California / Kaiser Foundation Hospital - Zion
CMS certification 050515 · San Diego, CA
Kaiser Foundation Hospital - Zion: charges and Medicare payments
Kaiser Foundation Hospital - Zion reported 407 Medicare inpatient stays across 15 DRGs in 2024. Across them it charged 2.95 times what it was paid — among the lower ratios in California, number 224 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: 126 stays at an average charge of $83,181, 8% below the national average. It also billed 294 outpatient services, charging 8.1 times what Medicare paid.
- 1Medicare inpatient stays 407
- 2Charge ÷ paid, inpatient 2.95×
- 3Rank in CA (highest ratio = 1) 224 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 15 DRGs that can be compared with the national average, Kaiser Foundation Hospital - Zion charged more than the national average in 5 (33%). 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 | 126 | $83,181 | -8% | $28,452 |
| 291 Heart Failure and Shock with MCC | 56 | $61,735 | +9% | $16,478 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 55 | $40,853 | -17% | $15,274 |
| 189 Pulmonary Edema and Respiratory Failure | 21 | $60,010 | +4% | $21,206 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 21 | $61,744 | -16% | $20,529 |
| 177 Respiratory Infections and Inflammations with MCC | 16 | $54,826 | -22% | $17,055 |
| 193 Simple Pneumonia and Pleurisy with MCC | 15 | $51,854 | -13% | $18,999 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 14 | $56,296 | +11% | $13,079 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 13 | $64,285 | -37% | $43,218 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $34,762 | -8% | $11,889 |
| 330 Major Small and Large Bowel Procedures with CC | 12 | $73,130 | -39% | $56,927 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 12 | $278,506 | +22% | $72,721 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 11 | $61,649 | -19% | $17,597 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $89,570 | -11% | $21,870 |
| 638 Diabetes with CC | 11 | $46,020 | +10% | $10,632 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 168 | $31,616 | $3,249 |
| Level 1 Intraocular Procedures | 46 | $9,342 | $2,719 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 28 | $10,719 | $1,844 |
| Level 5 Musculoskeletal Procedures | 22 | $53,186 | $15,190 |
| Level 3 Vascular Procedures | 15 | $29,486 | $3,843 |
| Level 2 Endovascular Procedures | 15 | $28,473 | $6,891 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Kaiser Foundation Hospital - Zion charged $83,181 on average, 42% less than the California average of $143,063, and was paid $28,452 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Kaiser Foundation Hospital - Zion charged $61,735 on average, 39% less than the California average of $100,739, and was paid $16,478 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Kaiser Foundation Hospital - Zion charged $40,853 on average, 46% less than the California average of $76,120, and was paid $15,274 against a state average of $12,552. For Pulmonary Edema and Respiratory Failure (DRG 189), Kaiser Foundation Hospital - Zion charged $60,010 on average, 42% less than the California average of $104,292, and was paid $21,206 against a state average of $15,897. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $31,616 was 24% below the state average of $41,628. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,342 was 55% below the state average of $20,986. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,719 was 27% below the state average of $14,749. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $53,186 was 51% below the state average of $109,149.
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.