California / Mercy Hospital of Folsom
CMS certification 050414 · Folsom, CA · 2 entries in CMS's price-transparency list
Mercy Hospital of Folsom: charges and Medicare payments
Mercy Hospital of Folsom reported 1,246 Medicare inpatient stays across 41 DRGs in 2024. Across them it charged 6.33 times what it was paid — among the higher ratios in California, number 78 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: 218 stays at an average charge of $112,129, 24% above the national average. It also billed 728 outpatient services, charging 10.81 times what Medicare paid.
- 1Medicare inpatient stays 1,246
- 2Charge ÷ paid, inpatient 6.33×
- 3Rank in CA (highest ratio = 1) 78 of 247
- 4CMS price-transparency actions 2
Inpatient stays
For the 41 DRGs that can be compared with the national average, Mercy Hospital of Folsom charged more than the national average in 39 (95%). 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 | 218 | $112,129 | +24% | $19,759 |
| 291 Heart Failure and Shock with MCC | 125 | $88,091 | +56% | $12,756 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 66 | $63,416 | +29% | $10,246 |
| 177 Respiratory Infections and Inflammations with MCC | 52 | $89,713 | +27% | $16,019 |
| 193 Simple Pneumonia and Pleurisy with MCC | 48 | $87,047 | +46% | $16,802 |
| 378 Gastrointestinal Hemorrhage with CC | 43 | $68,682 | +41% | $10,218 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 39 | $58,091 | +45% | $8,656 |
| 683 Renal Failure with CC | 34 | $60,776 | +49% | $10,011 |
| 689 Kidney and Urinary Tract Infections with MCC | 31 | $64,962 | +27% | $12,769 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 30 | $81,056 | +60% | $11,170 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 29 | $87,327 | +19% | $15,288 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 28 | $72,969 | +31% | $10,013 |
| 690 Kidney and Urinary Tract Infections without MCC | 28 | $56,029 | +48% | $8,282 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 27 | $69,246 | +15% | $13,185 |
| 682 Renal Failure with MCC | 26 | $77,233 | +17% | $14,621 |
| 603 Cellulitis without MCC | 25 | $67,369 | +81% | $9,870 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 24 | $163,569 | +76% | $18,757 |
| 312 Syncope and Collapse | 22 | $71,055 | +56% | $8,852 |
| 377 Gastrointestinal Hemorrhage with MCC | 21 | $102,482 | +20% | $18,121 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 20 | $117,512 | +18% | $18,877 |
| 460 Spinal Fusion except Cervical without MCC | 20 | $321,147 | +89% | $36,013 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 19 | $86,395 | +14% | $14,762 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $59,095 | +59% | $8,051 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 18 | $77,223 | +36% | $11,779 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $61,401 | +60% | $8,446 |
| 389 Gastrointestinal Obstruction with CC | 16 | $59,140 | +52% | $8,184 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 16 | $69,934 | +15% | $12,864 |
| 481 Hip and Femur Procedures except Major Joint with CC | 16 | $149,617 | +48% | $20,296 |
| 189 Pulmonary Edema and Respiratory Failure | 15 | $68,400 | +19% | $12,448 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 15 | $69,927 | +77% | $8,562 |
| 394 Other Digestive System Diagnoses with CC | 15 | $76,387 | +62% | $9,568 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $70,252 | +95% | $7,554 |
| 552 Medical Back Problems without MCC | 14 | $73,358 | +50% | $11,809 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 14 | $222,899 | -3% | $43,371 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 13 | $47,393 | +65% | $5,852 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 12 | $174,129 | +70% | $20,921 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 12 | $73,647 | +99% | $8,834 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 12 | $69,442 | -7% | $18,469 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 11 | $65,064 | +54% | $9,615 |
| 305 Hypertension without MCC | 11 | $65,222 | +63% | $7,781 |
| 637 Diabetes with MCC | 11 | $113,789 | +71% | $13,891 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 448 | $39,291 | $3,459 |
| Level 5 Musculoskeletal Procedures | 89 | $112,374 | $16,263 |
| Level 1 Laparoscopy and Related Services | 50 | $76,169 | $7,370 |
| Level 3 Musculoskeletal Procedures | 38 | $50,434 | $4,134 |
| Level 4 Musculoskeletal Procedures | 30 | $83,134 | $9,132 |
| Level 2 Musculoskeletal Procedures | 21 | $10,980 | $2,053 |
| Level 6 Musculoskeletal Procedures | 16 | $136,794 | $23,737 |
| Level 2 Breast/Lymphatic Surgery and Related Procedures | 13 | $63,660 | $8,327 |
| Level 2 Upper GI Procedures | 12 | $30,935 | $2,430 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 11 | $62,167 | $4,419 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Mercy Hospital of Folsom charged $112,129 on average, 22% less than the California average of $143,063, and was paid $19,759 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Mercy Hospital of Folsom charged $88,091 on average, 13% less than the California average of $100,739, and was paid $12,756 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Mercy Hospital of Folsom charged $63,416 on average, 17% less than the California average of $76,120, and was paid $10,246 against a state average of $12,552. For Respiratory Infections and Inflammations with MCC (DRG 177), Mercy Hospital of Folsom charged $89,713 on average, 28% less than the California average of $124,302, and was paid $16,019 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $39,291 was 6% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $112,374 was 3% above the state average of $109,149. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $76,169 was 18% above the state average of $64,351. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $50,434 was 39% above the state average of $36,238.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Mercy Hospital of Folsom in Folsom, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2022-12-05 (CMS case 593)
- Met Requirements — 2025-06-06 (CMS case 4958)
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.