California / Adventist Health Sonora
CMS certification 050335 · Sonora, CA · 4 entries in CMS's price-transparency list
Adventist Health Sonora: charges and Medicare payments
Adventist Health Sonora reported 1,427 Medicare inpatient stays across 45 DRGs in 2024. Across them it charged 5.94 times what it was paid — mid-range in California, number 92 of 247 hospitals with at least 100 stays (state median 5.18×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 395 stays at an average charge of $114,170, 26% above the national average. It also billed 3,448 outpatient services, charging 8.95 times what Medicare paid.
- 1Medicare inpatient stays 1,427
- 2Charge ÷ paid, inpatient 5.94×
- 3Rank in CA (highest ratio = 1) 92 of 247
- 4CMS price-transparency actions 4
Inpatient stays
For the 45 DRGs that can be compared with the national average, Adventist Health Sonora charged more than the national average in 44 (98%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 395 | $114,170 | +26% | $22,244 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 76 | $75,426 | +54% | $11,244 |
| 291 Heart Failure and Shock with MCC | 68 | $93,924 | +67% | $14,015 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 66 | $91,753 | +21% | $17,316 |
| 193 Simple Pneumonia and Pleurisy with MCC | 45 | $90,273 | +51% | $14,697 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 39 | $77,522 | +53% | $11,976 |
| 481 Hip and Femur Procedures except Major Joint with CC | 38 | $144,006 | +43% | $25,480 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 36 | $309,003 | +35% | $58,114 |
| 689 Kidney and Urinary Tract Infections with MCC | 35 | $82,940 | +62% | $12,775 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 34 | $91,291 | +24% | $17,989 |
| 378 Gastrointestinal Hemorrhage with CC | 32 | $83,936 | +73% | $10,720 |
| 177 Respiratory Infections and Inflammations with MCC | 30 | $81,219 | +15% | $18,233 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 30 | $92,707 | +84% | $10,175 |
| 683 Renal Failure with CC | 25 | $53,815 | +32% | $9,752 |
| 189 Pulmonary Edema and Respiratory Failure | 24 | $74,418 | +29% | $13,485 |
| 682 Renal Failure with MCC | 23 | $108,196 | +64% | $16,363 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 20 | $99,269 | +75% | $13,170 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 20 | $69,405 | +73% | $8,599 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 20 | $82,971 | +38% | $14,356 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 19 | $152,217 | +49% | $22,913 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 18 | $97,068 | -3% | $21,538 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 18 | $382,092 | +88% | $51,826 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 18 | $186,624 | +35% | $31,810 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 17 | $61,665 | +71% | $8,125 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $131,366 | +34% | $22,110 |
| 330 Major Small and Large Bowel Procedures with CC | 16 | $162,013 | +36% | $25,710 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $66,925 | +81% | $13,595 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 15 | $80,284 | +44% | $11,073 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 15 | $111,852 | +72% | $15,404 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $192,156 | +68% | $19,991 |
| 377 Gastrointestinal Hemorrhage with MCC | 15 | $120,310 | +41% | $19,628 |
| 389 Gastrointestinal Obstruction with CC | 15 | $45,455 | +17% | $8,658 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $63,410 | +68% | $8,787 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 14 | $465,996 | +67% | $68,788 |
| 638 Diabetes with CC | 14 | $81,904 | +97% | $12,124 |
| 329 Major Small and Large Bowel Procedures with MCC | 13 | $349,104 | +62% | $54,572 |
| 617 Amputation of Lower Limb for Endocrine, Nutritional and... | 12 | $112,617 | +30% | $21,372 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 12 | $67,092 | +81% | $9,278 |
| 282 Acute Myocardial Infarction, Discharged Alive without CC/MCC | 11 | $82,183 | +89% | $8,010 |
| 312 Syncope and Collapse | 11 | $104,876 | +130% | $9,569 |
| 315 Other Circulatory System Diagnoses with CC | 11 | $83,896 | +75% | $10,457 |
| 460 Spinal Fusion except Cervical without MCC | 11 | $308,739 | +81% | $42,756 |
| 482 Hip and Femur Procedures except Major Joint without CC/MCC | 11 | $111,513 | +43% | $17,172 |
| 603 Cellulitis without MCC | 11 | $77,513 | +108% | $9,640 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 11 | $71,535 | +51% | $11,228 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventist Health Sonora charged $114,170 on average, 20% less than the California average of $143,063, and was paid $22,244 against a state average of $23,020. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Adventist Health Sonora charged $75,426 on average, 1% less than the California average of $76,120, and was paid $11,244 against a state average of $12,552. For Heart Failure and Shock with MCC (DRG 291), Adventist Health Sonora charged $93,924 on average, 7% less than the California average of $100,739, and was paid $14,015 against a state average of $15,556. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Adventist Health Sonora charged $91,753 on average, 26% less than the California average of $123,896, and was paid $17,316 against a state average of $19,122. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,923 was 60% below the state average of $4,853. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $36,321 was 13% below the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,115 was 45% below the state average of $14,749. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $147,471 was 35% above the state average of $109,149.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Adventist Health Sonora in Sonora, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2022-12-07 (CMS case 943)
- Met Requirements — 2023-12-11 (CMS case 2104)
- Met Requirements — 2024-03-05 (CMS case 2312)
- Met Requirements — 2025-08-28 (CMS case 6418)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.