California / Kaiser Foundation Hospital-Santa Clara
CMS certification 050071 · Santa Clara, CA
Kaiser Foundation Hospital-Santa Clara: charges and Medicare payments
Kaiser Foundation Hospital-Santa Clara reported 235 Medicare inpatient stays across 8 DRGs in 2024. Across them it charged 2.7 times what it was paid — among the lower ratios in California, number 232 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: 104 stays at an average charge of $136,774, 51% above the national average. It also billed 88 outpatient services, charging 11.99 times what Medicare paid.
- 1Medicare inpatient stays 235
- 2Charge ÷ paid, inpatient 2.7×
- 3Rank in CA (highest ratio = 1) 232 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 8 DRGs that can be compared with the national average, Kaiser Foundation Hospital-Santa Clara charged more than the national average in 6 (75%). 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 | 104 | $136,774 | +51% | $53,362 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 28 | $47,300 | -4% | $29,028 |
| 189 Pulmonary Edema and Respiratory Failure | 26 | $77,169 | +34% | $26,674 |
| 291 Heart Failure and Shock with MCC | 26 | $194,326 | +245% | $76,791 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 16 | $74,932 | +34% | $17,198 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $111,597 | +31% | $26,799 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 12 | $209,264 | -9% | $56,180 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 11 | $106,994 | +7% | $31,102 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 50 | $41,254 | $3,780 |
| Level 3 Vascular Procedures | 15 | $30,839 | $4,168 |
| Level 1 Intraocular Procedures | 12 | $15,196 | $2,808 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 11 | $15,799 | $1,932 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Kaiser Foundation Hospital-Santa Clara charged $136,774 on average, 4% less than the California average of $143,063, and was paid $53,362 against a state average of $23,020. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Kaiser Foundation Hospital-Santa Clara charged $47,300 on average, 38% less than the California average of $76,120, and was paid $29,028 against a state average of $12,552. For Pulmonary Edema and Respiratory Failure (DRG 189), Kaiser Foundation Hospital-Santa Clara charged $77,169 on average, 26% less than the California average of $104,292, and was paid $26,674 against a state average of $15,897. For Heart Failure and Shock with MCC (DRG 291), Kaiser Foundation Hospital-Santa Clara charged $194,326 on average, 93% more than the California average of $100,739, and was paid $76,791 against a state average of $15,556. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $41,254 was 1% below the state average of $41,628. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $30,839 was 2% above the state average of $30,190. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $15,196 was 28% below the state average of $20,986. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,799 was 7% above the state average of $14,749.
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.