Riverside Community Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Riverside Community Hospital, Riverside, CA in 2024, from traditional Medicare claims. Back to the Riverside Community Hospital profile, with quality ratings, finances and negotiated rates.
3,409
Medicare inpatient discharges
In 101 published DRGs
2.11
Case mix index
IPPS FY 2027
15%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
1,043
Medicare outpatient services
In 25 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases881 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 614 | $276,017 | $20,984 | $20,701 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 98 | $136,963 | $11,099 | $10,272 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 92 | $815,153 | $54,787 | $61,137 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 52 | $1,129,427 | $69,420 | $84,707 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $212,897 | $19,324 | $15,967 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 11 | $201,333 | $22,793 | $15,100 | 2.04 |
Circulatory system690 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 119 | $181,630 | $17,444 | $13,622 | 1.59 |
| Heart failure and shock with MCCMS-DRG 291, medical | 114 | $153,920 | $14,966 | $11,544 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 54 | $123,724 | $9,377 | $9,279 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 47 | $123,778 | $9,939 | $9,283 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 33 | $363,125 | $17,032 | $27,234 | 1.82 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 29 | $458,991 | $31,302 | $34,424 | 2.87 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $394,309 | $39,096 | $29,573 | 3.35 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 26 | $106,242 | $11,684 | $7,968 | 1.07 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 24 | $87,872 | $7,826 | $6,590 | 0.72 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 22 | $202,046 | $17,827 | $15,153 | 1.58 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 22 | $235,449 | $22,874 | $17,659 | 2.09 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 21 | $110,245 | $7,854 | $8,268 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 19 | $166,775 | $9,785 | $12,508 | 1.08 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 17 | $210,643 | $14,096 | $15,798 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 15 | $747,186 | $55,967 | $56,039 | 4.88 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 15 | $791,642 | $50,489 | $59,373 | 5.06 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $127,788 | $8,204 | $9,584 | 0.75 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 13 | $249,968 | $23,490 | $18,748 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 12 | $993,068 | $76,059 | $74,480 | 6.25 |
| Atherosclerosis without MCCMS-DRG 303, medical | 12 | $71,633 | $7,346 | $5,372 | 0.66 |
| Chest painMS-DRG 313, medical | 12 | $95,883 | $7,629 | $7,191 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 11 | $1,130,507 | $77,601 | $84,788 | 7.80 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 11 | $233,671 | $24,448 | $17,525 | 2.28 |
Nervous system484 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 81 | $347,106 | $21,555 | $26,033 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 41 | $205,599 | $10,142 | $15,420 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 36 | $156,453 | $8,352 | $11,734 | 0.80 |
| Seizures with MCCMS-DRG 100, medical | 36 | $242,474 | $21,731 | $18,186 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 36 | $136,279 | $9,917 | $10,221 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 34 | $134,613 | $13,890 | $10,096 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 25 | $137,335 | $11,392 | $10,300 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 24 | $758,930 | $60,125 | $56,920 | 5.67 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 24 | $115,127 | $11,626 | $8,635 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 23 | $759,494 | $55,452 | $56,962 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 21 | $232,977 | $19,341 | $17,473 | 1.79 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 16 | $336,704 | $25,779 | $25,253 | 2.28 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 15 | $223,293 | $21,462 | $16,747 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 14 | $137,315 | $11,805 | $10,299 | 1.06 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $271,139 | $15,358 | $20,335 | 1.47 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 12 | $194,442 | $14,361 | $14,583 | 1.36 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 11 | $450,524 | $29,290 | $33,789 | 2.80 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 11 | $168,507 | $14,567 | $12,638 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 11 | $146,898 | $9,720 | $11,017 | 0.84 |
Kidney and urinary tract353 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 97 | $164,141 | $17,812 | $12,311 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 53 | $105,473 | $9,663 | $7,910 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 51 | $175,504 | $15,266 | $13,163 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 50 | $93,514 | $8,641 | $7,014 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 40 | $105,565 | $12,663 | $7,917 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 40 | $116,503 | $11,636 | $8,738 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 22 | $436,996 | $45,857 | $32,775 | 3.70 |
Respiratory system233 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 65 | $190,283 | $13,895 | $14,271 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 52 | $244,828 | $17,957 | $18,362 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 29 | $151,255 | $13,923 | $11,344 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 27 | $385,072 | $28,181 | $28,880 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 14 | $153,642 | $15,317 | $11,523 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 12 | $128,286 | $8,334 | $9,621 | 0.82 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $156,539 | $9,334 | $11,740 | 0.91 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 11 | $87,706 | $9,302 | $6,578 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 11 | $89,777 | $10,548 | $6,733 | 0.96 |
Musculoskeletal system and connective tissue224 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 43 | $122,404 | $10,005 | $9,180 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 32 | $248,669 | $21,615 | $18,650 | 2.07 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 25 | $88,864 | $9,610 | $6,665 | 0.90 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 20 | $228,991 | $20,069 | $17,174 | 1.88 |
| Medical back problems with MCCMS-DRG 551, medical | 19 | $160,737 | $15,789 | $12,055 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 17 | $261,636 | $21,320 | $19,623 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 16 | $351,491 | $30,345 | $26,362 | 2.95 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 15 | $367,506 | $41,235 | $27,563 | 3.66 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 15 | $223,658 | $15,388 | $16,774 | 1.59 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 11 | $316,189 | $26,373 | $23,714 | 2.38 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 11 | $95,442 | $9,339 | $7,158 | 0.82 |
Digestive system175 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 37 | $107,535 | $7,981 | $8,065 | 0.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 25 | $93,990 | $8,827 | $7,049 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 23 | $382,135 | $25,979 | $28,660 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 20 | $194,598 | $19,176 | $14,595 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 19 | $141,758 | $13,809 | $10,632 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 15 | $126,224 | $10,345 | $9,467 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 13 | $205,565 | $17,109 | $15,417 | 1.62 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 12 | $141,007 | $9,192 | $10,576 | 0.98 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $124,922 | $17,035 | $9,369 | 1.45 |
Endocrine, nutritional and metabolic156 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 64 | $149,529 | $14,715 | $11,215 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 43 | $88,550 | $8,121 | $6,641 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 31 | $110,173 | $9,488 | $8,263 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $150,324 | $15,929 | $11,274 | 1.45 |
Blood and immune system48 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 21 | $162,091 | $14,788 | $12,157 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 14 | $172,201 | $17,018 | $12,915 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 13 | $82,782 | $10,412 | $6,209 | 0.90 |
Mental diseases and disorders41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 28 | $90,342 | $17,133 | $6,776 | 1.76 |
| PsychosesMS-DRG 885, medical | 13 | $95,859 | $16,111 | $7,189 | 1.37 |
Transplants, ECMO and tracheostomy (pre-MDC)39 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 23 | $1,916,302 | $137,603 | $143,723 | 14.70 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 16 | $2,314,094 | $228,701 | $173,557 | 21.32 |
Injuries, poisonings and toxic effects of drugs25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $244,545 | $21,003 | $18,341 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $158,197 | $18,247 | $11,865 | 1.60 |
Liver, gallbladder and pancreas18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $213,515 | $21,386 | $16,014 | 1.92 |
Skin, subcutaneous tissue and breast17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 17 | $98,177 | $9,648 | $7,363 | 0.88 |
Factors influencing health status14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 14 | $71,797 | $8,595 | $5,385 | 0.80 |
Ear, nose, mouth and throat11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 11 | $114,978 | $8,073 | $8,623 | 0.74 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 281 | 257 | $65,523 | $2,680 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 134 | 134 | $72,482 | $2,848 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 79 | 78 | $199,678 | $14,510 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 47 | 46 | $71,687 | $3,121 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 47 | 46 | $113,820 | $5,629 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 43 | 41 | $20,993 | $1,866 | $1,445 |
| Level 3 Endovascular ProceduresAPC 5193 | 41 | 40 | $221,900 | $11,863 | $8,874 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 32 | 32 | $38,764 | $1,582 | $1,220 |
| Level 2 Endovascular ProceduresAPC 5192 | 30 | 27 | $141,706 | $5,411 | $4,338 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 29 | 28 | $156,688 | $6,926 | $5,339 |
| Level 4 Endovascular ProceduresAPC 5194 | 28 | 27 | $357,945 | $19,853 | $14,606 |
| Level 4 Vascular ProceduresAPC 5184 | 27 | 26 | $111,913 | $5,383 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 27 | 27 | $85,324 | $11,451 | $8,569 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 25 | 24 | $38,943 | $2,772 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 23 | 23 | $325,377 | $27,464 | $21,117 |
| Level 5 ENT ProceduresAPC 5165 | 19 | 19 | $113,843 | $5,736 | $4,436 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 18 | 16 | $47,889 | $1,564 | $1,196 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 17 | 17 | $91,007 | $3,378 | $2,636 |
| Level 5 Airway EndoscopyAPC 5155 | 16 | 16 | $85,693 | $6,404 | $5,183 |
| Level 4 Airway EndoscopyAPC 5154 | 14 | 14 | $58,802 | $3,668 | $2,833 |
| Level 2 Vascular ProceduresAPC 5182 | 14 | 13 | $36,847 | $1,569 | $1,204 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 14 | 14 | $177,518 | $10,981 | $8,164 |
| Level 3 Urology and Related ServicesAPC 5373 | 14 | 13 | $51,717 | $1,968 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 13 | 13 | $73,392 | $3,171 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 11 | 11 | $19,990 | $1,663 | $1,264 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.