California / Tri-City Medical Center
CMS certification 050128 · Oceanside, CA · 6 entries in CMS's price-transparency list
Tri-City Medical Center: charges and Medicare payments
Tri-City Medical Center reported 1,266 Medicare inpatient stays across 46 DRGs in 2024. Across them it charged 5.32 times what it was paid — mid-range in California, number 120 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: 228 stays at an average charge of $99,655, 10% above the national average. It also billed 1,099 outpatient services, charging 5.29 times what Medicare paid.
- 1Medicare inpatient stays 1,266
- 2Charge ÷ paid, inpatient 5.32×
- 3Rank in CA (highest ratio = 1) 120 of 247
- 4CMS price-transparency actions 6
Inpatient stays
For the 46 DRGs that can be compared with the national average, Tri-City Medical Center charged more than the national average in 24 (52%). 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 | 228 | $99,655 | +10% | $18,023 |
| 189 Pulmonary Edema and Respiratory Failure | 82 | $71,957 | +25% | $12,122 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 63 | $55,756 | +14% | $10,233 |
| 291 Heart Failure and Shock with MCC | 62 | $62,091 | +10% | $12,323 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 54 | $111,893 | -29% | $30,268 |
| 177 Respiratory Infections and Inflammations with MCC | 38 | $87,866 | +24% | $14,940 |
| 193 Simple Pneumonia and Pleurisy with MCC | 35 | $72,645 | +22% | $12,645 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 32 | $90,233 | -10% | $18,059 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 32 | $71,321 | +28% | $9,886 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $54,533 | -10% | $11,837 |
| 690 Kidney and Urinary Tract Infections without MCC | 29 | $51,788 | +37% | $7,763 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 25 | $84,216 | +11% | $13,845 |
| 070 Other Cerebrovascular Disorders with MCC | 22 | $83,462 | +10% | $15,582 |
| 071 Other Cerebrovascular Disorders with CC | 22 | $56,779 | +13% | $9,970 |
| 683 Renal Failure with CC | 22 | $43,155 | +6% | $8,604 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 20 | $61,410 | +21% | $10,073 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 20 | $356,491 | +25% | $60,040 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 20 | $40,267 | -20% | $9,033 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 20 | $74,808 | -35% | $17,859 |
| 378 Gastrointestinal Hemorrhage with CC | 20 | $46,753 | -4% | $9,516 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $75,695 | -25% | $19,203 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 20 | $210,700 | -8% | $47,295 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 19 | $333,879 | +51% | $47,352 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 19 | $52,742 | +46% | $7,534 |
| 603 Cellulitis without MCC | 19 | $41,466 | +11% | $8,744 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 19 | $118,435 | +61% | $15,519 |
| 682 Renal Failure with MCC | 18 | $56,482 | -14% | $14,124 |
| 091 Other Disorders of Nervous System with MCC | 17 | $82,191 | -1% | $16,632 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 16 | $119,315 | -27% | $25,593 |
| 377 Gastrointestinal Hemorrhage with MCC | 16 | $93,989 | +10% | $17,254 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $36,062 | -3% | $6,368 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 15 | $35,526 | +24% | $5,804 |
| 069 Transient Ischemia without Thrombolytic | 14 | $48,818 | -3% | $8,114 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 14 | $113,355 | -16% | $24,815 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $49,576 | -12% | $11,254 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 14 | $107,799 | +16% | $18,145 |
| 689 Kidney and Urinary Tract Infections with MCC | 14 | $44,416 | -13% | $10,450 |
| 252 Other Vascular Procedures with MCC | 13 | $132,106 | -23% | $32,042 |
| 314 Other Circulatory System Diagnoses with MCC | 13 | $89,893 | -5% | $20,186 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 13 | $297,469 | +38% | $51,922 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 12 | $60,199 | +42% | $7,026 |
| 552 Medical Back Problems without MCC | 12 | $40,857 | -16% | $8,924 |
| 092 Other Disorders of Nervous System with CC | 11 | $63,520 | +23% | $10,268 |
| 100 Seizures with MCC | 11 | $75,614 | -20% | $17,557 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 11 | $111,216 | -1% | $18,975 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 11 | $113,697 | -18% | $23,905 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Tri-City Medical Center charged $99,655 on average, 30% less than the California average of $143,063, and was paid $18,023 against a state average of $23,020. For Pulmonary Edema and Respiratory Failure (DRG 189), Tri-City Medical Center charged $71,957 on average, 31% less than the California average of $104,292, and was paid $12,122 against a state average of $15,897. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Tri-City Medical Center charged $55,756 on average, 27% less than the California average of $76,120, and was paid $10,233 against a state average of $12,552. For Heart Failure and Shock with MCC (DRG 291), Tri-City Medical Center charged $62,091 on average, 38% less than the California average of $100,739, and was paid $12,323 against a state average of $15,556. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,816 was 43% below the state average of $41,628. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $39,145 was 63% below the state average of $107,140. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $33,953 was 34% below the state average of $51,167. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $84,573 was 23% below the state average of $109,149.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Tri-City Medical Center in Oceanside, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-05-18 (CMS case 114)
- CAP Request — 2021-10-27 (CMS case 114)
- Closure Notice — 2022-11-07 (CMS case 114)
- Warning Notice — 2025-09-30 (CMS case 6308)
- Closure Notice — 2026-01-02 (CMS case 6308)
- Warning Notice — 2026-06-05 (CMS case 7944)
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.