Stanford Health Care Tri-Valley: charges and Medicare payments

Stanford Health Care Tri-Valley reported 1,579 Medicare inpatient stays across 57 DRGs in 2024. Across them it charged 7.41 times what it was paid — among the higher ratios in California, number 50 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: 282 stays at an average charge of $191,834, 112% above the national average. It also billed 3,665 outpatient services, charging 9.27 times what Medicare paid.

1Medicare inpatient stays 1,579
2Charge ÷ paid, inpatient 7.41×
3Rank in CA (highest ratio = 1) 50 of 247
4CMS price-transparency actions 0

Average charge per stay at Stanford Health Care Tri-Valley, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 57 DRGs that can be compared with the national average, Stanford Health Care Tri-Valley charged more than the national average in 56 (98%). 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	282	$191,834	+112%	$24,163
291 Heart Failure and Shock with MCC	146	$139,992	+148%	$14,563
177 Respiratory Infections and Inflammations with MCC	72	$167,573	+137%	$18,517
193 Simple Pneumonia and Pleurisy with MCC	42	$126,487	+112%	$14,132
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	39	$102,462	+109%	$15,065
189 Pulmonary Edema and Respiratory Failure	34	$170,956	+197%	$15,787
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	33	$176,645	+77%	$24,010
454 Combined Anterior and Posterior Spinal Fusion with CC	33	$260,155	-7%	$67,249
280 Acute Myocardial Infarction, Discharged Alive with MCC	32	$155,080	+105%	$20,125
689 Kidney and Urinary Tract Infections with MCC	32	$113,810	+122%	$12,819
682 Renal Failure with MCC	30	$166,834	+153%	$27,952
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	29	$119,333	+114%	$11,529
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	29	$124,455	+106%	$15,190
698 Other Kidney and Urinary Tract Diagnoses with MCC	29	$164,060	+123%	$18,174
683 Renal Failure with CC	28	$95,231	+134%	$10,246
377 Gastrointestinal Hemorrhage with MCC	27	$188,544	+121%	$22,117
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	27	$216,880	+7%	$51,012
252 Other Vascular Procedures with MCC	26	$327,264	+92%	$45,561
853 Infectious and Parasitic Diseases with O.R. Procedures with...	26	$412,543	+80%	$60,874
470 Major Hip and Knee Joint Replacement or Reattachment of...	24	$143,012	+53%	$21,114
267 Endovascular Cardiac Valve Replacement and Supplement...	23	$240,555	+9%	$52,984
378 Gastrointestinal Hemorrhage with CC	21	$107,618	+122%	$11,157
190 Chronic Obstructive Pulmonary Disease with MCC	20	$187,745	+271%	$18,128
322 Percutaneous Cardiovascular Procedures with Intraluminal...	20	$183,438	+60%	$21,276
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	20	$100,561	+150%	$9,155
690 Kidney and Urinary Tract Infections without MCC	20	$80,323	+112%	$9,110
286 Circulatory Disorders except AMI, with Cardiac...	19	$320,906	+186%	$40,903
308 Cardiac Arrhythmia and Conduction Disorders with MCC	19	$114,250	+102%	$13,704
253 Other Vascular Procedures with CC	18	$253,863	+93%	$28,910
481 Hip and Femur Procedures except Major Joint with CC	18	$160,263	+59%	$22,582
056 Degenerative Nervous System Disorders with MCC	17	$197,467	+106%	$22,967
270 Other Major Cardiovascular Procedures with MCC	17	$639,554	+147%	$93,872
271 Other Major Cardiovascular Procedures with CC	17	$291,622	+68%	$51,201
057 Degenerative Nervous System Disorders without MCC	16	$95,311	+68%	$14,777
389 Gastrointestinal Obstruction with CC	16	$78,396	+101%	$9,302
603 Cellulitis without MCC	16	$79,854	+114%	$10,250
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	16	$452,340	+109%	$53,295
164 Major Chest Procedures with CC	15	$228,447	+79%	$28,049
180 Respiratory Neoplasms with MCC	15	$137,985	+57%	$20,451
269 Aortic and Heart Assist Procedures except Pulsation Balloon...	14	$290,718	+51%	$45,891
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	14	$187,618	+83%	$25,004
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	13	$136,499	+124%	$14,528
543 Pathological Fractures and Musculoskeletal and Connective...	13	$78,883	+61%	$12,474
100 Seizures with MCC	12	$106,930	+13%	$20,094
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	12	$154,258	+137%	$14,639
309 Cardiac Arrhythmia and Conduction Disorders with CC	12	$96,822	+168%	$8,706
314 Other Circulatory System Diagnoses with MCC	12	$187,860	+98%	$23,036
321 Percutaneous Cardiovascular Procedures with Intraluminal...	12	$250,408	+53%	$32,032
330 Major Small and Large Bowel Procedures with CC	12	$189,283	+59%	$28,303
637 Diabetes with MCC	12	$160,682	+142%	$18,393
673 Other Kidney and Urinary Tract Procedures with MCC	12	$227,454	+31%	$41,080
243 Permanent Cardiac Pacemaker Implant with CC	11	$195,200	+76%	$42,367
435 Malignancy of Hepatobiliary System or Pancreas with MCC	11	$170,244	+80%	$19,979
469 Major Hip and Knee Joint Replacement or Reattachment of...	11	$187,664	+25%	$32,547
519 Back and Neck Procedures except Spinal Fusion with CC	11	$235,134	+125%	$23,951
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	11	$258,895	+91%	$31,723
919 Complications of Treatment with MCC	11	$165,465	+87%	$25,089

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Intraocular Procedures	530	$41,991	$3,262
Comprehensive Observation Services	488	$54,565	$3,848
Level 5 Musculoskeletal Procedures	420	$95,440	$18,437
Level 1 Endovascular Procedures	225	$53,855	$4,567
Level 2 Excision/ Biopsy/ Incision and Drainage	216	$15,840	$2,283
Level 4 Musculoskeletal Procedures	147	$77,296	$10,066
Level 2 Upper GI Procedures	142	$29,580	$2,664
Level 1 Laparoscopy and Related Services	139	$77,589	$7,910
Level 3 Vascular Procedures	117	$34,899	$4,458
Level 3 Endovascular Procedures	116	$114,228	$15,223
Level 1 Nerve Procedures	109	$18,045	$2,719
Level 5 Urology and Related Services	104	$54,332	$7,286
Level 3 Musculoskeletal Procedures	82	$47,718	$4,447
Level 2 Endovascular Procedures	71	$57,165	$8,048
Level 4 Endovascular Procedures	71	$128,482	$24,278
Level 4 Vascular Procedures	58	$57,068	$7,635
Level 2 Musculoskeletal Procedures	56	$23,123	$2,142
Level 3 Pacemaker and Similar Procedures	53	$67,686	$15,008
Level 4 Urology and Related Services	46	$45,457	$4,909
Level 2 Breast/Lymphatic Surgery and Related Procedures	40	$102,900	$9,178
Level 2 Vascular Procedures	38	$30,976	$2,255
Complex GI Procedures	38	$38,152	$7,181
Level 3 Urology and Related Services	36	$32,487	$2,868
Level 1 Breast/Lymphatic Surgery and Related Procedures	35	$56,520	$5,368
Level 2 Neurostimulator and Related Procedures	35	$40,036	$5,821

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Stanford Health Care Tri-Valley charged $191,834 on average, 34% more than the California average of $143,063, and was paid $24,163 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Stanford Health Care Tri-Valley charged $139,992 on average, 39% more than the California average of $100,739, and was paid $14,563 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Stanford Health Care Tri-Valley charged $167,573 on average, 35% more than the California average of $124,302, and was paid $18,517 against a state average of $18,986. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Stanford Health Care Tri-Valley charged $126,487 on average, 22% more than the California average of $103,761, and was paid $14,132 against a state average of $15,112. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $41,991 was 100% above the state average of $20,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $54,565 was 31% above the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $95,440 was 13% below the state average of $109,149. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $53,855 was 33% above the state average of $40,544.

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.