Rhode Island / Westerly Hospital
CMS certification 410013 · Westerly, RI · 3 entries in CMS's price-transparency list
Westerly Hospital: charges and Medicare payments
Westerly Hospital reported 647 Medicare inpatient stays across 25 DRGs in 2024. Across them it charged 3.56 times what it was paid — among the higher ratios in Rhode Island, number 2 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: 115 stays at an average charge of $52,634, 42% below the national average. It also billed 1,327 outpatient services, charging 6.03 times what Medicare paid.
- 1Medicare inpatient stays 647
- 2Charge ÷ paid, inpatient 3.56×
- 3Rank in RI (highest ratio = 1) 2 of 9
- 4CMS price-transparency actions 3
Inpatient stays
For the 25 DRGs that can be compared with the national average, Westerly 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 | 115 | $52,634 | -42% | $15,029 |
| 291 Heart Failure and Shock with MCC | 85 | $38,330 | -32% | $10,154 |
| 193 Simple Pneumonia and Pleurisy with MCC | 44 | $35,826 | -40% | $10,611 |
| 177 Respiratory Infections and Inflammations with MCC | 41 | $49,444 | -30% | $12,511 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 28 | $29,021 | -28% | $6,614 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 28 | $30,890 | -37% | $9,231 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $29,952 | -21% | $7,007 |
| 378 Gastrointestinal Hemorrhage with CC | 22 | $33,182 | -32% | $8,391 |
| 682 Renal Failure with MCC | 22 | $37,264 | -43% | $12,387 |
| 683 Renal Failure with CC | 21 | $32,031 | -21% | $7,007 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $31,591 | -45% | $10,712 |
| 389 Gastrointestinal Obstruction with CC | 20 | $28,998 | -26% | $6,834 |
| 330 Major Small and Large Bowel Procedures with CC | 17 | $61,375 | -48% | $25,658 |
| 377 Gastrointestinal Hemorrhage with MCC | 16 | $64,258 | -25% | $14,080 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $33,307 | -10% | $7,551 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 15 | $41,428 | -18% | $8,996 |
| 689 Kidney and Urinary Tract Infections with MCC | 15 | $30,121 | -41% | $8,827 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $24,962 | -31% | $6,134 |
| 194 Simple Pneumonia and Pleurisy with CC | 13 | $27,610 | -28% | $6,623 |
| 481 Hip and Femur Procedures except Major Joint with CC | 13 | $64,512 | -36% | $16,656 |
| 329 Major Small and Large Bowel Procedures with MCC | 12 | $85,796 | -60% | $32,692 |
| 394 Other Digestive System Diagnoses with CC | 12 | $30,736 | -35% | $7,473 |
| 603 Cellulitis without MCC | 12 | $30,560 | -18% | $7,080 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 12 | $35,407 | -48% | $10,959 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 11 | $99,363 | -57% | $35,027 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 264 | $27,276 | $2,761 |
| Level 2 Urology and Related Services | 255 | $2,340 | $691 |
| Level 3 Urology and Related Services | 129 | $9,717 | $2,044 |
| Level 2 Upper GI Procedures | 114 | $8,812 | $1,922 |
| Level 1 Intraocular Procedures | 112 | $9,422 | $2,365 |
| Level 5 Urology and Related Services | 88 | $16,580 | $5,179 |
| Level 1 Laparoscopy and Related Services | 70 | $19,914 | $5,856 |
| Level 4 Urology and Related Services | 68 | $13,759 | $3,538 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 53 | $8,454 | $1,645 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 38 | $14,661 | $2,884 |
| Level 5 Musculoskeletal Procedures | 36 | $29,705 | $13,335 |
| Level 3 Vascular Procedures | 33 | $13,580 | $3,235 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 20 | $18,156 | $3,511 |
| Level 1 Breast/Lymphatic Surgery and Related Procedures | 13 | $17,101 | $3,868 |
| Level 3 Intraocular Procedures | 12 | $12,939 | $5,304 |
| Level 2 Musculoskeletal Procedures | 11 | $8,192 | $1,555 |
| Level 3 Lower GI Procedures | 11 | $10,974 | $2,847 |
Against the Rhode Island average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Westerly Hospital charged $52,634 on average, 6% less than the Rhode Island average of $56,063, and was paid $15,029 against a state average of $18,474. For Heart Failure and Shock with MCC (DRG 291), Westerly Hospital charged $38,330 on average, 2% more than the Rhode Island average of $37,534, and was paid $10,154 against a state average of $12,554. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Westerly Hospital charged $35,826 on average, 2% more than the Rhode Island average of $35,281, and was paid $10,611 against a state average of $12,735. For Respiratory Infections and Inflammations with MCC (DRG 177), Westerly Hospital charged $49,444 on average, 6% more than the Rhode Island average of $46,857, and was paid $12,511 against a state average of $15,760. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $27,276 was 59% above the state average of $17,131. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,340 was 13% below the state average of $2,685. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $9,717 was 30% above the state average of $7,502. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $8,812 was 3% above the state average of $8,553.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Westerly Hospital in Westerly, RI, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-10-03 (CMS case 2760)
- CAP Request — 2025-01-13 (CMS case 2760)
- Closure Notice — 2025-03-06 (CMS case 2760)
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.