California / Highland Hospital
CMS certification 050320 · Oakland, CA · 4 entries in CMS's price-transparency list
Highland Hospital: charges and Medicare payments
Highland Hospital reported 1,374 Medicare inpatient stays across 50 DRGs in 2024. Across them it charged 4.27 times what it was paid — among the lower ratios in California, number 169 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: 201 stays at an average charge of $145,490, 61% above the national average. It also billed 894 outpatient services, charging 9.23 times what Medicare paid.
- 1Medicare inpatient stays 1,374
- 2Charge ÷ paid, inpatient 4.27×
- 3Rank in CA (highest ratio = 1) 169 of 247
- 4CMS price-transparency actions 4
Inpatient stays
For the 50 DRGs that can be compared with the national average, Highland Hospital charged more than the national average in 48 (96%). 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 | 201 | $145,490 | +61% | $33,676 |
| 291 Heart Failure and Shock with MCC | 112 | $103,803 | +84% | $23,977 |
| 189 Pulmonary Edema and Respiratory Failure | 71 | $96,246 | +67% | $22,526 |
| 193 Simple Pneumonia and Pleurisy with MCC | 58 | $74,332 | +24% | $22,648 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 48 | $93,042 | +54% | $23,247 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 43 | $117,421 | +60% | $27,873 |
| 177 Respiratory Infections and Inflammations with MCC | 37 | $111,585 | +58% | $29,580 |
| 481 Hip and Femur Procedures except Major Joint with CC | 36 | $167,533 | +66% | $35,812 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 35 | $65,630 | +77% | $15,952 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 31 | $200,458 | +48% | $49,496 |
| 683 Renal Failure with CC | 31 | $70,485 | +73% | $17,956 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 31 | $82,770 | +69% | $19,810 |
| 603 Cellulitis without MCC | 30 | $61,423 | +65% | $17,276 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 27 | $128,390 | +69% | $27,041 |
| 312 Syncope and Collapse | 27 | $74,168 | +63% | $17,187 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 26 | $99,516 | +33% | $27,309 |
| 378 Gastrointestinal Hemorrhage with CC | 24 | $66,793 | +38% | $18,281 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 24 | $56,326 | +40% | $16,153 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 23 | $425,093 | +86% | $96,526 |
| 552 Medical Back Problems without MCC | 22 | $92,687 | +90% | $18,591 |
| 812 Red Blood Cell Disorders without MCC | 21 | $68,348 | +54% | $18,103 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 20 | $240,447 | +141% | $41,265 |
| 377 Gastrointestinal Hemorrhage with MCC | 20 | $129,210 | +51% | $31,782 |
| 682 Renal Failure with MCC | 19 | $97,476 | +48% | $24,910 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 18 | $217,753 | +197% | $31,901 |
| 638 Diabetes with CC | 18 | $60,490 | +45% | $16,884 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 17 | $135,622 | +143% | $23,334 |
| 184 Major Chest Trauma with CC | 16 | $154,852 | +179% | $20,487 |
| 690 Kidney and Urinary Tract Infections without MCC | 16 | $53,179 | +41% | $15,673 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 16 | $593,244 | +84% | $145,525 |
| 100 Seizures with MCC | 15 | $145,445 | +54% | $32,908 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $85,569 | +40% | $23,299 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 15 | $98,195 | +130% | $17,634 |
| 070 Other Cerebrovascular Disorders with MCC | 14 | $118,346 | +56% | $29,477 |
| 101 Seizures without MCC | 14 | $78,476 | +61% | $17,306 |
| 314 Other Circulatory System Diagnoses with MCC | 14 | $134,045 | +41% | $33,773 |
| 885 Psychoses | 14 | $99,693 | +126% | $28,718 |
| 393 Other Digestive System Diagnoses with MCC | 13 | $52,906 | -31% | $26,782 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 13 | $131,912 | +29% | $34,909 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 13 | $76,812 | +107% | $17,548 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 12 | $566,714 | +102% | $129,030 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $93,799 | +85% | $20,866 |
| 252 Other Vascular Procedures with MCC | 12 | $260,860 | +53% | $57,016 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 12 | $90,788 | +80% | $17,957 |
| 602 Cellulitis with MCC | 12 | $102,884 | +71% | $25,044 |
| 884 Organic Disturbances and Intellectual Disability | 12 | $159,062 | +155% | $30,787 |
| 394 Other Digestive System Diagnoses with CC | 11 | $101,729 | +116% | $20,863 |
| 565 Other Musculoskeletal System and Connective Tissue Diagnoses... | 11 | $109,535 | +129% | $19,470 |
| 689 Kidney and Urinary Tract Infections with MCC | 11 | $68,216 | +33% | $21,678 |
| 847 Chemotherapy without Acute Leukemia As Secondary Diagnosis... | 11 | $49,133 | -27% | $22,869 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Highland Hospital charged $145,490 on average, 2% more than the California average of $143,063, and was paid $33,676 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Highland Hospital charged $103,803 on average, 3% more than the California average of $100,739, and was paid $23,977 against a state average of $15,556. For Pulmonary Edema and Respiratory Failure (DRG 189), Highland Hospital charged $96,246 on average, 8% less than the California average of $104,292, and was paid $22,526 against a state average of $15,897. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Highland Hospital charged $74,332 on average, 28% less than the California average of $103,761, and was paid $22,648 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $48,035 was 15% above the state average of $41,628. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $16,523 was 21% below the state average of $20,986. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,077 was 18% below the state average of $14,749. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $24,953 was 17% below the state average of $30,190.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Highland Hospital in Oakland, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-04-30 (CMS case 4171)
- CAP Request — 2025-08-05 (CMS case 4171)
- Closure Notice — 2025-08-29 (CMS case 4171)
- Met Requirements — 2026-04-07 (CMS case 7395)
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.