RI CMS Medicare PUF 2023 Avg payment #47 of 56

Rhode Island procedure costs

13 hospitals · 443 Medicare providers · 2,307 procedure codes with Rhode Island locality adjustments.

The short answer

Rhode Island has 13 hospitals and 443 Medicare-billing providers across 2,307 procedure codes. The average Medicare payment per procedure is $170.38; the average submitted (billed) charge is $981.70.

Procedure codes
2,307
Providers per hospital
34.1
Billed-to-Medicare ratio
5.8x
Markup rank
#21 of 56

Source: CMS Medicare Physician & Other Practitioners, 2023.

About this dataset, nationwide

According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.

13
Hospitals
443
Providers
$170.38
Avg Medicare Payment
$981.70
Avg Billed Charge

Rhode Island against every US state

Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions

$170 higher than 16% of 56 states

$75–$100: 3 states (5%). Below this entry. $100–$125: 1 states (2%). Below this entry. $125–$150: 2 states (4%). Below this entry. $150–$175: 5 states (9%). This entry sits in this band. $175–$200: 7 states (13%). Above this entry. $200–$225: 9 states (16%). Above this entry. $225–$250: 9 states (16%). Above this entry. $250–$275: 11 states (20%). Above this entry. $275–$300: 4 states (7%). Above this entry. $300–$325: 4 states (7%). Above this entry. $325–$350: 1 states (2%). Above this entry. This state $75 $350 every US state, bucketed by value

Each bar is a $25-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners, 2023

The priciest procedures in Rhode Island

Highest average Medicare payment per procedure billed in Rhode Island. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.

Top procedures by Medicare payment - Rhode Island

Removal Of Plaque In Arterie…6340Insertion Of Spinal Neurosti…5527Removal And/or Dissolving Of…4449Insertion Of Needle And/or T…2757Removal And/or Dissolving Of…2440Transplantation Of Donor Kid…1870Dilation Of Nasal Sinus Usin…1780Insertion Of Peripheral Or G…1682
Top procedures by Medicare payment - Rhode Island-Average Medicare payment per procedure (CMS 2023)

Top Procedures by Volume

Procedure Medicare Services
Injection, Gadoterate Meglumine, 0.1 Ml $0.11 399.7K
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.12 385.0K
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $79.18 294.0K
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $18.34 292.8K
Ground Mileage, Per Statute Mile $6.73 256.7K
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $3.91 253.6K
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $58.68 250.8K
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $10.90 190.4K
Therapy Procedure Using Manual Technique, Each 15 Minutes $16.24 158.0K
Therapy Procedure Using Functional Activities $26.88 154.9K
Injection, Onabotulinumtoxina, 1 Unit $4.60 129.3K
Therapy Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes $21.83 122.5K
Injection, Tocilizumab, 1 Mg $4.69 94.6K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $61.97 84.3K
Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Miles Actually Travelled $0.97 82.2K
Removal Of Cataract With Insertion Of Prosthetic Lens $38.46 79.3K
Injection, Ferric Carboxymaltose, 1 Mg $0.88 76.5K
Routine Electrocardiogram (ecg) Using At Least 12 Leads With Interpretation And Report Only $6.14 69.1K
Destruction Of Precancer Skin Growth, 2-14 Growths $4.87 67.2K
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.39 59.8K
Injection, Triamcinolone Acetonide, Not Otherwise Specified, 10 Mg $0.81 58.0K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes $93.06 48.5K
Injection, Testosterone Cypionate, 1 Mg $0.02 48.2K
Emergency Department Visit With High Level Of Medical Decision Making $139.07 43.7K
Injection, Golimumab, 1 Mg, For Intravenous Use $10.50 43.1K
X-Ray Of Chest, 1 View $7.14 40.8K
Injection, Vedolizumab, 1 Mg $17.24 40.8K
Hyaluronan Or Derivative, Gelsyn-3, For Intra-Articular Injection, 0.1 Mg $0.57 39.9K
Injection, Denosumab, 1 Mg $18.16 39.2K
Injection, Faricimab-Svoa, 0.1 Mg $28.96 39.1K

Rhode Island Healthcare Cost Landscape

CMS lists 13 hospitals in Rhode Island across 8 cities. PROVIDENCE holds 6 (46%). The three densest cities together hold 62% of the state roster. Statewide that is 443 Medicare-billing providers, 34.1 per listed hospital.

11 hospitals carry a CMS overall star rating (1 five-star, 4 four-star, 4 three-star, 2 two-star, 0 one-star) ; five-star share among rated facilities is 9%. 2 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 10 (77%); Psychiatric 2 (15%); Acute Care - Veterans Administration 1 (8%).

Among the 30 highest-volume procedure codes billed in Rhode Island, Drugs (Administered) leads with 862.3K services (22% of this top-volume slice) across 11 codes. Next is Medicine at 18%.

Submitted charges average $981.70 against $170.38 Medicare payment (5.8x billed-to-Medicare). That ratio ranks #21 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #47 of 56.

Volume leaders are not the high-payment codes. Injection, Gadoterate Meglumine, 0.1 Ml is in the top volume slice but not the highest Medicare payments; Removal Of Plaque In Arteries Of Leg is in the high-payment set without matching volume rank.

These are CMS roster and claims aggregates for Rhode Island, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.

Where Rhode Island hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 8 distinct cities appear on 13 listed facilities.

City Hospitals Share of state roster
PROVIDENCE 6 46%
EAST PROVIDENCE 1 8%
NEWPORT 1 8%
NORTH PROVIDENCE 1 8%
WAKEFIELD 1 8%
WARWICK 1 8%
WESTERLY 1 8%
WOONSOCKET 1 8%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for Rhode Island: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.

Similar CMS hospital count

Nearest states with ≥5 hospitals (13 here).

Similar average Medicare payment

Nearest states with published averages ($170.38 here).

How Rhode Island Compares Nationally

Rhode Island's average Medicare payment is #47 of 56 in this extract. Submitted-over-Medicare markup ranks #21 of 56 (5.8x). Hospital-count peers (nearest CMS roster size to 13): Delaware 13, District of Columbia 10, Vermont 17, Hawaii 24. Payment peers (nearest average Medicare payment to $170.38): West Virginia $167.89, Wyoming $173.02, New Mexico $178.42, South Dakota $160.44.

Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for Rhode Island, not an out-of-pocket quote.

Related registry pages

Rhode Island averages sit on two maps: Medicare payment and submitted-over-Medicare markup.

Figures here are Rhode Island CMS averages, not a quote for any patient, plan, or visit.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure  · Verify with CMS →

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.