Arizona / Oro Valley Hospital
CMS certification 030114 · Oro Valley, AZ · 1 entry in CMS's price-transparency list
Oro Valley Hospital: charges and Medicare payments
Oro Valley Hospital reported 1,207 Medicare inpatient stays across 37 DRGs in 2024. Across them it charged 7.72 times what it was paid — among the higher ratios in Arizona, number 12 of 53 hospitals with at least 100 stays (state median 5×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 166 stays at an average charge of $85,366, 5% below the national average. It also billed 1,481 outpatient services, charging 12.53 times what Medicare paid.
- 1Medicare inpatient stays 1,207
- 2Charge ÷ paid, inpatient 7.72×
- 3Rank in AZ (highest ratio = 1) 12 of 53
- 4CMS price-transparency actions 1
Inpatient stays
For the 37 DRGs that can be compared with the national average, Oro Valley Hospital charged more than the national average in 32 (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 | 166 | $85,366 | -5% | $13,599 |
| 291 Heart Failure and Shock with MCC | 130 | $73,372 | +30% | $9,046 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 66 | $131,518 | +41% | $13,814 |
| 177 Respiratory Infections and Inflammations with MCC | 58 | $69,862 | -1% | $11,952 |
| 193 Simple Pneumonia and Pleurisy with MCC | 57 | $73,534 | +23% | $9,710 |
| 481 Hip and Femur Procedures except Major Joint with CC | 47 | $130,738 | +30% | $14,531 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 43 | $53,648 | +9% | $7,441 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 33 | $69,450 | +15% | $8,948 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 33 | $48,787 | +32% | $5,709 |
| 683 Renal Failure with CC | 33 | $45,774 | +12% | $6,197 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 32 | $71,267 | +41% | $8,261 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 30 | $136,926 | +34% | $14,921 |
| 690 Kidney and Urinary Tract Infections without MCC | 30 | $49,494 | +31% | $5,808 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 28 | $79,156 | +42% | $7,009 |
| 467 Revision of Hip or Knee Replacement with CC | 28 | $196,292 | +24% | $25,621 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 27 | $48,192 | +20% | $5,728 |
| 603 Cellulitis without MCC | 25 | $47,360 | +27% | $6,618 |
| 682 Renal Failure with MCC | 22 | $63,529 | -4% | $10,571 |
| 689 Kidney and Urinary Tract Infections with MCC | 22 | $59,309 | +16% | $8,291 |
| 312 Syncope and Collapse | 21 | $59,012 | +30% | $6,312 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $58,737 | +2% | $8,990 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 20 | $50,529 | +40% | $5,398 |
| 389 Gastrointestinal Obstruction with CC | 19 | $45,894 | +18% | $5,692 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 19 | $159,583 | +29% | $20,836 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 18 | $49,110 | +15% | $6,270 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $56,970 | -22% | $11,477 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 17 | $153,561 | +11% | $19,514 |
| 536 Fractures of Hip and Pelvis without MCC | 17 | $44,003 | +17% | $5,597 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 16 | $72,151 | +27% | $8,057 |
| 552 Medical Back Problems without MCC | 16 | $60,216 | +23% | $6,950 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 15 | $80,312 | +23% | $9,513 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 15 | $67,743 | -11% | $10,141 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $82,374 | +35% | $9,612 |
| 521 Hip Replacement with Principal Diagnosis of Hip Fracture... | 14 | $174,765 | +29% | $19,600 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $71,576 | +47% | $7,137 |
| 178 Respiratory Infections and Inflammations with CC | 12 | $55,048 | +21% | $7,198 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 12 | $123,511 | +4% | $16,743 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 426 | $110,504 | $12,683 |
| Comprehensive Observation Services | 413 | $44,080 | $2,669 |
| Level 4 Musculoskeletal Procedures | 119 | $73,646 | $6,821 |
| Level 2 Upper GI Procedures | 92 | $19,321 | $1,824 |
| Level 1 Laparoscopy and Related Services | 92 | $73,241 | $5,592 |
| Level 3 Musculoskeletal Procedures | 81 | $46,222 | $3,125 |
| Level 6 Musculoskeletal Procedures | 53 | $136,946 | $18,131 |
| Level 2 Laparoscopy and Related Services | 39 | $167,200 | $9,814 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 32 | $41,408 | $2,771 |
| Level 2 Musculoskeletal Procedures | 25 | $21,768 | $1,567 |
| Level 3 Vascular Procedures | 24 | $35,371 | $3,108 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 21 | $59,104 | $3,374 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 20 | $25,405 | $1,581 |
| Level 2 Vascular Procedures | 15 | $18,745 | $1,562 |
| Level 1 Nerve Procedures | 15 | $30,736 | $1,883 |
| Level 5 Gynecologic Procedures | 14 | $83,615 | $4,850 |
Against the Arizona average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Oro Valley Hospital charged $85,366 on average, 3% less than the Arizona average of $87,638, and was paid $13,599 against a state average of $17,455. For Heart Failure and Shock with MCC (DRG 291), Oro Valley Hospital charged $73,372 on average, 23% more than the Arizona average of $59,877, and was paid $9,046 against a state average of $11,479. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Oro Valley Hospital charged $131,518 on average, 18% more than the Arizona average of $111,535, and was paid $13,814 against a state average of $15,451. For Respiratory Infections and Inflammations with MCC (DRG 177), Oro Valley Hospital charged $69,862 on average, 1% less than the Arizona average of $70,869, and was paid $11,952 against a state average of $14,917. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $110,504 was 21% above the state average of $91,091. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $44,080 was 83% above the state average of $24,129. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $73,646 was 27% above the state average of $57,782. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $19,321 was 33% above the state average of $14,511.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Oro Valley Hospital in Oro Valley, AZ, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-08 (CMS case 3676)
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.