Saint Joseph Regional Medical Center
Saint Joseph Regional Medical Center in Mishawaka, Indiana charges 4.7x the Medicare reimbursement rate on average across 61 analyzed procedures at this nonprofit hospital.
Mishawaka, IN 46545 · Acute Care Hospitals · CMS Rating: 2/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
C
Average
Avg markup vs Medicare
4.73x
Charge / Medicare rate
Max markup
8.72x
Worst procedure
Procedures analyzed
61
With pricing data
Outlier procedures
0%
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 |
|---|---|---|---|---|---|
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $130,314 | $65,157 | — | 8.7x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $63,576 | $31,788 | — | 6.5x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $30,197 | $15,099 | — | 6.1x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $56,368 | $28,184 | — | 6x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $76,203 | $38,102 | — | 6x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $75,301 | $37,650 | — | 5.9x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $182,177 | $91,089 | — | 5.8x |
| HEART FAILURE AND SHOCK WITH CC | 292 | $33,529 | $16,764 | — | 5.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $35,461 | $17,731 | — | 5.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $18,683 | $9,342 | — | 5.6x |
| REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | 468 | $101,113 | $50,557 | — | 5.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $28,090 | $14,045 | — | 5.5x |
| SYNCOPE AND COLLAPSE | 312 | $29,544 | $14,772 | — | 5.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $44,664 | $22,332 | — | 5.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $25,005 | $12,502 | — | 5.3x |
| DIABETES WITH CC | 638 | $30,265 | $15,133 | — | 5.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $31,046 | $15,523 | — | 5.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $26,280 | $13,140 | — | 5.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $24,462 | $12,231 | — | 5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $34,522 | $17,261 | — | 5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $49,172 | $24,586 | — | 5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $33,044 | $16,522 | — | 4.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $31,723 | $15,862 | — | 4.8x |
| RENAL FAILURE WITH MCC | 682 | $55,388 | $27,694 | — | 4.7x |
| CELLULITIS WITHOUT MCC | 603 | $26,439 | $13,220 | — | 4.7x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $27,736 | $13,868 | — | 4.7x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $108,770 | $54,385 | — | 4.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $66,067 | $33,033 | — | 4.6x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $51,778 | $25,889 | — | 4.6x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $77,274 | $38,637 | — | 4.6x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $101,247 | $50,623 | — | 4.5x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $22,383 | $11,191 | — | 4.5x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $26,048 | $13,024 | — | 4.5x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $37,279 | $18,640 | — | 4.5x |
| RENAL FAILURE WITH CC | 683 | $26,078 | $13,039 | — | 4.5x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $66,596 | $33,298 | — | 4.4x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $27,889 | $13,944 | — | 4.4x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $34,141 | $17,071 | — | 4.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $45,817 | $22,908 | — | 4.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $56,564 | $28,282 | — | 4.4x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $22,632 | $11,316 | — | 4.4x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $52,698 | $26,349 | — | 4.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $53,822 | $26,911 | — | 4.3x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $114,077 | $57,039 | — | 4.3x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $23,715 | $11,858 | — | 4.3x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $124,555 | $62,277 | — | 4.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $22,852 | $11,426 | — | 4.2x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $34,388 | $17,194 | — | 4.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $53,383 | $26,692 | — | 4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $117,913 | $58,956 | — | 4x |
Showing 50 of 61 procedures
How SAINT JOSEPH REGIONAL MEDICAL CENTER 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.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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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