Indiana / Saint Joseph Regional Medical Center
CMS certification 150012 · Mishawaka, IN
Saint Joseph Regional Medical Center: charges and Medicare payments
Saint Joseph Regional Medical Center reported 1,712 Medicare inpatient stays across 56 DRGs in 2024. Across them it charged 3.63 times what it was paid — mid-range in Indiana, number 44 of 70 hospitals with at least 100 stays (state median 4.08×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 218 stays at an average charge of $57,633, 36% below the national average. It also billed 1,763 outpatient services, charging 6.88 times what Medicare paid.
- 1Medicare inpatient stays 1,712
- 2Charge ÷ paid, inpatient 3.63×
- 3Rank in IN (highest ratio = 1) 44 of 70
- 4CMS price-transparency actions 0
Inpatient stays
For the 56 DRGs that can be compared with the national average, Saint Joseph Regional Medical Center charged more than the national average in 0 (0%). 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 | 218 | $57,633 | -36% | $15,891 |
| 291 Heart Failure and Shock with MCC | 107 | $39,084 | -31% | $10,510 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 69 | $44,985 | -41% | $13,248 |
| 193 Simple Pneumonia and Pleurisy with MCC | 59 | $32,488 | -46% | $10,905 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 54 | $32,931 | -33% | $9,359 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 53 | $132,729 | -42% | $37,056 |
| 177 Respiratory Infections and Inflammations with MCC | 52 | $47,018 | -33% | $14,523 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 49 | $56,065 | -24% | $13,883 |
| 683 Renal Failure with CC | 47 | $28,470 | -30% | $8,103 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 44 | $26,991 | -33% | $7,132 |
| 378 Gastrointestinal Hemorrhage with CC | 43 | $31,374 | -35% | $8,827 |
| 689 Kidney and Urinary Tract Infections with MCC | 42 | $34,935 | -32% | $9,983 |
| 690 Kidney and Urinary Tract Infections without MCC | 41 | $26,342 | -30% | $7,087 |
| 189 Pulmonary Edema and Respiratory Failure | 38 | $33,836 | -41% | $9,978 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 38 | $42,711 | -29% | $11,591 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 33 | $24,419 | -34% | $7,329 |
| 682 Renal Failure with MCC | 32 | $44,348 | -33% | $12,290 |
| 603 Cellulitis without MCC | 30 | $24,549 | -34% | $7,825 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 28 | $33,851 | -33% | $9,331 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 27 | $24,152 | -33% | $6,807 |
| 377 Gastrointestinal Hemorrhage with MCC | 26 | $43,749 | -49% | $13,686 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 25 | $67,551 | -41% | $17,538 |
| 481 Hip and Femur Procedures except Major Joint with CC | 25 | $63,567 | -37% | $16,572 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 25 | $79,223 | -23% | $17,667 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 24 | $114,275 | -27% | $24,946 |
| 467 Revision of Hip or Knee Replacement with CC | 24 | $112,218 | -29% | $25,426 |
| 330 Major Small and Large Bowel Procedures with CC | 23 | $73,697 | -38% | $19,820 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 22 | $35,806 | -37% | $10,225 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 20 | $53,081 | -47% | $17,476 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 20 | $37,225 | -33% | $8,355 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 19 | $28,116 | -34% | $7,853 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 18 | $33,544 | -34% | $7,824 |
| 394 Other Digestive System Diagnoses with CC | 18 | $26,947 | -43% | $8,247 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 18 | $78,448 | -16% | $14,970 |
| 617 Amputation of Lower Limb for Endocrine, Nutritional and... | 18 | $65,174 | -25% | $17,488 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $30,133 | -21% | $7,789 |
| 252 Other Vascular Procedures with MCC | 17 | $76,946 | -55% | $29,165 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 17 | $84,920 | -39% | $23,936 |
| 312 Syncope and Collapse | 16 | $24,302 | -47% | $7,042 |
| 389 Gastrointestinal Obstruction with CC | 15 | $25,878 | -34% | $7,128 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 15 | $31,321 | -34% | $9,346 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 14 | $22,899 | -42% | $7,414 |
| 445 Disorders of The Biliary Tract with CC | 14 | $38,010 | -35% | $9,920 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 14 | $53,032 | -21% | $11,232 |
| 180 Respiratory Neoplasms with MCC | 13 | $57,932 | -34% | $14,364 |
| 253 Other Vascular Procedures with CC | 13 | $86,913 | -34% | $32,917 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 13 | $80,237 | -33% | $20,885 |
| 552 Medical Back Problems without MCC | 13 | $29,054 | -41% | $8,156 |
| 638 Diabetes with CC | 13 | $31,124 | -25% | $7,816 |
| 329 Major Small and Large Bowel Procedures with MCC | 12 | $113,282 | -47% | $39,752 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 12 | $208,613 | -35% | $62,754 |
| 057 Degenerative Nervous System Disorders without MCC | 11 | $40,350 | -29% | $10,078 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 11 | $38,494 | -41% | $11,201 |
| 270 Other Major Cardiovascular Procedures with MCC | 11 | $179,017 | -31% | $46,360 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $58,289 | -4% | $9,922 |
| 659 Kidney and Ureter Procedures for Non-Neoplasm with MCC | 11 | $89,383 | -25% | $20,755 |
Outpatient services
Against the Indiana average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Saint Joseph Regional Medical Center charged $57,633 on average, 9% less than the Indiana average of $63,232, and was paid $15,891 against a state average of $15,368. For Heart Failure and Shock with MCC (DRG 291), Saint Joseph Regional Medical Center charged $39,084 on average, 4% less than the Indiana average of $40,842, and was paid $10,510 against a state average of $10,315. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Saint Joseph Regional Medical Center charged $44,985 on average, 21% less than the Indiana average of $56,757, and was paid $13,248 against a state average of $12,726. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Saint Joseph Regional Medical Center charged $32,488 on average, 26% less than the Indiana average of $43,683, and was paid $10,905 against a state average of $10,631. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $16,381 was 11% below the state average of $18,399. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $62,894 was 18% below the state average of $77,048. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,034 was 26% below the state average of $10,786. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $18,168 was 18% below the state average of $22,260.
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.