494
Level 3 Electrophysiologic Procedures	23	$325,377	$29,114
Level 5 ENT Procedures	19	$113,843	$7,200
Level 2 Musculoskeletal Procedures	18	$47,889	$1,976
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	17	$91,007	$4,254
Level 5 Airway Endoscopy	16	$85,693	$8,036
Level 4 Airway Endoscopy	14	$58,802	$4,604
Level 2 Vascular Procedures	14	$36,847	$1,969
Level 2 Laparoscopy and Related Services	14	$177,518	$12,637
Level 3 Urology and Related Services	14	$51,717	$2,505
Level 3 Musculoskeletal Procedures	13	$73,392	$3,980
Level 3 Airway Endoscopy	11	$19,990	$2,087

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Riverside Community Hospital charged $276,017 on average, 93% more than the California average of $143,063, and was paid $25,680 against a state average of $23,020. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Riverside Community Hospital charged $181,630 on average, 47% more than the California average of $123,896, and was paid $20,974 against a state average of $19,122. For Heart Failure and Shock with MCC (DRG 291), Riverside Community Hospital charged $153,920 on average, 53% more than the California average of $100,739, and was paid $16,918 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Riverside Community Hospital charged $136,963 on average, 80% more than the California average of $76,120, and was paid $13,526 against a state average of $12,552. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $65,523 was 57% above the state average of $41,628. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $72,482 was 79% above the state average of $40,544. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $199,678 was 83% above the state average of $109,149. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $71,687 was 137% above the state average of $30,190.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Riverside Community Hospital in Riverside, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2023-06-29 (CMS case 1150)
Closure Notice — 2023-11-14 (CMS case 1150)
Met Requirements — 2025-04-08 (CMS case 3664)
Met Requirements — 2025-05-05 (CMS case 4264)

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.