Sierra Medical Center: charges and Medicare payments

Sierra Medical Center reported 766 Medicare inpatient stays across 36 DRGs in 2024. Across them it charged 15.42 times what it was paid — among the higher ratios in Texas, number 1 of 190 hospitals with at least 100 stays (state median 5.35×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 101 stays at an average charge of $230,145, 155% above the national average. It also billed 635 outpatient services, charging 19.99 times what Medicare paid.

1Medicare inpatient stays 766
2Charge ÷ paid, inpatient 15.42×
3Rank in TX (highest ratio = 1) 1 of 190
4CMS price-transparency actions 0

Average charge per stay at Sierra Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 36 DRGs that can be compared with the national average, Sierra Medical Center charged more than the national average in 36 (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	101	$230,145	+155%	$13,595
291 Heart Failure and Shock with MCC	47	$113,175	+101%	$8,913
193 Simple Pneumonia and Pleurisy with MCC	41	$142,858	+139%	$9,510
266 Endovascular Cardiac Valve Replacement and Supplement...	38	$765,916	+169%	$46,709
274 Percutaneous and Other Intracardiac Procedures without MCC	38	$345,773	+121%	$21,104
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	37	$211,192	+111%	$13,541
470 Major Hip and Knee Joint Replacement or Reattachment of...	33	$211,937	+127%	$13,512
177 Respiratory Infections and Inflammations with MCC	25	$139,037	+97%	$11,766
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	22	$137,407	+147%	$7,393
690 Kidney and Urinary Tract Infections without MCC	21	$109,519	+190%	$6,175
853 Infectious and Parasitic Diseases with O.R. Procedures with...	20	$524,112	+129%	$36,581
378 Gastrointestinal Hemorrhage with CC	18	$102,118	+110%	$7,173
286 Circulatory Disorders except AMI, with Cardiac...	16	$227,273	+102%	$16,582
287 Circulatory Disorders except AMI, with Cardiac...	16	$145,786	+128%	$9,062
308 Cardiac Arrhythmia and Conduction Disorders with MCC	15	$100,020	+77%	$8,566
309 Cardiac Arrhythmia and Conduction Disorders with CC	15	$66,280	+84%	$5,613
312 Syncope and Collapse	15	$92,026	+102%	$6,507
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	15	$81,405	+103%	$5,850
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	15	$105,286	+184%	$5,852
689 Kidney and Urinary Tract Infections with MCC	15	$126,016	+146%	$8,104
189 Pulmonary Edema and Respiratory Failure	14	$105,518	+83%	$9,774
280 Acute Myocardial Infarction, Discharged Alive with MCC	14	$176,888	+133%	$11,295
314 Other Circulatory System Diagnoses with MCC	14	$200,008	+111%	$14,111
682 Renal Failure with MCC	14	$141,088	+114%	$9,839
870 Septicemia or Severe Sepsis with MV >96 Hours	14	$559,790	+73%	$42,550
377 Gastrointestinal Hemorrhage with MCC	13	$258,208	+202%	$13,297
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	13	$183,063	+200%	$9,580
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	13	$435,863	+102%	$30,285
069 Transient Ischemia without Thrombolytic	12	$98,266	+95%	$5,954
389 Gastrointestinal Obstruction with CC	12	$59,382	+53%	$5,923
472 Cervical Spinal Fusion with CC	12	$286,825	+101%	$19,811
483 Major Joint or Limb Reattachment Procedures of Upper...	12	$279,774	+122%	$16,871
683 Renal Failure with CC	12	$94,561	+132%	$6,577
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	12	$102,856	+110%	$7,077
393 Other Digestive System Diagnoses with MCC	11	$182,307	+137%	$11,231
698 Other Kidney and Urinary Tract Diagnoses with MCC	11	$247,537	+237%	$11,477

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	67	$174,371	$10,676
Level 2 Excision/ Biopsy/ Incision and Drainage	57	$17,515	$1,370
Level 5 Urology and Related Services	49	$54,547	$4,206
Level 1 Laparoscopy and Related Services	48	$76,763	$4,758
Level 5 Neurostimulator and Related Procedures	47	$375,762	$25,793
Level 1 Endovascular Procedures	41	$67,885	$2,832
Level 4 Urology and Related Services	41	$47,395	$2,849
Level 4 Musculoskeletal Procedures	37	$118,293	$6,207
Level 3 Electrophysiologic Procedures	32	$399,491	$20,557
Level 3 Urology and Related Services	31	$38,619	$1,768
Level 3 Musculoskeletal Procedures	21	$61,188	$2,639
Level 2 Pacemaker and Similar Procedures	20	$97,049	$7,078
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	20	$76,366	$2,882
Level 3 Endovascular Procedures	19	$176,237	$9,540
Level 2 Upper GI Procedures	19	$23,469	$1,651
Level 7 Radiation Therapy	16	$165,605	$6,420
Level 1 Nerve Procedures	15	$44,757	$1,594
Level 2 Musculoskeletal Procedures	14	$31,956	$1,395
Level 3 Vascular Procedures	14	$52,427	$2,766
Level 6 Urology and Related Services	14	$108,446	$7,993
Level 2 Breast/Lymphatic Surgery and Related Procedures	13	$150,498	$5,658

Against the Texas average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Sierra Medical Center charged $230,145 on average, 107% more than the Texas average of $111,133, and was paid $13,595 against a state average of $16,694. For Heart Failure and Shock with MCC (DRG 291), Sierra Medical Center charged $113,175 on average, 67% more than the Texas average of $67,944, and was paid $8,913 against a state average of $11,820. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Sierra Medical Center charged $142,858 on average, 94% more than the Texas average of $73,756, and was paid $9,510 against a state average of $11,597. For Endovascular Cardiac Valve Replacement and Supplement Procedures with MCC (DRG 266), Sierra Medical Center charged $765,916 on average, 106% more than the Texas average of $372,420, and was paid $46,709 against a state average of $49,901. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $174,371 was 77% above the state average of $98,771. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $17,515 was 24% above the state average of $14,089. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $54,547 was 41% above the state average of $38,562. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $76,763 was 51% above the state average of $50,995.

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.