California / Mercy General Hospital

CMS certification 050017 · Sacramento, CA · 3 entries in CMS's price-transparency list

Mercy General Hospital: charges and Medicare payments

Mercy General Hospital reported 2,329 Medicare inpatient stays across 71 DRGs in 2024. Across them it charged 7.15 times what it was paid — among the higher ratios in California, number 54 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: 212 stays at an average charge of $132,488, 47% above the national average. It also billed 3,086 outpatient services, charging 7.15 times what Medicare paid.

1Medicare inpatient stays 2,329
2Charge ÷ paid, inpatient 7.15×
3Rank in CA (highest ratio = 1) 54 of 247
4CMS price-transparency actions 3

Average charge per stay at Mercy General Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 71 DRGs that can be compared with the national average, Mercy General Hospital charged more than the national average in 69 (97%). 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	212	$132,488	+47%	$19,990
291 Heart Failure and Shock with MCC	211	$96,886	+72%	$14,315
274 Percutaneous and Other Intracardiac Procedures without MCC	127	$204,132	+30%	$34,115
280 Acute Myocardial Infarction, Discharged Alive with MCC	96	$128,037	+69%	$17,147
267 Endovascular Cardiac Valve Replacement and Supplement...	65	$348,909	+58%	$50,208
322 Percutaneous Cardiovascular Procedures with Intraluminal...	65	$150,671	+32%	$19,891
378 Gastrointestinal Hemorrhage with CC	54	$77,091	+59%	$10,713
321 Percutaneous Cardiovascular Procedures with Intraluminal...	49	$237,940	+45%	$30,844
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	47	$917,857	+130%	$97,306
193 Simple Pneumonia and Pleurisy with MCC	45	$115,960	+94%	$13,283
470 Major Hip and Knee Joint Replacement or Reattachment of...	45	$157,297	+69%	$19,901
698 Other Kidney and Urinary Tract Diagnoses with MCC	45	$91,479	+25%	$18,677
309 Cardiac Arrhythmia and Conduction Disorders with CC	41	$68,315	+89%	$8,237
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	41	$80,587	+64%	$11,326
229 Other Cardiothoracic Procedures without MCC	39	$240,200	+45%	$34,370
177 Respiratory Infections and Inflammations with MCC	36	$113,120	+60%	$17,292
190 Chronic Obstructive Pulmonary Disease with MCC	35	$92,394	+83%	$18,632
281 Acute Myocardial Infarction, Discharged Alive with CC	35	$84,752	+68%	$9,944
683 Renal Failure with CC	34	$57,151	+40%	$9,810
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	33	$67,725	+69%	$13,768
101 Seizures without MCC	32	$66,208	+36%	$10,805
377 Gastrointestinal Hemorrhage with MCC	32	$104,074	+22%	$18,242
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	32	$91,094	+51%	$14,147
682 Renal Failure with MCC	31	$80,100	+21%	$14,969
287 Circulatory Disorders except AMI, with Cardiac...	30	$109,719	+72%	$11,754
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	28	$128,514	+29%	$20,244
189 Pulmonary Edema and Respiratory Failure	28	$89,327	+55%	$12,791
286 Circulatory Disorders except AMI, with Cardiac...	28	$193,712	+73%	$25,003
233 Coronary Bypass with Cardiac Catheterization or Open...	27	$871,782	+126%	$120,495
308 Cardiac Arrhythmia and Conduction Disorders with MCC	27	$88,889	+57%	$12,791
312 Syncope and Collapse	27	$68,137	+50%	$9,482
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	26	$85,986	+54%	$10,807
853 Infectious and Parasitic Diseases with O.R. Procedures with...	25	$249,435	+9%	$48,798
313 Chest Pain	24	$58,071	+45%	$7,994
236 Coronary Bypass without Cardiac Catheterization without MCC	23	$570,637	+171%	$54,333
314 Other Circulatory System Diagnoses with MCC	23	$110,099	+16%	$21,914
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	23	$334,262	+65%	$48,277
689 Kidney and Urinary Tract Infections with MCC	22	$75,697	+47%	$17,019
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	21	$652,400	+136%	$76,941
603 Cellulitis without MCC	21	$46,924	+26%	$9,669
228 Other Cardiothoracic Procedures with MCC	20	$290,528	+16%	$52,826
235 Coronary Bypass without Cardiac Catheterization with MCC	20	$702,636	+140%	$92,944
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	20	$53,930	+88%	$7,710
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	20	$61,110	+65%	$8,621
330 Major Small and Large Bowel Procedures with CC	19	$229,704	+93%	$25,195
690 Kidney and Urinary Tract Infections without MCC	19	$61,902	+64%	$8,719
069 Transient Ischemia without Thrombolytic	18	$70,002	+39%	$8,759
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	17	$156,549	+53%	$19,550
173 Ultrasound Accelerated and Other Thrombolysis with Principal...	16	$143,313	+3%	$31,050
270 Other Major Cardiovascular Procedures with MCC	15	$345,887	+33%	$48,054
273 Percutaneous and Other Intracardiac Procedures with MCC	15	$239,470	+12%	$41,420
637 Diabetes with MCC	14	$118,357	+78%	$15,046
699 Other Kidney and Urinary Tract Diagnoses with CC	14	$56,931	+20%	$10,996
812 Red Blood Cell Disorders without MCC	14	$61,858	+39%	$9,907
242 Permanent Cardiac Pacemaker Implant with MCC	13	$223,405	+39%	$34,150
243 Permanent Cardiac Pacemaker Implant with CC	13	$100,953	-9%	$23,540
283 Acute Myocardial Infarction, Expired with MCC	13	$127,056	+23%	$23,167
315 Other Circulatory System Diagnoses with CC	13	$74,858	+56%	$10,533
329 Major Small and Large Bowel Procedures with MCC	13	$242,243	+13%	$45,314
194 Simple Pneumonia and Pleurisy with CC	12	$59,859	+56%	$9,019

Showing the 60 most frequent of 71 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 3 Electrophysiologic Procedures	743	$176,515	$30,054
Level 1 Endovascular Procedures	312	$60,403	$4,159
Comprehensive Observation Services	260	$39,777	$3,461
Level 1 Intraocular Procedures	224	$14,900	$2,976
Level 1 Laparoscopy and Related Services	135	$67,714	$7,244
Level 5 Musculoskeletal Procedures	120	$118,003	$16,396
Level 4 Musculoskeletal Procedures	110	$85,018	$9,132
Level 2 Intraocular Procedures	108	$21,358	$5,154
Level 3 Endovascular Procedures	95	$99,321	$14,026
Level 4 Pacemaker and Similar Procedures	62	$151,852	$24,817
Level 3 Vascular Procedures	60	$23,995	$4,003
Level 3 Musculoskeletal Procedures	58	$24,873	$3,964
Level 2 Upper GI Procedures	55	$14,127	$2,430
Level 5 ENT Procedures	48	$46,984	$7,479
Level 3 Urology and Related Services	48	$16,008	$2,601
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	47	$41,113	$4,344
Level 2 Endovascular Procedures	45	$58,106	$7,300
Level 6 Musculoskeletal Procedures	39	$134,157	$23,737
Level 3 Pacemaker and Similar Procedures	37	$56,732	$13,615
Level 2 Excision/ Biopsy/ Incision and Drainage	36	$14,391	$2,071
Level 2 ICD and Similar Procedures	34	$186,823	$41,879
Level 4 Vascular Procedures	32	$31,163	$7,018
Level 3 Excision/ Biopsy/ Incision and Drainage	31	$26,648	$3,629
Level 2 Breast/Lymphatic Surgery and Related Procedures	31	$69,086	$8,327
Level 4 Gynecologic Procedures	31	$26,082	$3,993

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mercy General Hospital charged $132,488 on average, 7% less than the California average of $143,063, and was paid $19,990 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Mercy General Hospital charged $96,886 on average, 4% less than the California average of $100,739, and was paid $14,315 against a state average of $15,556. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Mercy General Hospital charged $204,132 on average, 2% more than the California average of $200,964, and was paid $34,115 against a state average of $35,770. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Mercy General Hospital charged $128,037 on average, 3% more than the California average of $123,896, and was paid $17,147 against a state average of $19,122. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $176,515 was 14% below the state average of $205,167. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $60,403 was 49% above the state average of $40,544. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $39,777 was 4% below the state average of $41,628. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $14,900 was 29% below the state average of $20,986.

Price-transparency record

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

Warning Notice — 2024-02-07 (CMS case 591)
Closure Notice — 2024-05-13 (CMS case 591)
Met Requirements — 2025-06-06 (CMS case 4962)

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.