California / St Mary's Medical Center
CMS certification 050457 · San Francisco, CA · 4 entries in CMS's price-transparency list
St Mary's Medical Center: charges and Medicare payments
St Mary's Medical Center reported 861 Medicare inpatient stays across 29 DRGs in 2024. Across them it charged 5.96 times what it was paid — mid-range in California, number 90 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: 200 stays at an average charge of $158,017, 75% above the national average. It also billed 540 outpatient services, charging 6.53 times what Medicare paid.
- 1Medicare inpatient stays 861
- 2Charge ÷ paid, inpatient 5.96×
- 3Rank in CA (highest ratio = 1) 90 of 247
- 4CMS price-transparency actions 4
Inpatient stays
For the 29 DRGs that can be compared with the national average, St Mary's Medical Center charged more than the national average in 29 (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 | 200 | $158,017 | +75% | $28,112 |
| 291 Heart Failure and Shock with MCC | 86 | $143,614 | +155% | $18,731 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 46 | $132,780 | +42% | $26,469 |
| 177 Respiratory Infections and Inflammations with MCC | 44 | $107,017 | +52% | $22,824 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 33 | $489,667 | +114% | $75,399 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 33 | $110,475 | +125% | $14,749 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $122,725 | +104% | $19,308 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 27 | $172,994 | +128% | $23,196 |
| 377 Gastrointestinal Hemorrhage with MCC | 27 | $169,257 | +98% | $27,551 |
| 690 Kidney and Urinary Tract Infections without MCC | 25 | $54,551 | +44% | $11,995 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 22 | $76,482 | +106% | $11,854 |
| 193 Simple Pneumonia and Pleurisy with MCC | 21 | $85,823 | +44% | $18,320 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 20 | $70,721 | +40% | $15,757 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 20 | $61,325 | +53% | $11,507 |
| 682 Renal Failure with MCC | 20 | $109,034 | +65% | $20,911 |
| 683 Renal Failure with CC | 20 | $73,105 | +80% | $13,296 |
| 603 Cellulitis without MCC | 19 | $64,327 | +73% | $12,561 |
| 689 Kidney and Urinary Tract Infections with MCC | 19 | $82,474 | +61% | $17,008 |
| 312 Syncope and Collapse | 18 | $87,489 | +92% | $13,713 |
| 189 Pulmonary Edema and Respiratory Failure | 15 | $91,180 | +58% | $17,716 |
| 637 Diabetes with MCC | 15 | $144,277 | +117% | $21,495 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 15 | $128,750 | +75% | $23,835 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 14 | $107,105 | +76% | $18,850 |
| 552 Medical Back Problems without MCC | 14 | $81,783 | +67% | $14,512 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $94,120 | +94% | $14,552 |
| 638 Diabetes with CC | 13 | $65,196 | +56% | $12,643 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 11 | $170,872 | +71% | $25,852 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 11 | $142,380 | +156% | $15,518 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $194,521 | +93% | $29,595 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 93 | $33,680 | $3,913 |
| Level 2 Intraocular Procedures | 73 | $31,754 | $5,812 |
| Level 5 Musculoskeletal Procedures | 49 | $82,802 | $18,419 |
| Level 3 Musculoskeletal Procedures | 38 | $23,424 | $4,627 |
| Level 1 Endovascular Procedures | 36 | $34,086 | $4,665 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 32 | $13,070 | $2,318 |
| Level 2 Musculoskeletal Procedures | 28 | $11,269 | $2,297 |
| Level 4 Musculoskeletal Procedures | 26 | $50,528 | $10,217 |
| Level 3 Vascular Procedures | 22 | $24,481 | $4,556 |
| Level 2 Endovascular Procedures | 21 | $45,064 | $8,170 |
| Level 3 Endovascular Procedures | 19 | $109,988 | $15,694 |
| Level 3 Pacemaker and Similar Procedures | 19 | $57,531 | $15,234 |
| Level 1 Nerve Procedures | 19 | $13,010 | $2,644 |
| Level 2 Breast/Lymphatic Surgery and Related Procedures | 16 | $49,165 | $9,316 |
| Level 4 Endovascular Procedures | 14 | $125,726 | $24,996 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 13 | $14,332 | $3,813 |
| Level 1 Laparoscopy and Related Services | 11 | $43,219 | $7,667 |
| Level 1 Intraocular Procedures | 11 | $39,910 | $3,090 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Mary's Medical Center charged $158,017 on average, 10% more than the California average of $143,063, and was paid $28,112 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), St Mary's Medical Center charged $143,614 on average, 43% more than the California average of $100,739, and was paid $18,731 against a state average of $15,556. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), St Mary's Medical Center charged $132,780 on average, 4% less than the California average of $137,972, and was paid $26,469 against a state average of $21,800. For Respiratory Infections and Inflammations with MCC (DRG 177), St Mary's Medical Center charged $107,017 on average, 14% less than the California average of $124,302, and was paid $22,824 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $33,680 was 19% below the state average of $41,628. For Level 2 Intraocular Procedures (outpatient APC 5492), its average charge of $31,754 was 21% below the state average of $40,214. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $82,802 was 24% below the state average of $109,149. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $23,424 was 35% below the state average of $36,238.
Price-transparency record
CMS's enforcement list records these actions for a hospital named St Mary's Medical Center in San Francisco, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-05 (CMS case 605)
- Met Requirements — 2024-03-28 (CMS case 2350)
- Warning Notice — 2025-04-23 (CMS case 3954)
- Closure Notice — 2025-05-30 (CMS case 3954)
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.