California / Providence St Mary Medical Center
CMS certification 050300 · Apple Valley, CA
Providence St Mary Medical Center: charges and Medicare payments
Providence St Mary Medical Center reported 1,594 Medicare inpatient stays across 52 DRGs in 2024. Across them it charged 4.66 times what it was paid — mid-range in California, number 154 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: 327 stays at an average charge of $98,632, 9% above the national average. It also billed 1,351 outpatient services, charging 7.12 times what Medicare paid.
- 1Medicare inpatient stays 1,594
- 2Charge ÷ paid, inpatient 4.66×
- 3Rank in CA (highest ratio = 1) 154 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 52 DRGs that can be compared with the national average, Providence St Mary Medical Center charged more than the national average in 27 (52%). 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 | 327 | $98,632 | +9% | $21,560 |
| 291 Heart Failure and Shock with MCC | 164 | $68,097 | +21% | $13,299 |
| 193 Simple Pneumonia and Pleurisy with MCC | 87 | $60,392 | +1% | $13,836 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 51 | $50,766 | +4% | $11,063 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 49 | $79,270 | +8% | $16,782 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 38 | $235,589 | +3% | $51,306 |
| 682 Renal Failure with MCC | 37 | $63,756 | -3% | $15,008 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 36 | $51,884 | -7% | $10,382 |
| 177 Respiratory Infections and Inflammations with MCC | 36 | $106,655 | +51% | $17,498 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 34 | $90,530 | -9% | $19,236 |
| 377 Gastrointestinal Hemorrhage with MCC | 28 | $72,646 | -15% | $18,052 |
| 689 Kidney and Urinary Tract Infections with MCC | 28 | $57,223 | +11% | $12,053 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 27 | $112,955 | +49% | $18,981 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 25 | $56,391 | -6% | $13,823 |
| 432 Cirrhosis and Alcoholic Hepatitis with MCC | 24 | $52,303 | -45% | $20,318 |
| 314 Other Circulatory System Diagnoses with MCC | 23 | $105,202 | +11% | $21,236 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $51,888 | +37% | $10,949 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 22 | $63,441 | +12% | $13,024 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 22 | $36,215 | 0% | $8,015 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $44,490 | +11% | $9,354 |
| 683 Renal Failure with CC | 22 | $38,612 | -5% | $9,479 |
| 637 Diabetes with MCC | 21 | $59,005 | -11% | $14,208 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $66,538 | +16% | $13,077 |
| 603 Cellulitis without MCC | 20 | $43,525 | +17% | $9,430 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 20 | $329,447 | +2% | $65,806 |
| 299 Peripheral Vascular Disorders with MCC | 19 | $71,578 | -5% | $16,269 |
| 389 Gastrointestinal Obstruction with CC | 19 | $40,516 | +4% | $8,462 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 18 | $88,020 | -22% | $22,278 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 18 | $52,311 | -18% | $11,574 |
| 602 Cellulitis with MCC | 18 | $55,237 | -8% | $14,332 |
| 312 Syncope and Collapse | 17 | $57,370 | +26% | $9,813 |
| 388 Gastrointestinal Obstruction with MCC | 16 | $76,684 | +12% | $14,682 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 16 | $61,784 | +30% | $10,586 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 15 | $44,474 | -12% | $9,456 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $123,281 | -25% | $29,245 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $79,221 | -31% | $18,888 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $56,042 | -8% | $13,342 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 15 | $126,805 | +24% | $21,378 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 14 | $53,987 | +7% | $11,598 |
| 481 Hip and Femur Procedures except Major Joint with CC | 14 | $128,107 | +27% | $21,234 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 13 | $63,248 | -3% | $14,189 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 13 | $157,086 | +16% | $36,202 |
| 313 Chest Pain | 13 | $28,089 | -30% | $7,898 |
| 070 Other Cerebrovascular Disorders with MCC | 12 | $63,405 | -17% | $18,068 |
| 100 Seizures with MCC | 12 | $67,594 | -28% | $19,056 |
| 252 Other Vascular Procedures with MCC | 12 | $157,975 | -8% | $34,117 |
| 300 Peripheral Vascular Disorders with CC | 12 | $45,871 | -7% | $13,602 |
| 441 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic... | 12 | $75,123 | -13% | $16,970 |
| 638 Diabetes with CC | 12 | $50,174 | +20% | $9,702 |
| 378 Gastrointestinal Hemorrhage with CC | 11 | $53,312 | +10% | $10,505 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 11 | $123,991 | -11% | $28,799 |
| 673 Other Kidney and Urinary Tract Procedures with MCC | 11 | $244,820 | +41% | $44,183 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Providence St Mary Medical Center charged $98,632 on average, 31% less than the California average of $143,063, and was paid $21,560 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Providence St Mary Medical Center charged $68,097 on average, 32% less than the California average of $100,739, and was paid $13,299 against a state average of $15,556. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Providence St Mary Medical Center charged $60,392 on average, 42% less than the California average of $103,761, and was paid $13,836 against a state average of $15,112. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Providence St Mary Medical Center charged $50,766 on average, 33% less than the California average of $76,120, and was paid $11,063 against a state average of $12,552. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $32,740 was 21% below the state average of $41,628. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $22,093 was 46% below the state average of $40,544. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,415 was 43% below the state average of $14,749. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,732 was 49% below the state average of $20,986.
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.