UCSF Medical Center: charges and Medicare payments

UCSF Medical Center reported 8,018 Medicare inpatient stays across 231 DRGs in 2024. Across them it charged 5.08 times what it was paid — mid-range in California, number 128 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: 558 stays at an average charge of $245,418, 172% above the national average. It also billed 14,594 outpatient services, charging 7.81 times what Medicare paid.

1Medicare inpatient stays 8,018
2Charge ÷ paid, inpatient 5.08×
3Rank in CA (highest ratio = 1) 128 of 247
4CMS price-transparency actions 0

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

Inpatient stays

For the 231 DRGs that can be compared with the national average, UCSF Medical Center charged more than the national average in 230 (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	558	$245,418	+172%	$43,403
025 Craniotomy and Endovascular Intracranial Procedures with MCC	184	$343,323	+48%	$74,161
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	168	$131,010	+94%	$23,716
280 Acute Myocardial Infarction, Discharged Alive with MCC	159	$217,031	+186%	$34,833
470 Major Hip and Knee Joint Replacement or Reattachment of...	157	$149,465	+60%	$32,373
291 Heart Failure and Shock with MCC	142	$156,962	+178%	$26,634
454 Combined Anterior and Posterior Spinal Fusion with CC	134	$551,579	+97%	$107,427
699 Other Kidney and Urinary Tract Diagnoses with CC	123	$109,999	+132%	$20,006
177 Respiratory Infections and Inflammations with MCC	111	$187,931	+166%	$33,284
698 Other Kidney and Urinary Tract Diagnoses with MCC	105	$180,258	+145%	$33,373
853 Infectious and Parasitic Diseases with O.R. Procedures with...	96	$622,968	+172%	$119,142
330 Major Small and Large Bowel Procedures with CC	90	$196,440	+65%	$43,087
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	89	$264,981	+165%	$43,177
467 Revision of Hip or Knee Replacement with CC	86	$242,084	+53%	$56,431
472 Cervical Spinal Fusion with CC	82	$228,396	+60%	$49,484
267 Endovascular Cardiac Valve Replacement and Supplement...	77	$245,802	+11%	$74,649
846 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	75	$278,048	+107%	$54,386
453 Combined Anterior and Posterior Spinal Fusion with MCC	73	$709,251	+56%	$152,267
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	69	$101,710	+107%	$20,090
027 Craniotomy and Endovascular Intracranial Procedures without...	68	$206,506	+48%	$40,969
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	66	$77,476	+93%	$14,715
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	66	$152,477	+153%	$27,423
164 Major Chest Procedures with CC	64	$186,409	+46%	$40,721
840 Lymphoma and Non-Acute Leukemia with MCC	64	$456,317	+193%	$78,201
193 Simple Pneumonia and Pleurisy with MCC	55	$151,740	+154%	$28,073
862 Postoperative and Post-Traumatic Infections with MCC	55	$148,520	+78%	$32,772
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	54	$116,631	+109%	$18,709
457 Spinal Fusion except Cervical with Spinal Curvature,...	54	$552,042	+91%	$104,171
652 Kidney Transplant	53	$565,559	+68%	$57,213
460 Spinal Fusion except Cervical without MCC	51	$295,555	+74%	$61,106
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	49	$2,193,031	+108%	$433,445
329 Major Small and Large Bowel Procedures with MCC	49	$477,108	+122%	$103,993
919 Complications of Treatment with MCC	49	$141,441	+60%	$34,757
377 Gastrointestinal Hemorrhage with MCC	48	$175,589	+106%	$34,394
456 Spinal Fusion except Cervical with Spinal Curvature,...	47	$783,179	+84%	$153,937
189 Pulmonary Edema and Respiratory Failure	46	$161,059	+180%	$30,286
023 Craniotomy with Major Device Implant or Acute Complex Cns...	45	$491,873	+75%	$101,212
100 Seizures with MCC	45	$197,119	+109%	$34,066
101 Seizures without MCC	45	$87,282	+79%	$17,295
018 Chimeric Antigen Receptor (Car) T-Cell and Other...	44	$1,856,460	-16%	$500,198
309 Cardiac Arrhythmia and Conduction Disorders with CC	44	$66,234	+83%	$14,192
314 Other Circulatory System Diagnoses with MCC	44	$242,280	+155%	$47,015
394 Other Digestive System Diagnoses with CC	44	$100,687	+114%	$17,971
603 Cellulitis without MCC	44	$75,865	+103%	$16,048
057 Degenerative Nervous System Disorders without MCC	43	$104,358	+84%	$25,281
253 Other Vascular Procedures with CC	43	$206,517	+57%	$42,558
393 Other Digestive System Diagnoses with MCC	42	$220,507	+187%	$37,664
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	41	$589,149	+48%	$128,696
389 Gastrointestinal Obstruction with CC	41	$89,951	+131%	$19,004
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	41	$100,394	+171%	$16,790
056 Degenerative Nervous System Disorders with MCC	40	$257,978	+169%	$47,730
266 Endovascular Cardiac Valve Replacement and Supplement...	40	$702,024	+146%	$138,738
481 Hip and Femur Procedures except Major Joint with CC	40	$186,236	+85%	$36,766
483 Major Joint or Limb Reattachment Procedures of Upper...	40	$192,588	+53%	$40,438
519 Back and Neck Procedures except Spinal Fusion with CC	40	$183,107	+75%	$33,983
552 Medical Back Problems without MCC	40	$103,448	+112%	$19,752
092 Other Disorders of Nervous System with CC	39	$111,253	+116%	$19,985
435 Malignancy of Hepatobiliary System or Pancreas with MCC	39	$157,066	+66%	$31,368
286 Circulatory Disorders except AMI, with Cardiac...	38	$292,838	+161%	$46,143
378 Gastrointestinal Hemorrhage with CC	38	$95,500	+97%	$18,261

Showing the 60 most frequent of 231 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	2,215	$5,723	$958
Level 3 Urology and Related Services	1,293	$12,054	$2,853
Level 2 Excision/ Biopsy/ Incision and Drainage	831	$15,859	$2,271
Level 1 Intraocular Procedures	795	$34,541	$3,268
Level 3 Excision/ Biopsy/ Incision and Drainage	699	$26,258	$3,986
Comprehensive Observation Services	624	$43,574	$3,817
Level 2 Upper GI Procedures	485	$20,460	$2,672
Level 5 Urology and Related Services	469	$64,659	$7,286
Level 4 Airway Endoscopy	441	$44,332	$5,246
Level 4 Urology and Related Services	396	$35,648	$4,894
Level 1 Nerve Procedures	388	$23,118	$2,702
Level 3 Vascular Procedures	379	$26,893	$4,458
Level 4 Musculoskeletal Procedures	340	$62,172	$9,991
Level 1 Endovascular Procedures	307	$37,109	$4,564
Level 3 Airway Endoscopy	241	$17,509	$2,377
Level 1 Laparoscopy and Related Services	238	$67,130	$8,097
Level 5 Musculoskeletal Procedures	233	$95,650	$18,418
Level 3 Endovascular Procedures	230	$105,026	$15,401
Level 4 Vascular Procedures	215	$44,150	$6,126
Level 5 ENT Procedures	214	$57,722	$8,184
Level 3 Extraocular, Repair, and Plastic Eye Procedures	207	$30,139	$3,265
Level 3 Electrophysiologic Procedures	205	$143,801	$33,341
Level 3 Lower GI Procedures	201	$27,043	$3,954
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	200	$30,401	$4,854
Level 2 Intraocular Procedures	193	$53,446	$5,702

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UCSF Medical Center charged $245,418 on average, 72% more than the California average of $143,063, and was paid $43,403 against a state average of $23,020. For Craniotomy and Endovascular Intracranial Procedures with MCC (DRG 025), UCSF Medical Center charged $343,323 on average, 11% less than the California average of $384,874, and was paid $74,161 against a state average of $59,908. For Chemotherapy without Acute Leukemia As Secondary Diagnosis with CC (DRG 847), UCSF Medical Center charged $131,010 on average, 24% more than the California average of $106,036, and was paid $23,716 against a state average of $18,781. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), UCSF Medical Center charged $217,031 on average, 75% more than the California average of $123,896, and was paid $34,833 against a state average of $19,122. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $5,723 was 18% above the state average of $4,853. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $12,054 was 32% below the state average of $17,793. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,859 was 8% above the state average of $14,749. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $34,541 was 65% above the state average of $20,986.

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.