California / San Antonio Regional Hospital
CMS certification 050099 · Upland, CA · 5 entries in CMS's price-transparency list
San Antonio Regional Hospital: charges and Medicare payments
San Antonio Regional Hospital reported 2,247 Medicare inpatient stays across 70 DRGs in 2024. Across them it charged 8.02 times what it was paid — among the higher ratios in California, number 38 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: 253 stays at an average charge of $158,124, 75% above the national average. It also billed 1,568 outpatient services, charging 11.45 times what Medicare paid.
- 1Medicare inpatient stays 2,247
- 2Charge ÷ paid, inpatient 8.02×
- 3Rank in CA (highest ratio = 1) 38 of 247
- 4CMS price-transparency actions 5
Inpatient stays
For the 70 DRGs that can be compared with the national average, San Antonio Regional Hospital charged more than the national average in 68 (97%). 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 | 253 | $158,124 | +75% | $19,185 |
| 291 Heart Failure and Shock with MCC | 157 | $107,286 | +90% | $13,110 |
| 177 Respiratory Infections and Inflammations with MCC | 125 | $138,046 | +96% | $16,715 |
| 193 Simple Pneumonia and Pleurisy with MCC | 109 | $108,976 | +82% | $13,178 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 75 | $94,404 | +57% | $13,495 |
| 689 Kidney and Urinary Tract Infections with MCC | 74 | $93,512 | +82% | $11,520 |
| 690 Kidney and Urinary Tract Infections without MCC | 66 | $60,703 | +61% | $7,957 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 58 | $144,005 | +90% | $16,997 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 51 | $106,178 | +91% | $10,113 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 44 | $88,274 | +80% | $10,630 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 41 | $57,268 | +43% | $8,023 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 40 | $211,589 | +112% | $19,894 |
| 378 Gastrointestinal Hemorrhage with CC | 38 | $68,606 | +41% | $10,297 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 35 | $57,328 | +55% | $7,874 |
| 682 Renal Failure with MCC | 35 | $135,754 | +106% | $14,743 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 33 | $402,728 | +76% | $47,734 |
| 389 Gastrointestinal Obstruction with CC | 32 | $61,586 | +58% | $8,120 |
| 603 Cellulitis without MCC | 32 | $61,860 | +66% | $8,725 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 31 | $551,089 | +70% | $66,268 |
| 194 Simple Pneumonia and Pleurisy with CC | 29 | $63,859 | +66% | $8,289 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 27 | $64,404 | +78% | $7,626 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 27 | $49,200 | +71% | $5,912 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 27 | $125,422 | +71% | $15,787 |
| 189 Pulmonary Edema and Respiratory Failure | 26 | $87,889 | +53% | $12,334 |
| 207 Respiratory System Diagnosis with Ventilator Support >96... | 26 | $392,942 | +34% | $59,792 |
| 377 Gastrointestinal Hemorrhage with MCC | 26 | $121,507 | +42% | $17,622 |
| 312 Syncope and Collapse | 25 | $75,015 | +65% | $9,099 |
| 330 Major Small and Large Bowel Procedures with CC | 25 | $178,513 | +50% | $22,973 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 24 | $269,841 | +433% | $31,978 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 24 | $210,090 | +83% | $17,983 |
| 683 Renal Failure with CC | 24 | $68,831 | +69% | $9,269 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 23 | $97,999 | +73% | $12,076 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 22 | $122,151 | +91% | $10,910 |
| 390 Gastrointestinal Obstruction without CC/MCC | 22 | $51,494 | +84% | $6,409 |
| 393 Other Digestive System Diagnoses with MCC | 21 | $143,053 | +86% | $16,175 |
| 418 Laparoscopic Cholecystectomy without C.D.E. with CC | 21 | $135,904 | +46% | $18,569 |
| 481 Hip and Femur Procedures except Major Joint with CC | 21 | $154,442 | +53% | $20,265 |
| 637 Diabetes with MCC | 21 | $91,778 | +38% | $13,575 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 19 | $109,696 | +68% | $15,517 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 19 | $84,679 | +68% | $9,077 |
| 394 Other Digestive System Diagnoses with CC | 19 | $76,132 | +62% | $10,407 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 19 | $126,195 | +23% | $20,319 |
| 100 Seizures with MCC | 18 | $150,290 | +59% | $18,335 |
| 092 Other Disorders of Nervous System with CC | 17 | $95,493 | +85% | $10,234 |
| 638 Diabetes with CC | 17 | $78,150 | +88% | $9,431 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 16 | $162,939 | +45% | $21,425 |
| 811 Red Blood Cell Disorders with MCC | 16 | $74,631 | +9% | $13,757 |
| 812 Red Blood Cell Disorders without MCC | 16 | $38,225 | -14% | $9,195 |
| 101 Seizures without MCC | 15 | $78,449 | +61% | $9,098 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $324,851 | +98% | $29,757 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 15 | $79,551 | +68% | $10,217 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 14 | $171,022 | +26% | $26,488 |
| 314 Other Circulatory System Diagnoses with MCC | 14 | $161,474 | +70% | $20,009 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 14 | $137,094 | +125% | $12,786 |
| 536 Fractures of Hip and Pelvis without MCC | 14 | $70,276 | +86% | $7,961 |
| 552 Medical Back Problems without MCC | 14 | $71,730 | +47% | $9,851 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 14 | $299,668 | +39% | $44,290 |
| 282 Acute Myocardial Infarction, Discharged Alive without CC/MCC | 13 | $68,440 | +58% | $7,492 |
| 329 Major Small and Large Bowel Procedures with MCC | 13 | $343,965 | +60% | $40,982 |
| 948 Signs and Symptoms without MCC | 13 | $45,865 | +20% | $8,058 |
Showing the 60 most frequent of 70 DRGs.
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), San Antonio Regional Hospital charged $158,124 on average, 11% more than the California average of $143,063, and was paid $19,185 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), San Antonio Regional Hospital charged $107,286 on average, 6% more than the California average of $100,739, and was paid $13,110 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), San Antonio Regional Hospital charged $138,046 on average, 11% more than the California average of $124,302, and was paid $16,715 against a state average of $18,986. For Simple Pneumonia and Pleurisy with MCC (DRG 193), San Antonio Regional Hospital charged $108,976 on average, 5% more than the California average of $103,761, and was paid $13,178 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $46,302 was 11% above the state average of $41,628. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $70,002 was 73% above the state average of $40,544. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $17,820 was 21% above the state average of $14,749. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $26,121 was 13% below the state average of $30,190.
Price-transparency record
CMS's enforcement list records these actions for a hospital named San Antonio Regional Hospital in Upland, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-03-27 (CMS case 944)
- Warning Notice — 2024-08-08 (CMS case 2299)
- CAP Request — 2024-11-12 (CMS case 2299)
- Closure Notice — 2024-12-30 (CMS case 2299)
- Met Requirements — 2025-07-31 (CMS case 6075)
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.