Mercy Hospital: charges and Medicare payments

Mercy Hospital reported 1,532 Medicare inpatient stays across 42 DRGs in 2024. Across them it charged 5.79 times what it was paid — mid-range in California, number 95 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: 337 stays at an average charge of $111,566, 24% above the national average. It also billed 1,302 outpatient services, charging 9.1 times what Medicare paid.

1Medicare inpatient stays 1,532
2Charge ÷ paid, inpatient 5.79×
3Rank in CA (highest ratio = 1) 95 of 247
4CMS price-transparency actions 0

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

Inpatient stays

For the 42 DRGs that can be compared with the national average, Mercy Hospital charged more than the national average in 36 (86%). 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	337	$111,566	+24%	$19,590
193 Simple Pneumonia and Pleurisy with MCC	121	$83,964	+41%	$13,562
291 Heart Failure and Shock with MCC	78	$79,964	+42%	$13,324
177 Respiratory Infections and Inflammations with MCC	69	$112,179	+59%	$16,881
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	66	$58,006	+18%	$11,148
698 Other Kidney and Urinary Tract Diagnoses with MCC	56	$77,032	+5%	$16,064
481 Hip and Femur Procedures except Major Joint with CC	50	$114,452	+14%	$20,570
853 Infectious and Parasitic Diseases with O.R. Procedures with...	46	$223,463	-2%	$46,512
189 Pulmonary Edema and Respiratory Failure	44	$106,075	+84%	$13,822
682 Renal Failure with MCC	38	$71,721	+9%	$14,822
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	37	$69,938	+26%	$10,007
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	33	$88,338	+47%	$13,346
378 Gastrointestinal Hemorrhage with CC	31	$60,575	+25%	$10,230
377 Gastrointestinal Hemorrhage with MCC	30	$143,290	+68%	$19,678
689 Kidney and Urinary Tract Infections with MCC	30	$63,747	+24%	$11,472
683 Renal Failure with CC	29	$54,783	+35%	$9,266
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	26	$50,430	+36%	$9,244
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	25	$69,273	+14%	$13,799
330 Major Small and Large Bowel Procedures with CC	24	$125,965	+6%	$22,820
389 Gastrointestinal Obstruction with CC	24	$50,045	+29%	$8,801
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	22	$99,838	0%	$18,850
190 Chronic Obstructive Pulmonary Disease with MCC	20	$71,093	+41%	$11,536
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	20	$48,588	+21%	$9,526
870 Septicemia or Severe Sepsis with MV >96 Hours	20	$567,375	+75%	$81,190
280 Acute Myocardial Infarction, Discharged Alive with MCC	17	$72,748	-4%	$14,134
854 Infectious and Parasitic Diseases with O.R. Procedures with...	17	$91,919	-6%	$20,359
331 Major Small and Large Bowel Procedures without CC/MCC	16	$106,164	+24%	$18,211
480 Hip and Femur Procedures except Major Joint with MCC	16	$129,608	-7%	$28,291
637 Diabetes with MCC	16	$96,267	+45%	$14,967
638 Diabetes with CC	16	$47,273	+13%	$9,673
690 Kidney and Urinary Tract Infections without MCC	16	$49,541	+31%	$8,560
314 Other Circulatory System Diagnoses with MCC	14	$81,632	-14%	$19,674
394 Other Digestive System Diagnoses with CC	14	$59,927	+27%	$9,880
070 Other Cerebrovascular Disorders with MCC	13	$142,340	+87%	$24,083
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	13	$87,301	+34%	$14,421
194 Simple Pneumonia and Pleurisy with CC	13	$64,012	+67%	$8,717
308 Cardiac Arrhythmia and Conduction Disorders with MCC	13	$70,997	+25%	$12,378
482 Hip and Femur Procedures except Major Joint without CC/MCC	13	$84,881	+9%	$16,149
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	13	$117,119	+14%	$20,800
603 Cellulitis without MCC	13	$42,021	+13%	$9,099
208 Respiratory System Diagnosis with Ventilator Support <=96...	12	$164,096	+21%	$27,001
917 Poisoning and Toxic Effects of Drugs with MCC	11	$124,663	+66%	$16,867

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	510	$38,158	$3,349
Level 1 Laparoscopy and Related Services	123	$52,869	$7,003
Level 5 Musculoskeletal Procedures	106	$82,285	$16,148
Level 2 Upper GI Procedures	94	$19,595	$2,320
Level 4 Urology and Related Services	55	$24,571	$4,188
Level 3 Vascular Procedures	48	$24,003	$3,772
Level 5 Urology and Related Services	40	$32,841	$6,362
Level 5 Gynecologic Procedures	34	$30,623	$5,972
Level 2 Laparoscopy and Related Services	33	$74,586	$11,637
Level 4 Musculoskeletal Procedures	32	$62,580	$8,345
Level 2 Musculoskeletal Procedures	30	$14,717	$1,923
Level 3 Musculoskeletal Procedures	30	$30,258	$3,874
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	28	$37,106	$4,254
Level 2 Breast/Lymphatic Surgery and Related Procedures	22	$64,713	$8,017
Level 2 Vascular Procedures	21	$24,385	$1,969
Level 3 Urology and Related Services	19	$19,053	$2,504
Level 3 Excision/ Biopsy/ Incision and Drainage	17	$21,069	$3,494
Implantation of Drug Infusion Device	14	$81,861	$18,979
Level 3 Extraocular, Repair, and Plastic Eye Procedures	13	$23,549	$2,873
Level 1 Breast/Lymphatic Surgery and Related Procedures	11	$28,327	$4,347
Complex GI Procedures	11	$45,232	$6,688
Level 1 Nerve Procedures	11	$24,927	$2,374

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mercy Hospital charged $111,566 on average, 22% less than the California average of $143,063, and was paid $19,590 against a state average of $23,020. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Mercy Hospital charged $83,964 on average, 19% less than the California average of $103,761, and was paid $13,562 against a state average of $15,112. For Heart Failure and Shock with MCC (DRG 291), Mercy Hospital charged $79,964 on average, 21% less than the California average of $100,739, and was paid $13,324 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Mercy Hospital charged $112,179 on average, 10% less than the California average of $124,302, and was paid $16,881 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $38,158 was 8% below the state average of $41,628. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $52,869 was 18% below the state average of $64,351. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $82,285 was 25% below the state average of $109,149. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $19,595 was 3% above the state average of $19,034.

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.