Rhode Island / The Miriam Hospital
CMS certification 410012 · Providence, RI · 3 entries in CMS's price-transparency list
The Miriam Hospital: charges and Medicare payments
The Miriam Hospital reported 3,367 Medicare inpatient stays across 97 DRGs in 2024. Across them it charged 2.65 times what it was paid — among the lower ratios in Rhode Island, number 7 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: 252 stays at an average charge of $53,991, 40% below the national average. It also billed 2,621 outpatient services, charging 3.97 times what Medicare paid.
- 1Medicare inpatient stays 3,367
- 2Charge ÷ paid, inpatient 2.65×
- 3Rank in RI (highest ratio = 1) 7 of 9
- 4CMS price-transparency actions 3
Inpatient stays
For the 97 DRGs that can be compared with the national average, The Miriam Hospital 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 | 252 | $53,991 | -40% | $18,060 |
| 291 Heart Failure and Shock with MCC | 234 | $33,787 | -40% | $12,299 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 161 | $31,533 | -66% | $17,627 |
| 177 Respiratory Infections and Inflammations with MCC | 97 | $44,945 | -36% | $15,328 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 87 | $43,936 | -42% | $15,470 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 81 | $21,087 | -42% | $7,839 |
| 193 Simple Pneumonia and Pleurisy with MCC | 75 | $29,747 | -50% | $12,211 |
| 378 Gastrointestinal Hemorrhage with CC | 75 | $32,224 | -34% | $9,546 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 66 | $30,968 | -39% | $11,556 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 66 | $22,908 | -43% | $7,836 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 63 | $63,359 | -45% | $20,342 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 62 | $45,490 | -38% | $16,064 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 54 | $32,582 | -42% | $12,162 |
| 330 Major Small and Large Bowel Procedures with CC | 54 | $45,225 | -62% | $24,084 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 49 | $103,144 | -37% | $31,957 |
| 690 Kidney and Urinary Tract Infections without MCC | 46 | $24,865 | -34% | $7,834 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 45 | $29,457 | -42% | $9,690 |
| 603 Cellulitis without MCC | 44 | $25,172 | -32% | $8,781 |
| 057 Degenerative Nervous System Disorders without MCC | 43 | $34,403 | -39% | $12,089 |
| 194 Simple Pneumonia and Pleurisy with CC | 43 | $21,688 | -43% | $8,460 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 43 | $32,461 | -46% | $12,432 |
| 689 Kidney and Urinary Tract Infections with MCC | 43 | $29,373 | -43% | $11,016 |
| 683 Renal Failure with CC | 42 | $24,508 | -40% | $8,984 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 40 | $21,286 | -43% | $7,747 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 38 | $32,524 | -49% | $12,924 |
| 178 Respiratory Infections and Inflammations with CC | 37 | $30,704 | -32% | $9,646 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 37 | $22,706 | -52% | $10,411 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 35 | $31,095 | -49% | $13,647 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 35 | $34,631 | -29% | $12,466 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 34 | $29,359 | -47% | $9,538 |
| 189 Pulmonary Edema and Respiratory Failure | 33 | $29,442 | -49% | $12,861 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 33 | $36,307 | -58% | $18,302 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 32 | $65,027 | -42% | $20,080 |
| 394 Other Digestive System Diagnoses with CC | 32 | $27,598 | -41% | $10,097 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 32 | $133,602 | -42% | $41,990 |
| 377 Gastrointestinal Hemorrhage with MCC | 30 | $42,011 | -51% | $16,254 |
| 481 Hip and Femur Procedures except Major Joint with CC | 29 | $53,685 | -47% | $21,403 |
| 638 Diabetes with CC | 29 | $30,934 | -26% | $9,046 |
| 682 Renal Failure with MCC | 29 | $31,091 | -53% | $13,716 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 28 | $47,157 | -62% | $23,961 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 28 | $49,061 | -52% | $20,776 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 27 | $68,576 | -38% | $23,411 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 27 | $143,711 | -49% | $58,320 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 27 | $90,830 | -55% | $47,330 |
| 389 Gastrointestinal Obstruction with CC | 25 | $26,773 | -31% | $9,385 |
| 552 Medical Back Problems without MCC | 25 | $27,586 | -44% | $9,284 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 24 | $38,860 | -40% | $12,687 |
| 176 Pulmonary Embolism without MCC | 22 | $20,295 | -51% | $9,589 |
| 282 Acute Myocardial Infarction, Discharged Alive without CC/MCC | 22 | $23,891 | -45% | $8,297 |
| 292 Heart Failure and Shock with CC | 22 | $27,134 | -30% | $8,549 |
| 312 Syncope and Collapse | 22 | $26,939 | -41% | $8,957 |
| 329 Major Small and Large Bowel Procedures with MCC | 22 | $81,942 | -62% | $39,649 |
| 884 Organic Disturbances and Intellectual Disability | 22 | $29,002 | -54% | $13,717 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 21 | $39,478 | -60% | $16,584 |
| 036 Carotid Artery Stent Procedures without CC/MCC | 20 | $52,004 | -41% | $16,854 |
| 314 Other Circulatory System Diagnoses with MCC | 19 | $51,330 | -46% | $19,732 |
| 390 Gastrointestinal Obstruction without CC/MCC | 19 | $21,401 | -23% | $6,038 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 19 | $28,934 | -41% | $9,997 |
| 661 Kidney and Ureter Procedures for Non-Neoplasm without CC/MCC | 19 | $25,911 | -54% | $11,132 |
| 602 Cellulitis with MCC | 18 | $34,791 | -42% | $13,048 |
Showing the 60 most frequent of 97 DRGs.
Outpatient services
Against the Rhode Island average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), The Miriam Hospital charged $53,991 on average, 4% less than the Rhode Island average of $56,063, and was paid $18,060 against a state average of $18,474. For Heart Failure and Shock with MCC (DRG 291), The Miriam Hospital charged $33,787 on average, 10% less than the Rhode Island average of $37,534, and was paid $12,299 against a state average of $12,554. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), The Miriam Hospital charged $31,533 on average, 9% less than the Rhode Island average of $34,801, and was paid $17,627 against a state average of $16,780. For Respiratory Infections and Inflammations with MCC (DRG 177), The Miriam Hospital charged $44,945 on average, 4% less than the Rhode Island average of $46,857, and was paid $15,328 against a state average of $15,760. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,264 was 11% below the state average of $17,131. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $12,888 was 10% below the state average of $14,245. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $6,764 was 10% below the state average of $7,502. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $25,469 was 19% below the state average of $31,558.
Price-transparency record
CMS's enforcement list records these actions for a hospital named The Miriam Hospital in Providence, RI, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-02-05 (CMS case 455)
- Closure Notice — 2024-05-13 (CMS case 455)
- Met Requirements — 2025-03-19 (CMS case 3313)
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.