California / Memorial Hospital Los Banos
CMS certification 050528 · Los Banos, CA · 2 entries in CMS's price-transparency list
Memorial Hospital Los Banos: charges and Medicare payments
Memorial Hospital Los Banos reported 172 Medicare inpatient stays across 8 DRGs in 2024. Across them it charged 1.6 times what it was paid — among the lower ratios in California, number 245 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: 75 stays at an average charge of $72,846, 19% below the national average. It also billed 130 outpatient services, charging 11.45 times what Medicare paid.
- 1Medicare inpatient stays 172
- 2Charge ÷ paid, inpatient 1.6×
- 3Rank in CA (highest ratio = 1) 245 of 247
- 4CMS price-transparency actions 2
Inpatient stays
For the 8 DRGs that can be compared with the national average, Memorial Hospital Los Banos charged more than the national average in 3 (38%). 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 | 75 | $72,846 | -19% | $49,025 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 19 | $52,475 | +7% | $25,559 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $47,720 | -20% | $32,775 |
| 291 Heart Failure and Shock with MCC | 16 | $46,834 | -17% | $32,563 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $42,482 | +6% | $19,225 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $57,950 | -4% | $32,785 |
| 689 Kidney and Urinary Tract Infections with MCC | 11 | $50,618 | -1% | $28,977 |
| 690 Kidney and Urinary Tract Infections without MCC | 11 | $43,160 | +14% | $20,034 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 91 | $36,081 | $3,604 |
| Level 3 Vascular Procedures | 15 | $41,881 | $4,057 |
| Level 3 Musculoskeletal Procedures | 13 | $24,386 | $3,740 |
| Level 1 Laparoscopy and Related Services | 11 | $39,800 | $7,047 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Memorial Hospital Los Banos charged $72,846 on average, 49% less than the California average of $143,063, and was paid $49,025 against a state average of $23,020. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Memorial Hospital Los Banos charged $52,475 on average, 31% less than the California average of $76,120, and was paid $25,559 against a state average of $12,552. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Memorial Hospital Los Banos charged $47,720 on average, 54% less than the California average of $103,761, and was paid $32,775 against a state average of $15,112. For Heart Failure and Shock with MCC (DRG 291), Memorial Hospital Los Banos charged $46,834 on average, 54% less than the California average of $100,739, and was paid $32,563 against a state average of $15,556. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $36,081 was 13% below the state average of $41,628. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $41,881 was 39% above the state average of $30,190. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $24,386 was 33% below the state average of $36,238. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $39,800 was 38% below the state average of $64,351.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Memorial Hospital Los Banos in Los Banos, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-11-13 (CMS case 2919)
- Met Requirements — 2025-08-01 (CMS case 6115)
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.