Rhode Island / Roger Williams Medical Center
CMS certification 410004 · Providence, RI
Roger Williams Medical Center: charges and Medicare payments
Roger Williams Medical Center reported 354 Medicare inpatient stays across 18 DRGs in 2024. Across them it charged 2.81 times what it was paid — mid-range in Rhode Island, number 6 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: 67 stays at an average charge of $57,273, 37% below the national average. It also billed 568 outpatient services, charging 4.78 times what Medicare paid.
- 1Medicare inpatient stays 354
- 2Charge ÷ paid, inpatient 2.81×
- 3Rank in RI (highest ratio = 1) 6 of 9
- 4CMS price-transparency actions 0
Inpatient stays
For the 18 DRGs that can be compared with the national average, Roger Williams Medical Center charged more than the national average in 2 (11%). 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 | 67 | $57,273 | -37% | $20,490 |
| 291 Heart Failure and Shock with MCC | 26 | $31,965 | -43% | $13,226 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 24 | $41,067 | +11% | $12,205 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 20 | $97,916 | +29% | $31,842 |
| 689 Kidney and Urinary Tract Infections with MCC | 19 | $29,851 | -42% | $12,713 |
| 885 Psychoses | 19 | $29,882 | -32% | $15,751 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $47,155 | -21% | $16,313 |
| 683 Renal Failure with CC | 18 | $32,131 | -21% | $9,414 |
| 177 Respiratory Infections and Inflammations with MCC | 17 | $49,255 | -30% | $16,337 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 17 | $49,293 | -3% | $13,071 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $24,613 | -39% | $8,764 |
| 682 Renal Failure with MCC | 17 | $33,557 | -49% | $14,229 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $26,684 | -28% | $9,297 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $34,085 | -30% | $11,109 |
| 603 Cellulitis without MCC | 13 | $22,612 | -39% | $10,135 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 12 | $23,069 | -54% | $9,620 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $42,083 | -30% | $14,897 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 11 | $33,499 | -32% | $11,464 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Urology and Related Services | 92 | $5,124 | $693 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 57 | $13,516 | $1,626 |
| Level 1 Intraocular Procedures | 56 | $10,325 | $2,344 |
| Level 2 Upper GI Procedures | 54 | $10,398 | $1,927 |
| Level 3 Urology and Related Services | 39 | $7,623 | $2,067 |
| Level 3 Vascular Procedures | 37 | $12,381 | $3,235 |
| Level 3 Musculoskeletal Procedures | 33 | $7,894 | $3,285 |
| Level 5 Musculoskeletal Procedures | 32 | $36,703 | $13,335 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 30 | $12,632 | $2,884 |
| Level 1 Laparoscopy and Related Services | 28 | $14,445 | $5,856 |
| Comprehensive Observation Services | 21 | $20,701 | $2,778 |
| Level 4 Musculoskeletal Procedures | 19 | $17,655 | $7,260 |
| Level 2 Musculoskeletal Procedures | 16 | $3,813 | $1,550 |
| Level 2 Vascular Procedures | 15 | $6,210 | $1,626 |
| Level 3 Upper GI Procedures | 14 | $12,966 | $3,665 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 13 | $13,478 | $3,511 |
| Level 3 Airway Endoscopy | 12 | $11,586 | $1,722 |
Against the Rhode Island average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Roger Williams Medical Center charged $57,273 on average, 2% more than the Rhode Island average of $56,063, and was paid $20,490 against a state average of $18,474. For Heart Failure and Shock with MCC (DRG 291), Roger Williams Medical Center charged $31,965 on average, 15% less than the Rhode Island average of $37,534, and was paid $13,226 against a state average of $12,554. For Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy without MCC (DRG 897), Roger Williams Medical Center charged $41,067 on average, 54% more than the Rhode Island average of $26,682, and was paid $12,205 against a state average of $9,410. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Roger Williams Medical Center charged $97,916 on average, 78% more than the Rhode Island average of $54,945, and was paid $31,842 against a state average of $17,096. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $5,124 was 91% above the state average of $2,685. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $13,516 was 82% above the state average of $7,430. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,325 was 44% above the state average of $7,186. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $10,398 was 22% above the state average of $8,553.
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.