California / Doctors Medical Center

CMS certification 050464 · Modesto, CA · 1 entry in CMS's price-transparency list

Doctors Medical Center: charges and Medicare payments

Doctors Medical Center reported 2,691 Medicare inpatient stays across 86 DRGs in 2024. Across them it charged 16.39 times what it was paid — among the higher ratios in California, number 1 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: 315 stays at an average charge of $418,206, 363% above the national average. It also billed 1,237 outpatient services, charging 15.53 times what Medicare paid.

1Medicare inpatient stays 2,691
2Charge ÷ paid, inpatient 16.39×
3Rank in CA (highest ratio = 1) 1 of 247
4CMS price-transparency actions 1

Average charge per stay at Doctors Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 86 DRGs that can be compared with the national average, Doctors Medical Center charged more than the national average in 86 (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	315	$418,206	+363%	$21,538
291 Heart Failure and Shock with MCC	166	$259,631	+361%	$13,827
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	137	$438,490	+339%	$21,244
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	70	$243,595	+337%	$10,803
193 Simple Pneumonia and Pleurisy with MCC	70	$246,652	+313%	$13,783
378 Gastrointestinal Hemorrhage with CC	69	$175,794	+262%	$10,662
023 Craniotomy with Major Device Implant or Acute Complex Cns...	64	$762,415	+171%	$67,303
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	57	$209,467	+327%	$11,142
280 Acute Myocardial Infarction, Discharged Alive with MCC	56	$374,870	+394%	$18,741
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	52	$269,236	+347%	$15,066
377 Gastrointestinal Hemorrhage with MCC	50	$418,308	+390%	$22,187
698 Other Kidney and Urinary Tract Diagnoses with MCC	47	$228,938	+212%	$17,100
308 Cardiac Arrhythmia and Conduction Disorders with MCC	46	$309,232	+446%	$13,356
682 Renal Failure with MCC	46	$254,492	+286%	$15,769
853 Infectious and Parasitic Diseases with O.R. Procedures with...	46	$710,111	+210%	$49,838
683 Renal Failure with CC	45	$180,184	+343%	$9,731
177 Respiratory Infections and Inflammations with MCC	41	$252,055	+257%	$18,097
322 Percutaneous Cardiovascular Procedures with Intraluminal...	41	$346,096	+202%	$19,555
267 Endovascular Cardiac Valve Replacement and Supplement...	38	$708,553	+220%	$52,698
481 Hip and Femur Procedures except Major Joint with CC	35	$322,778	+220%	$22,825
314 Other Circulatory System Diagnoses with MCC	33	$335,070	+253%	$22,238
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	32	$165,129	+311%	$9,327
069 Transient Ischemia without Thrombolytic	31	$211,662	+320%	$8,775
083 Traumatic Stupor and Coma >1 Hour with CC	31	$274,913	+275%	$14,172
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	29	$278,444	+172%	$22,043
690 Kidney and Urinary Tract Infections without MCC	29	$166,718	+341%	$11,570
208 Respiratory System Diagnosis with Ventilator Support <=96...	28	$636,190	+369%	$32,837
309 Cardiac Arrhythmia and Conduction Disorders with CC	28	$161,676	+348%	$8,268
394 Other Digestive System Diagnoses with CC	28	$163,763	+248%	$9,869
312 Syncope and Collapse	27	$194,117	+326%	$9,433
235 Coronary Bypass without Cardiac Catheterization with MCC	26	$1,236,188	+322%	$69,870
321 Percutaneous Cardiovascular Procedures with Intraluminal...	26	$475,639	+191%	$31,128
552 Medical Back Problems without MCC	26	$171,366	+251%	$12,620
190 Chronic Obstructive Pulmonary Disease with MCC	25	$205,870	+307%	$11,922
082 Traumatic Stupor and Coma >1 Hour with MCC	24	$429,226	+272%	$26,419
189 Pulmonary Edema and Respiratory Failure	24	$224,183	+289%	$13,261
699 Other Kidney and Urinary Tract Diagnoses with CC	24	$155,056	+227%	$10,849
603 Cellulitis without MCC	21	$182,818	+390%	$10,187
025 Craniotomy and Endovascular Intracranial Procedures with MCC	20	$565,380	+144%	$45,346
233 Coronary Bypass with Cardiac Catheterization or Open...	19	$1,281,964	+233%	$79,321
281 Acute Myocardial Infarction, Discharged Alive with CC	19	$185,254	+267%	$9,774
637 Diabetes with MCC	19	$201,750	+203%	$15,879
870 Septicemia or Severe Sepsis with MV >96 Hours	19	$1,343,542	+316%	$76,599
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	18	$268,332	+312%	$14,826
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	18	$158,383	+327%	$8,581
689 Kidney and Urinary Tract Infections with MCC	18	$168,768	+229%	$12,496
917 Poisoning and Toxic Effects of Drugs with MCC	18	$303,906	+306%	$18,554
092 Other Disorders of Nervous System with CC	17	$201,094	+290%	$12,859
101 Seizures without MCC	17	$176,456	+262%	$9,788
282 Acute Myocardial Infarction, Discharged Alive without CC/MCC	17	$141,326	+226%	$7,888
393 Other Digestive System Diagnoses with MCC	17	$389,633	+407%	$17,446
480 Hip and Femur Procedures except Major Joint with MCC	17	$428,115	+209%	$29,953
811 Red Blood Cell Disorders with MCC	17	$256,509	+276%	$18,106
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	17	$989,908	+358%	$59,553
313 Chest Pain	16	$158,451	+297%	$8,678
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	16	$236,063	+287%	$13,760
673 Other Kidney and Urinary Tract Procedures with MCC	16	$735,560	+325%	$45,426
100 Seizures with MCC	15	$337,128	+257%	$21,153
242 Permanent Cardiac Pacemaker Implant with MCC	15	$536,432	+234%	$46,125
270 Other Major Cardiovascular Procedures with MCC	15	$880,595	+240%	$54,391

Showing the 60 most frequent of 86 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Endovascular Procedures	168	$94,064	$3,980
Level 5 Musculoskeletal Procedures	93	$163,052	$16,148
Comprehensive Observation Services	89	$85,877	$3,365
Level 1 Nerve Procedures	62	$21,977	$2,374
Level 2 Excision/ Biopsy/ Incision and Drainage	59	$30,506	$1,993
Level 3 Vascular Procedures	54	$73,647	$3,861
Level 4 Musculoskeletal Procedures	50	$108,700	$8,506
Level 1 Laparoscopy and Related Services	50	$84,917	$7,094
Level 3 Endovascular Procedures	49	$218,998	$13,261
Level 3 Urology and Related Services	49	$34,125	$2,504
Level 6 Musculoskeletal Procedures	42	$191,353	$22,346
Level 4 Vascular Procedures	37	$100,320	$6,756
Level 2 Upper GI Procedures	36	$30,591	$2,339
Level 5 Urology and Related Services	34	$76,106	$6,215
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	33	$73,223	$4,151
Level 3 Musculoskeletal Procedures	32	$63,976	$3,880
Level 4 Urology and Related Services	32	$62,797	$4,286
Level 2 Breast/Lymphatic Surgery and Related Procedures	29	$99,940	$8,017
Level 3 Electrophysiologic Procedures	29	$251,424	$29,114
Level 3 Excision/ Biopsy/ Incision and Drainage	28	$49,132	$3,494
Level 1 Breast/Lymphatic Surgery and Related Procedures	28	$66,287	$4,686
Level 2 Vascular Procedures	20	$23,371	$1,969
Level 4 Endovascular Procedures	20	$273,969	$18,278
Level 1 Intraocular Procedures	20	$28,381	$2,865
Level 2 Endovascular Procedures	16	$105,966	$7,027

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Doctors Medical Center charged $418,206 on average, 192% more than the California average of $143,063, and was paid $21,538 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Doctors Medical Center charged $259,631 on average, 158% more than the California average of $100,739, and was paid $13,827 against a state average of $15,556. For Intracranial Hemorrhage or Cerebral Infarction with MCC (DRG 064), Doctors Medical Center charged $438,490 on average, 151% more than the California average of $174,368, and was paid $21,244 against a state average of $24,500. For Intracranial Hemorrhage or Cerebral Infarction with CC or Tpa in 24 Hours (DRG 065), Doctors Medical Center charged $243,595 on average, 153% more than the California average of $96,351, and was paid $10,803 against a state average of $12,570. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $94,064 was 132% above the state average of $40,544. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $163,052 was 49% above the state average of $109,149. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $85,877 was 106% above the state average of $41,628. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $21,977 was 13% above the state average of $19,391.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Doctors Medical Center in Modesto, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2025-03-10 (CMS case 3227)

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.