California / Adventist Health St Helena
CMS certification 050013 · Saint Helena, CA · 4 entries in CMS's price-transparency list
Adventist Health St Helena: charges and Medicare payments
Adventist Health St Helena reported 829 Medicare inpatient stays across 33 DRGs in 2024. Across them it charged 7.49 times what it was paid — among the higher ratios in California, number 46 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: 97 stays at an average charge of $151,262, 68% above the national average. It also billed 2,028 outpatient services, charging 11.32 times what Medicare paid.
- 1Medicare inpatient stays 829
- 2Charge ÷ paid, inpatient 7.49×
- 3Rank in CA (highest ratio = 1) 46 of 247
- 4CMS price-transparency actions 4
Inpatient stays
For the 33 DRGs that can be compared with the national average, Adventist Health St Helena charged more than the national average in 33 (100%). 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 | 97 | $151,262 | +68% | $20,656 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 82 | $202,217 | +29% | $34,003 |
| 885 Psychoses | 73 | $81,253 | +84% | $15,597 |
| 291 Heart Failure and Shock with MCC | 52 | $129,508 | +130% | $13,796 |
| 229 Other Cardiothoracic Procedures without MCC | 39 | $284,105 | +72% | $33,755 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 39 | $241,724 | +9% | $51,285 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 33 | $121,429 | +60% | $17,191 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 33 | $170,726 | +49% | $19,473 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 25 | $87,785 | +46% | $14,727 |
| 378 Gastrointestinal Hemorrhage with CC | 22 | $84,516 | +74% | $10,684 |
| 234 Coronary Bypass with Cardiac Catheterization or Open... | 20 | $608,039 | +126% | $55,146 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 19 | $85,521 | +69% | $9,949 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 19 | $253,675 | +55% | $30,413 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $117,456 | +66% | $17,045 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 17 | $848,636 | +113% | $90,695 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 17 | $509,564 | +79% | $73,082 |
| 193 Simple Pneumonia and Pleurisy with MCC | 16 | $126,537 | +112% | $13,787 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 16 | $234,889 | +152% | $20,123 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 16 | $76,098 | +55% | $10,868 |
| 163 Major Chest Procedures with MCC | 14 | $252,720 | +20% | $49,752 |
| 270 Other Major Cardiovascular Procedures with MCC | 14 | $554,447 | +114% | $62,950 |
| 317 Concomitant Left Atrial Appendage Closure and Cardiac... | 14 | $386,262 | +7% | $65,599 |
| 682 Renal Failure with MCC | 14 | $125,089 | +90% | $15,391 |
| 271 Other Major Cardiovascular Procedures with CC | 13 | $318,685 | +83% | $39,312 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 13 | $631,715 | +176% | $68,728 |
| 164 Major Chest Procedures with CC | 12 | $334,804 | +163% | $27,018 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 12 | $144,667 | +29% | $22,954 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 12 | $109,661 | +72% | $11,719 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 12 | $73,324 | +29% | $12,981 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 12 | $59,567 | +65% | $8,049 |
| 314 Other Circulatory System Diagnoses with MCC | 12 | $130,794 | +38% | $22,227 |
| 253 Other Vascular Procedures with CC | 11 | $293,320 | +122% | $27,177 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 11 | $133,684 | +82% | $16,298 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventist Health St Helena charged $151,262 on average, 6% more than the California average of $143,063, and was paid $20,656 against a state average of $23,020. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Adventist Health St Helena charged $202,217 on average, 1% more than the California average of $200,964, and was paid $34,003 against a state average of $35,770. For Psychoses (DRG 885), Adventist Health St Helena charged $81,253 on average, 58% more than the California average of $51,465, and was paid $15,597 against a state average of $15,642. For Heart Failure and Shock with MCC (DRG 291), Adventist Health St Helena charged $129,508 on average, 29% more than the California average of $100,739, and was paid $13,796 against a state average of $15,556. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $191,731 was 76% above the state average of $109,149. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $49,598 was 22% above the state average of $40,544. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $209,822 was 2% above the state average of $205,167. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $21,325 was 12% above the state average of $19,034.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Adventist Health St Helena in Saint Helena, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-08-25 (CMS case 177)
- Closure Notice — 2022-03-22 (CMS case 177)
- Met Requirements — 2024-02-22 (CMS case 2175)
- Met Requirements — 2025-08-27 (CMS case 6398)
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.