Riverside Community Hospital
Riverside Community Hospital in Riverside, CA charges 13.5x the Medicare reimbursement rate across 87 analyzed procedures, with all procedures showing significant price variations above standard benchmarks.
Riverside, CA 92501 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
No credit card required. Results in 60 seconds.
Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
13.52x
Charge / Medicare rate
Max markup
24.21x
Worst procedure
Procedures analyzed
87
With pricing data
Outlier procedures
100%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $1,244,745 | $622,373 | — | 24.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $182,135 | $91,068 | — | 20.7x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | 086 | $218,688 | $109,344 | — | 20.3x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $182,872 | $91,436 | — | 19.5x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $369,251 | $184,626 | — | 19.1x |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O | 023 | $869,327 | $434,664 | — | 18.9x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $148,559 | $74,279 | — | 18.9x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $826,577 | $413,288 | — | 18.1x |
| DIABETES WITH MCC | 637 | $227,239 | $113,620 | — | 17.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $320,289 | $160,144 | — | 17.6x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $545,025 | $272,513 | — | 17x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $467,516 | $233,758 | — | 16.9x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $215,464 | $107,732 | — | 16.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $319,438 | $159,719 | — | 16.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $117,814 | $58,907 | — | 16.1x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $245,633 | $122,817 | — | 15.6x |
| ATHEROSCLEROSIS WITHOUT MCC | 303 | $99,561 | $49,780 | — | 15.6x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $213,961 | $106,980 | — | 15.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $289,805 | $144,902 | — | 15.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $194,078 | $97,039 | — | 15x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $113,760 | $56,880 | — | 14.6x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $171,615 | $85,808 | — | 14.5x |
| TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOU | 004 | $1,779,237 | $889,619 | — | 14.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $698,221 | $349,111 | — | 14.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $120,212 | $60,106 | — | 14.4x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $100,199 | $50,099 | — | 14.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $270,287 | $135,144 | — | 14.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $182,712 | $91,356 | — | 14.1x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $234,766 | $117,383 | — | 14.1x |
| HYPERTENSION WITHOUT MCC | 305 | $99,939 | $49,969 | — | 14.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $128,789 | $64,395 | — | 14.1x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $383,033 | $191,517 | — | 14x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $130,006 | $65,003 | — | 14x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $130,595 | $65,298 | — | 13.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $210,149 | $105,075 | — | 13.9x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $142,191 | $71,095 | — | 13.9x |
| SEIZURES WITHOUT MCC | 101 | $127,763 | $63,881 | — | 13.8x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $780,429 | $390,215 | — | 13.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $886,782 | $443,391 | — | 13.5x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $110,604 | $55,302 | — | 13.4x |
| CHEST PAIN | 313 | $86,786 | $43,393 | — | 13.3x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $263,907 | $131,953 | — | 13.3x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $374,561 | $187,281 | — | 13.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $388,537 | $194,269 | — | 13.2x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $123,841 | $61,921 | — | 13x |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $417,178 | $208,589 | — | 12.9x |
| TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | 605 | $116,106 | $58,053 | — | 12.9x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $280,736 | $140,368 | — | 12.9x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $499,546 | $249,773 | — | 12.8x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $212,934 | $106,467 | — | 12.8x |
Showing 50 of 87 procedures
How RIVERSIDE COMMUNITY HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
Got a bill from RIVERSIDE COMMUNITY HOSPITAL?
Upload your bill and our AI compares every line item against these benchmark prices. Free analysis in 60 seconds. You only pay if we find savings.
Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — for-profit hospital billing
How much do for-profit hospitals typically charge compared to Medicare rates?
Why do for-profit hospitals charge more than Medicare rates?
Does insurance typically pay the full hospital charge amount?
What should I know about billing differences between hospital types?
Related pricing data
Got a bill from Riverside Community Hospital?
Free guides to help you take action
Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use