Washington / Virginia Mason Medical Center

CMS certification 500005 · Seattle, WA · 1 entry in CMS's price-transparency list

Virginia Mason Medical Center: charges and Medicare payments

Virginia Mason Medical Center reported 2,700 Medicare inpatient stays across 102 DRGs in 2024. Across them it charged 3.65 times what it was paid — among the lower ratios in Washington, number 34 of 43 hospitals with at least 100 stays (state median 4.37×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 154 stays at an average charge of $97,145, 8% above the national average. It also billed 6,423 outpatient services, charging 6.27 times what Medicare paid.

1Medicare inpatient stays 2,700
2Charge ÷ paid, inpatient 3.65×
3Rank in WA (highest ratio = 1) 34 of 43
4CMS price-transparency actions 1

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

Inpatient stays

For the 102 DRGs that can be compared with the national average, Virginia Mason Medical Center charged more than the national average in 12 (12%). 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	154	$97,145	+8%	$24,838
274 Percutaneous and Other Intracardiac Procedures without MCC	125	$103,754	-34%	$31,345
267 Endovascular Cardiac Valve Replacement and Supplement...	93	$158,600	-28%	$46,124
291 Heart Failure and Shock with MCC	70	$52,828	-6%	$14,832
378 Gastrointestinal Hemorrhage with CC	64	$38,207	-21%	$10,821
435 Malignancy of Hepatobiliary System or Pancreas with MCC	63	$89,205	-6%	$19,696
330 Major Small and Large Bowel Procedures with CC	59	$94,560	-21%	$25,513
331 Major Small and Large Bowel Procedures without CC/MCC	59	$70,056	-18%	$16,573
280 Acute Myocardial Infarction, Discharged Alive with MCC	55	$58,085	-23%	$17,731
470 Major Hip and Knee Joint Replacement or Reattachment of...	51	$65,009	-30%	$19,806
266 Endovascular Cardiac Valve Replacement and Supplement...	49	$186,613	-34%	$60,787
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	48	$29,592	-26%	$9,100
853 Infectious and Parasitic Diseases with O.R. Procedures with...	45	$181,933	-21%	$59,094
460 Spinal Fusion except Cervical without MCC	41	$133,604	-22%	$39,611
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	41	$38,016	-22%	$11,303
164 Major Chest Procedures with CC	39	$84,141	-34%	$24,957
177 Respiratory Infections and Inflammations with MCC	39	$68,367	-3%	$20,067
236 Coronary Bypass without Cardiac Catheterization without MCC	38	$199,160	-6%	$43,205
377 Gastrointestinal Hemorrhage with MCC	32	$82,924	-3%	$21,805
652 Kidney Transplant	32	$280,762	-17%	$33,569
281 Acute Myocardial Infarction, Discharged Alive with CC	31	$35,553	-30%	$9,998
326 Stomach, Esophageal and Duodenal Procedures with MCC	31	$231,653	-3%	$68,687
445 Disorders of The Biliary Tract with CC	31	$55,745	-4%	$11,842
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	30	$46,765	-16%	$11,568
393 Other Digestive System Diagnoses with MCC	30	$73,762	-4%	$20,717
025 Craniotomy and Endovascular Intracranial Procedures with MCC	29	$173,176	-25%	$51,634
220 Cardiac Valve and Other Major Cardiothoracic Procedures...	29	$233,241	-16%	$51,690
329 Major Small and Large Bowel Procedures with MCC	29	$207,914	-3%	$60,693
683 Renal Failure with CC	28	$27,797	-32%	$10,102
189 Pulmonary Edema and Respiratory Failure	27	$86,564	+50%	$21,288
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	26	$89,709	-10%	$21,318
286 Circulatory Disorders except AMI, with Cardiac...	26	$96,140	-14%	$24,675
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	26	$189,077	-13%	$52,811
252 Other Vascular Procedures with MCC	25	$126,052	-26%	$37,894
322 Percutaneous Cardiovascular Procedures with Intraluminal...	25	$93,946	-18%	$19,466
444 Disorders of The Biliary Tract with MCC	25	$91,220	+10%	$23,228
698 Other Kidney and Urinary Tract Diagnoses with MCC	25	$70,277	-4%	$19,501
163 Major Chest Procedures with MCC	24	$127,738	-39%	$48,860
287 Circulatory Disorders except AMI, with Cardiac...	24	$40,824	-36%	$12,209
328 Stomach, Esophageal and Duodenal Procedures without CC/MCC	24	$56,128	-35%	$16,038
327 Stomach, Esophageal and Duodenal Procedures with CC	23	$112,766	-11%	$26,032
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	23	$57,504	-5%	$14,057
312 Syncope and Collapse	22	$44,819	-2%	$9,586
682 Renal Failure with MCC	22	$59,031	-10%	$16,738
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	21	$570,674	-46%	$229,255
165 Major Chest Procedures without CC/MCC	21	$72,257	-30%	$19,387
406 Pancreas, Liver and Shunt Procedures with CC	21	$150,238	-7%	$30,897
467 Revision of Hip or Knee Replacement with CC	21	$111,876	-29%	$42,822
699 Other Kidney and Urinary Tract Diagnoses with CC	21	$44,376	-7%	$11,265
394 Other Digestive System Diagnoses with CC	20	$48,118	+2%	$12,348
235 Coronary Bypass without Cardiac Catheterization with MCC	19	$285,157	-3%	$70,772
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	19	$56,535	-7%	$15,022
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	19	$163,922	-19%	$44,098
919 Complications of Treatment with MCC	19	$78,366	-11%	$19,356
026 Craniotomy and Endovascular Intracranial Procedures with CC	18	$142,741	-14%	$29,530
027 Craniotomy and Endovascular Intracranial Procedures without...	18	$133,803	-4%	$24,344
389 Gastrointestinal Obstruction with CC	18	$24,841	-36%	$8,805
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	18	$45,172	-33%	$14,073
193 Simple Pneumonia and Pleurisy with MCC	17	$53,898	-10%	$15,061
243 Permanent Cardiac Pacemaker Implant with CC	17	$108,666	-2%	$24,002

Showing the 60 most frequent of 102 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	955	$2,453	$681
Level 3 Urology and Related Services	571	$9,314	$2,006
Level 2 Upper GI Procedures	475	$12,204	$1,896
Level 2 Excision/ Biopsy/ Incision and Drainage	435	$8,704	$1,588
Level 1 Endovascular Procedures	215	$17,661	$3,249
Level 5 Musculoskeletal Procedures	201	$50,790	$12,872
Level 4 Musculoskeletal Procedures	200	$32,805	$7,107
Level 5 Urology and Related Services	185	$27,887	$5,182
Level 4 Urology and Related Services	177	$15,476	$3,491
Level 1 Laparoscopy and Related Services	176	$30,004	$5,623
Level 5 Airway Endoscopy	149	$66,968	$6,745
Level 3 Vascular Procedures	140	$19,177	$3,138
Level 3 Electrophysiologic Procedures	136	$117,610	$23,396
Complex GI Procedures	132	$42,604	$5,621
Comprehensive Observation Services	131	$13,329	$2,724
Level 3 Airway Endoscopy	125	$6,143	$1,669
Level 2 Musculoskeletal Procedures	121	$8,051	$1,590
Level 4 Airway Endoscopy	116	$21,773	$3,673
Level 1 Nerve Procedures	115	$9,652	$1,934
Level 2 Laparoscopy and Related Services	102	$51,734	$10,214
Level 3 Excision/ Biopsy/ Incision and Drainage	94	$13,763	$2,767
Level 3 Endovascular Procedures	92	$74,329	$10,903
Level 3 Musculoskeletal Procedures	88	$19,310	$3,183
Level 3 Upper GI Procedures	86	$25,477	$3,835
Level 5 ENT Procedures	85	$27,302	$5,700

Against the Washington average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Virginia Mason Medical Center charged $97,145 on average, 23% more than the Washington average of $78,715, and was paid $24,838 against a state average of $18,304. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Virginia Mason Medical Center charged $103,754 on average, 22% less than the Washington average of $132,875, and was paid $31,345 against a state average of $29,468. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Virginia Mason Medical Center charged $158,600 on average, 17% less than the Washington average of $191,979, and was paid $46,124 against a state average of $45,203. For Heart Failure and Shock with MCC (DRG 291), Virginia Mason Medical Center charged $52,828 on average, 1% less than the Washington average of $53,424, and was paid $14,832 against a state average of $12,124. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,453 was 30% above the state average of $1,884. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $9,314 was 3% above the state average of $9,013. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,204 was 13% above the state average of $10,814. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,704 was 10% below the state average of $9,672.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Virginia Mason Medical Center in Seattle, WA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Met Requirements — 2025-05-12 (CMS case 4472)

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.