California / Providence Queen of the Valley Medical Center
CMS certification 050009 · Napa, CA · 3 entries in CMS's price-transparency list
Providence Queen of the Valley Medical Center: charges and Medicare payments
Providence Queen of the Valley Medical Center reported 1,381 Medicare inpatient stays across 47 DRGs in 2024. Across them it charged 6.63 times what it was paid — among the higher ratios in California, number 68 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: 268 stays at an average charge of $152,981, 69% above the national average. It also billed 1,893 outpatient services, charging 9.78 times what Medicare paid.
- 1Medicare inpatient stays 1,381
- 2Charge ÷ paid, inpatient 6.63×
- 3Rank in CA (highest ratio = 1) 68 of 247
- 4CMS price-transparency actions 3
Inpatient stays
For the 47 DRGs that can be compared with the national average, Providence Queen of the Valley Medical Center charged more than the national average in 47 (100%). 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 | 268 | $152,981 | +69% | $21,924 |
| 291 Heart Failure and Shock with MCC | 105 | $92,714 | +64% | $14,793 |
| 177 Respiratory Infections and Inflammations with MCC | 75 | $110,067 | +56% | $17,977 |
| 193 Simple Pneumonia and Pleurisy with MCC | 54 | $96,353 | +61% | $14,375 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 47 | $119,541 | +63% | $18,110 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 45 | $113,108 | +49% | $17,124 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 43 | $92,475 | +89% | $15,985 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 38 | $84,310 | +51% | $11,878 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 33 | $77,382 | +109% | $9,383 |
| 689 Kidney and Urinary Tract Infections with MCC | 30 | $104,480 | +104% | $14,325 |
| 189 Pulmonary Edema and Respiratory Failure | 29 | $99,807 | +73% | $14,796 |
| 682 Renal Failure with MCC | 27 | $111,069 | +68% | $16,505 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 26 | $68,452 | +70% | $10,628 |
| 603 Cellulitis without MCC | 26 | $65,807 | +76% | $10,647 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 26 | $87,879 | +46% | $14,868 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 25 | $252,441 | +10% | $46,415 |
| 389 Gastrointestinal Obstruction with CC | 23 | $64,852 | +67% | $10,379 |
| 481 Hip and Femur Procedures except Major Joint with CC | 23 | $164,118 | +63% | $24,615 |
| 683 Renal Failure with CC | 23 | $66,372 | +63% | $10,459 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 22 | $280,774 | +107% | $32,425 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 22 | $101,818 | +80% | $18,266 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 22 | $164,279 | +61% | $23,907 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 19 | $123,127 | +23% | $21,230 |
| 951 Other Factors Influencing Health Status | 19 | $63,318 | +148% | $7,210 |
| 552 Medical Back Problems without MCC | 18 | $88,813 | +82% | $11,559 |
| 690 Kidney and Urinary Tract Infections without MCC | 18 | $67,411 | +78% | $9,394 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $81,284 | +112% | $9,966 |
| 377 Gastrointestinal Hemorrhage with MCC | 17 | $164,576 | +93% | $21,729 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 16 | $70,974 | +97% | $9,003 |
| 378 Gastrointestinal Hemorrhage with CC | 15 | $90,265 | +86% | $11,533 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 15 | $82,570 | +74% | $12,203 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 14 | $88,247 | +74% | $12,627 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 13 | $71,335 | +69% | $8,421 |
| 101 Seizures without MCC | 13 | $105,869 | +117% | $10,964 |
| 242 Permanent Cardiac Pacemaker Implant with MCC | 13 | $238,258 | +48% | $53,942 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 13 | $125,743 | +13% | $26,224 |
| 314 Other Circulatory System Diagnoses with MCC | 13 | $137,916 | +45% | $24,034 |
| 637 Diabetes with MCC | 13 | $150,768 | +127% | $15,980 |
| 638 Diabetes with CC | 13 | $96,988 | +133% | $10,578 |
| 178 Respiratory Infections and Inflammations with CC | 12 | $72,571 | +60% | $11,125 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 12 | $91,088 | +80% | $11,783 |
| 091 Other Disorders of Nervous System with MCC | 11 | $116,578 | +41% | $19,854 |
| 100 Seizures with MCC | 11 | $97,627 | +3% | $22,823 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 11 | $52,805 | +84% | $6,839 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 11 | $180,068 | +57% | $32,255 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $97,939 | +60% | $15,130 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 11 | $282,979 | +31% | $43,984 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Providence Queen of the Valley Medical Center charged $152,981 on average, 7% more than the California average of $143,063, and was paid $21,924 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Providence Queen of the Valley Medical Center charged $92,714 on average, 8% less than the California average of $100,739, and was paid $14,793 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Providence Queen of the Valley Medical Center charged $110,067 on average, 11% less than the California average of $124,302, and was paid $17,977 against a state average of $18,986. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Providence Queen of the Valley Medical Center charged $96,353 on average, 7% less than the California average of $103,761, and was paid $14,375 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $52,413 was 26% above the state average of $41,628. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $25,604 was 22% above the state average of $20,986. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $13,668 was 7% below the state average of $14,749. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $57,946 was 43% above the state average of $40,544.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Providence Queen of the Valley Medical Center in Napa, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-04-27 (CMS case 1395)
- Closure Notice — 2023-08-18 (CMS case 1395)
- Met Requirements — 2025-04-03 (CMS case 3587)
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.