California / Barton Memorial Hospital
CMS certification 050352 · South Lake Tahoe, CA
Barton Memorial Hospital: charges and Medicare payments
Barton Memorial Hospital reported 119 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 4.5 times what it was paid — mid-range in California, number 162 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: 36 stays at an average charge of $110,102, 22% above the national average. It also billed 792 outpatient services, charging 11.71 times what Medicare paid.
- 1Medicare inpatient stays 119
- 2Charge ÷ paid, inpatient 4.5×
- 3Rank in CA (highest ratio = 1) 162 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 7 DRGs that can be compared with the national average, Barton Memorial Hospital charged more than the national average in 7 (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 | 36 | $110,102 | +22% | $32,053 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $73,847 | +92% | $11,273 |
| 291 Heart Failure and Shock with MCC | 17 | $105,133 | +86% | $18,890 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $76,950 | +9% | $22,992 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 13 | $92,066 | +88% | $14,191 |
| 193 Simple Pneumonia and Pleurisy with MCC | 11 | $122,277 | +105% | $21,552 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $89,705 | +123% | $15,691 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 220 | $41,028 | $3,471 |
| Level 5 Musculoskeletal Procedures | 136 | $150,475 | $16,461 |
| Level 4 Musculoskeletal Procedures | 83 | $83,280 | $9,042 |
| Level 3 Musculoskeletal Procedures | 64 | $46,102 | $4,050 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 37 | $20,361 | $1,970 |
| Level 1 Laparoscopy and Related Services | 36 | $135,443 | $7,206 |
| Level 6 Musculoskeletal Procedures | 33 | $168,009 | $23,737 |
| Level 5 Urology and Related Services | 31 | $68,914 | $6,608 |
| Level 4 Urology and Related Services | 28 | $52,126 | $4,452 |
| Level 2 Upper GI Procedures | 25 | $24,709 | $2,430 |
| Level 2 Musculoskeletal Procedures | 23 | $23,897 | $1,982 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 15 | $53,172 | $3,629 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 15 | $69,172 | $4,418 |
| Level 1 Nerve Procedures | 13 | $20,890 | $2,466 |
| Level 3 Vascular Procedures | 11 | $45,450 | $4,071 |
| Level 3 Lower GI Procedures | 11 | $24,162 | $3,421 |
| Level 3 Urology and Related Services | 11 | $31,285 | $2,601 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Barton Memorial Hospital charged $110,102 on average, 23% less than the California average of $143,063, and was paid $32,053 against a state average of $23,020. For Simple Pneumonia and Pleurisy with CC (DRG 194), Barton Memorial Hospital charged $73,847 on average, 5% more than the California average of $70,084, and was paid $11,273 against a state average of $10,026. For Heart Failure and Shock with MCC (DRG 291), Barton Memorial Hospital charged $105,133 on average, 4% more than the California average of $100,739, and was paid $18,890 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Barton Memorial Hospital charged $76,950 on average, 38% less than the California average of $124,302, and was paid $22,992 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $41,028 was 1% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $150,475 was 38% above the state average of $109,149. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $83,280 was 20% above the state average of $69,476. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $46,102 was 27% above the state average of $36,238.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.