California / Sutter Coast Hospital
CMS certification 050417 · Crescent City, CA · 4 entries in CMS's price-transparency list
Sutter Coast Hospital: charges and Medicare payments
Sutter Coast Hospital reported 408 Medicare inpatient stays across 11 DRGs in 2024. Across them it charged 3.21 times what it was paid — among the lower ratios in California, number 213 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: 192 stays at an average charge of $70,059, 22% below the national average. It also billed 321 outpatient services, charging 7.54 times what Medicare paid.
- 1Medicare inpatient stays 408
- 2Charge ÷ paid, inpatient 3.21×
- 3Rank in CA (highest ratio = 1) 213 of 247
- 4CMS price-transparency actions 4
Inpatient stays
For the 11 DRGs that can be compared with the national average, Sutter Coast Hospital charged more than the national average in 3 (27%). 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 | 192 | $70,059 | -22% | $23,247 |
| 291 Heart Failure and Shock with MCC | 53 | $60,902 | +8% | $14,829 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 45 | $41,657 | -15% | $11,948 |
| 193 Simple Pneumonia and Pleurisy with MCC | 21 | $52,306 | -12% | $15,251 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 17 | $66,372 | -10% | $19,257 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $148,966 | -35% | $59,579 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 15 | $62,735 | -17% | $18,024 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $66,293 | -6% | $19,654 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $47,885 | +19% | $10,045 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 11 | $60,172 | +8% | $11,795 |
| 378 Gastrointestinal Hemorrhage with CC | 11 | $38,747 | -20% | $11,510 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 133 | $30,498 | $3,583 |
| Level 3 Vascular Procedures | 28 | $21,080 | $4,197 |
| Level 1 Laparoscopy and Related Services | 24 | $33,216 | $7,598 |
| Level 2 Upper GI Procedures | 20 | $13,721 | $2,505 |
| Level 5 Urology and Related Services | 16 | $27,900 | $6,814 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 15 | $22,854 | $4,555 |
| Level 3 Lower GI Procedures | 14 | $18,542 | $3,697 |
| Level 2 Urology and Related Services | 14 | $5,135 | $899 |
| Level 2 Musculoskeletal Procedures | 13 | $10,686 | $2,116 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 11 | $16,066 | $3,741 |
| Level 4 Musculoskeletal Procedures | 11 | $36,079 | $9,414 |
| Level 2 Vascular Procedures | 11 | $12,121 | $2,109 |
| Level 4 Urology and Related Services | 11 | $20,118 | $4,590 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Sutter Coast Hospital charged $70,059 on average, 51% less than the California average of $143,063, and was paid $23,247 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Sutter Coast Hospital charged $60,902 on average, 40% less than the California average of $100,739, and was paid $14,829 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Sutter Coast Hospital charged $41,657 on average, 45% less than the California average of $76,120, and was paid $11,948 against a state average of $12,552. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Sutter Coast Hospital charged $52,306 on average, 50% less than the California average of $103,761, and was paid $15,251 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $30,498 was 27% below the state average of $41,628. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $21,080 was 30% below the state average of $30,190. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $33,216 was 48% below the state average of $64,351. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $13,721 was 28% below the state average of $19,034.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Sutter Coast Hospital in Crescent City, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-01 (CMS case 1131)
- Closure Notice — 2023-06-12 (CMS case 1131)
- Warning Notice — 2025-02-18 (CMS case 3059)
- Closure Notice — 2025-03-26 (CMS case 3059)
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.