California / Adventist Health Tulare
CMS certification 050784 · Tulare, CA · 2 entries in CMS's price-transparency list
Adventist Health Tulare: charges and Medicare payments
Adventist Health Tulare reported 250 Medicare inpatient stays across 10 DRGs in 2024. Across them it charged 4.07 times what it was paid — among the lower ratios in California, number 177 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: 98 stays at an average charge of $71,440, 21% below the national average. It also billed 365 outpatient services, charging 5.97 times what Medicare paid.
- 1Medicare inpatient stays 250
- 2Charge ÷ paid, inpatient 4.07×
- 3Rank in CA (highest ratio = 1) 177 of 247
- 4CMS price-transparency actions 2
Inpatient stays
For the 10 DRGs that can be compared with the national average, Adventist Health Tulare charged more than the national average in 3 (30%). 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 | 98 | $71,440 | -21% | $18,960 |
| 291 Heart Failure and Shock with MCC | 29 | $67,724 | +20% | $14,858 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $49,353 | -17% | $12,703 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 19 | $38,854 | -21% | $10,961 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $68,325 | +19% | $13,345 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $89,798 | +27% | $16,692 |
| 069 Transient Ischemia without Thrombolytic | 13 | $49,433 | -2% | $9,027 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 12 | $44,594 | -41% | $13,921 |
| 683 Renal Failure with CC | 12 | $36,898 | -9% | $9,924 |
| 637 Diabetes with MCC | 11 | $57,696 | -13% | $14,834 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 3 Musculoskeletal Procedures | 84 | $19,891 | $3,956 |
| Comprehensive Observation Services | 50 | $32,534 | $3,365 |
| Level 1 Nerve Procedures | 48 | $13,750 | $2,335 |
| Level 1 Laparoscopy and Related Services | 47 | $31,347 | $7,094 |
| Level 4 Musculoskeletal Procedures | 36 | $36,658 | $8,792 |
| Level 3 Electrophysiologic Procedures | 32 | $129,914 | $29,114 |
| Level 2 Musculoskeletal Procedures | 28 | $15,406 | $1,976 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 21 | $24,932 | $4,253 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 19 | $15,180 | $1,993 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventist Health Tulare charged $71,440 on average, 50% less than the California average of $143,063, and was paid $18,960 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Adventist Health Tulare charged $67,724 on average, 33% less than the California average of $100,739, and was paid $14,858 against a state average of $15,556. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Adventist Health Tulare charged $49,353 on average, 52% less than the California average of $103,761, and was paid $12,703 against a state average of $15,112. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Adventist Health Tulare charged $38,854 on average, 49% less than the California average of $76,120, and was paid $10,961 against a state average of $12,552. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $19,891 was 45% below the state average of $36,238. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $32,534 was 22% below the state average of $41,628. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $13,750 was 29% below the state average of $19,391. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $31,347 was 51% below the state average of $64,351.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Adventist Health Tulare in Tulare, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-29 (CMS case 2202)
- Met Requirements — 2025-08-25 (CMS case 6374)
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.