Other circulatory system operating room procedures in California
What 12 hospitals in California charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.
Average charge
$291,690
Hospital list price billed
Average payment
$42,113
Medicare + patient + other payers
Medicare paid
$37,255
Average per stay
State rank
#18 of 21
1 = lowest average payment
Hospitals in California billed an average of $291,690 for other circulatory system operating room procedures, about 6.9 times the average total payment of $42,113. That payment is 19% above the U.S. average of $35,518.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $42,113Billed $291,690
About 14¢ was paid for every $1 hospitals in California billed for this stay.
California hospitals: other circulatory system operating room procedures
Every California hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Cedars-Sinai Medical CenterLos Angeles | 41 | $599,392 | $50,061 | $41,947 |
| John Muir Medical Center - Concord CampusConcord | 18 | $273,978 | $40,393 | $30,579 |
| Salinas Valley Memorial HospitalSalinas | 17 | $233,484 | $35,687 | $34,919 |
| Santa Rosa Memorial HospitalSanta Rosa | 15 | $290,041 | $40,607 | $32,400 |
| Stanford HospitalPalo Alto | 15 | $355,678 | $52,781 | $46,871 |
| Mercy San Juan Medical CenterCarmichael | 14 | $112,235 | $32,086 | $30,770 |
| Kaweah Delta Medical CenterVisalia | 12 | $95,019 | $36,980 | $34,635 |
| Community Hospital of the Monterey PeninsulaMonterey | 12 | $276,035 | $46,125 | $45,175 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco | 11 | $109,124 | $48,238 | $41,337 |
| Community Regional Medical CenterFresno | 11 | $112,283 | $35,255 | $33,893 |
| Scripps Mercy HospitalSan Diego | 11 | $148,250 | $37,319 | $36,033 |
| Providence Holy Cross Medical CenterMission Hills | 11 | $144,173 | $32,262 | $30,776 |
Lowest and highest payments in California
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Mercy San Juan Medical CenterCarmichael, CA | $32,086 |
|---|---|
| Providence Holy Cross Medical CenterMission Hills, CA | $32,262 |
| Community Regional Medical CenterFresno, CA | $35,255 |
| Salinas Valley Memorial HospitalSalinas, CA | $35,687 |
| Kaweah Delta Medical CenterVisalia, CA | $36,980 |
Highest
| Stanford HospitalPalo Alto, CA | $52,781 |
|---|---|
| Cedars-Sinai Medical CenterLos Angeles, CA | $50,061 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $48,238 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $46,125 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $40,607 |
Other circulatory system operating room procedures in other states
Questions
How much does other circulatory system operating room procedures cost in California?
In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 12 hospitals in California was billed at $291,690 on average, while the average total payment was $42,113, of which Medicare paid $37,255. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in California, average charges were 6.9 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.