Medicare & Medicaid in Rhode Island (RI)
2026 healthcare costs, coverage, and spending data for Rhode Island.
$11,129
Spending/Capita
2,377,160
Medicare Enrollees
3,202,880
Medicaid Enrollees
3.3%
Uninsured Rate
Medicare Premiums in Rhode Island
Part B Premium
$185/mo
Part D Premium (Avg)
$39/mo
Medigap Premium (Avg)
$340/mo
Medicaid Expansion: Yes - Rhode Island expanded Medicaid under the ACA
Procedure Costs in Rhode Island
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $203,677 | $162,941 | $40,735 |
| Kidney Transplant | $127,240 | $101,792 | $25,448 |
| Heart Valve Replacement | $71,957 | $57,566 | $14,391 |
| Coronary Artery Bypass Graft (CABG) | $67,672 | $54,138 | $13,535 |
| Defibrillator Implantation (ICD) | $53,209 | $42,567 | $10,642 |
| Spinal Fusion | $52,647 | $42,117 | $10,529 |
| Sepsis Treatment | $29,900 | $23,920 | $5,980 |
| Colectomy | $29,863 | $23,890 | $5,973 |
| Hip Fracture Repair | $28,604 | $22,883 | $5,721 |
| Cardiac Catheterization with Stent | $28,569 | $22,855 | $5,714 |
| Total Knee Replacement | $28,536 | $22,829 | $5,707 |
| Total Hip Replacement | $26,866 | $21,492 | $5,373 |
| Lumbar Disc Surgery | $26,402 | $21,121 | $5,280 |
| Pacemaker Implantation | $23,717 | $18,973 | $4,743 |
| Stroke Treatment (Acute) | $23,139 | $18,511 | $4,628 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| TURP (Prostate) | $8,657 | $6,925 | $1,731 |
| Endoscopic Sinus Surgery | $7,655 | $6,124 | $1,531 |
| Lithotripsy (Kidney Stones) | $7,039 | $5,631 | $1,408 |
| Bunionectomy | $6,877 | $5,502 | $1,375 |
| Dialysis Access Surgery | $6,491 | $5,193 | $1,298 |
| Arthroscopic Knee Surgery | $6,015 | $4,812 | $1,203 |
| Tonsillectomy | $5,360 | $4,288 | $1,072 |
| Nasal Polyp Removal | $4,887 | $3,910 | $977 |
| Pilonidal Cyst Surgery | $4,605 | $3,684 | $921 |
| Septoplasty | $4,359 | $3,487 | $872 |
| Hemorrhoid Surgery | $4,269 | $3,416 | $854 |
| Carpal Tunnel Release | $4,188 | $3,350 | $838 |
| Ganglion Cyst Removal | $3,745 | $2,996 | $749 |
| Cataract Surgery (Outpatient) | $3,667 | $2,934 | $733 |
| Trigger Finger Release | $3,532 | $2,826 | $706 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,297 | $2,637 | $659 |
| Nuclear Stress Test | $1,918 | $1,534 | $384 |
| MRI Brain | $1,646 | $1,317 | $329 |
| CT Angiography | $1,576 | $1,260 | $315 |
| CT Scan Abdomen/Pelvis | $1,447 | $1,157 | $289 |
| MRI Spine (Lumbar) | $1,365 | $1,092 | $273 |
| MRI Shoulder | $1,345 | $1,076 | $269 |
| MRI Spine (Cervical) | $1,256 | $1,005 | $251 |
| MRI Knee | $1,120 | $896 | $224 |
| MRI Hip | $1,102 | $882 | $220 |
| Bone Scan | $1,098 | $879 | $220 |
| CT Colonography (Virtual) | $919 | $736 | $184 |
| CT Scan Chest | $913 | $731 | $183 |
| Echocardiogram | $710 | $568 | $142 |
| CT Scan Head | $688 | $550 | $138 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $401 | $321 | $80 |
| Annual Wellness Visit | $293 | $293 | $0 |
| Mammogram (Screening) | $256 | $256 | $0 |
| Wound Care Visit | $244 | $195 | $49 |
| Allergy Testing | $240 | $192 | $48 |
| Psychiatry Visit | $238 | $190 | $48 |
| Office Visit (New Patient) | $232 | $186 | $46 |
| Mental Health Counseling | $191 | $153 | $38 |
| Shingles Vaccination | $188 | $188 | $0 |
| Bone Density Test (DEXA Scan) | $166 | $133 | $33 |
| Office Visit (Established Patient) | $146 | $117 | $29 |
| Vision Exam (Diabetic) | $142 | $114 | $28 |
| Skin Cancer Screening | $138 | $111 | $28 |
| Occupational Therapy Session | $137 | $110 | $27 |
| EKG (Electrocardiogram) | $136 | $108 | $27 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Blood Type and Crossmatch | $57 | $46 | $11 |
| Blood Culture | $52 | $42 | $10 |
| Vitamin D Level | $45 | $36 | $9 |
| BNP (Heart Failure Marker) | $44 | $36 | $9 |
| Troponin Level | $44 | $35 | $9 |
| Iron Studies (Ferritin) | $44 | $35 | $9 |
| PSA (Prostate-Specific Antigen) | $41 | $32 | $8 |
| Thyroid Panel (TSH) | $37 | $29 | $7 |
| Lipid Panel | $34 | $27 | $7 |
| Comprehensive Metabolic Panel | $33 | $26 | $7 |
| B12 Level | $32 | $26 | $6 |
| Glucose Tolerance Test | $30 | $24 | $6 |
| Pap Smear Lab Processing | $30 | $24 | $6 |
| Liver Function Panel | $30 | $24 | $6 |
| Basic Metabolic Panel | $29 | $24 | $6 |
Compare Rhode Island With Other States
Frequently Asked Questions
How much does Medicare spend per person in Rhode Island?
In 2026, the average Medicare spending per beneficiary in Rhode Island is $11,129.
How many people are enrolled in Medicare in Rhode Island?
Rhode Island has approximately 2,377,160 Medicare beneficiaries.
Did Rhode Island expand Medicaid?
Yes, Rhode Island expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Rhode Island?
The uninsured rate in Rhode Island is 3.3%.
What is the average Medigap premium in Rhode Island?
The average Medigap (Medicare Supplement) premium in Rhode Island is $340 per month.