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The Price of Medicare Procedures in California



This table shows the 100 most frequently charged procedures/diagnosis in California to the Inpatient Prospective Payment System (IPPS). This table will give a basic idea of the cost of medicare for hospital procedures. Hospitals determine what they bill according to a "chargemaster". The charge master serves as a price point for the beginning of negotiations between you and the health care provider.



ProcedureProvider StateTotal DischargesHospital Charge(s)Medicare Payment(s)Your Cost
Acute Myocardial Infarction Discharged Alive No Complications
 California 1013 $40505 $6444 $34061
Acute Myocardial Infarction Discharged Alive With Complications
 California 2290 $55746 $9903 $45843
Acute Myocardial Infarction Discharged Alive With Major Complications
 California 4443 $83364 $15491 $67873
Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications
 California 2056 $27915 $5741 $22174
Atherosclerosis No Major Complications
 California 1922 $28823 $4913 $23910
Back And Neck Proc Exc Spinal Fusion No Complications
 California 2930 $57529 $8621 $48908
Bronchitis And Asthma No Complications
 California 609 $35518 $5397 $30121
Bronchitis And Asthma With Complications
 California 1979 $47094 $7271 $39823
Cardiac Arrhythmia And Conduction Disorders No Complications
 California 5621 $28713 $4819 $23894
Cardiac Arrhythmia And Conduction Disorders With Complications
 California 6165 $39980 $7146 $32834
Cardiac Arrhythmia And Conduction Disorders With Major Complications
 California 3749 $59369 $10810 $48559
Cellulitis No Major Complications
 California 9880 $36663 $7245 $29418
Cellulitis With Major Complications
 California 1334 $67232 $12858 $54374
Cervical Spinal Fusion No Complications
 California 1248 $95386 $17648 $77738
Chest Pain
 California 10070 $28981 $4742 $24239
Chronic Obstructive Pulmonary Disease No Complications
 California 5280 $35106 $6206 $28900
Chronic Obstructive Pulmonary Disease With Complications
 California 8297 $46765 $8290 $38475
Chronic Obstructive Pulmonary Disease With Major Complications
 California 9472 $58013 $10305 $47708
Circulatory Disorders Except Ami With Card Cath No Major Complications
 California 6092 $62234 $9681 $52553
Circulatory Disorders Except Ami With Card Cath With Major Complications
 California 1214 $117989 $20259 $97730
Cranial And Peripheral Nerve Disorders No Major Complications
 California 1347 $42162 $7743 $34419
Degenerative Nervous System Disorders No Major Complications
 California 1469 $45639 $8555 $37084
Diabetes With Complications
 California 3299 $38874 $7469 $31405
Disorders Of Pancreas Except Malignancy With Complications
 California 1051 $49068 $8923 $40145
Dysequilibrium
 California 1076 $32624 $5257 $27367
Esophagitis Gastroent And Misc Digest Disorders No Major Complications
 California 14718 $36879 $6233 $30646
Esophagitis Gastroent And Misc Digest Disorders With Major Complications
 California 3188 $55741 $10484 $45257
Extracranial Procedures No Complications
 California 1715 $54275 $8252 $46023
Fractures Of Hip And Pelvis No Major Complications
 California 1449 $33350 $5631 $27719
Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications
 California 1204 $37991 $6089 $31902
Gi Hemorrhage No Complications
 California 2076 $31715 $5899 $25816
Gi Hemorrhage With Complications
 California 9249 $46027 $8685 $37342
Gi Hemorrhage With Major Complications
 California 3767 $80936 $15696 $65240
Gi Obstruction No Complications
 California 2209 $30586 $5436 $25150
Gi Obstruction With Complications
 California 3433 $44086 $8042 $36044
Heart Failure And Shock No Complications
 California 4863 $32995 $5851 $27144
Heart Failure And Shock With Complications
 California 13819 $47265 $8831 $38434
Heart Failure And Shock With Major Complications
 California 14425 $70896 $13158 $57738
Hip And Femur Procedures Except Major Joint No Complications
 California 1542 $68603 $12359 $56244
Hip And Femur Procedures Except Major Joint With Complications
 California 4971 $88197 $15201 $72996
Hip And Femur Procedures Except Major Joint With Major Complications
 California 1203 $139101 $25918 $113183
Hypertension No Major Complications
 California 881 $30058 $5453 $24605
Infectious And Parasitic Diseases Or Procedure With Major Complications
 California 4108 $260329 $51393 $208936
Intracranial Hemorrhage Or Cerebral Infarction No Complications
 California 3723 $42438 $6978 $35460
Intracranial Hemorrhage Or Cerebral Infarction With Complications
 California 7840 $55669 $9837 $45832
Intracranial Hemorrhage Or Cerebral Infarction With Major Complications
 California 5260 $95326 $17327 $77999
Kidney And Urinary Tract Infections No Major Complications
 California 14151 $36092 $6728 $29364
Kidney And Urinary Tract Infections With Major Complications
 California 4685 $52262 $10172 $42090
Laparoscopic Cholecystectomy No Cde No Complications
 California 1109 $55567 $9493 $46074
Laparoscopic Cholecystectomy No Cde With Complications
 California 1170 $83366 $14137 $69229
Major Cardiovasc Procedures No Major Complications
 California 1740 $143072 $27615 $115457
Major Gastrointestinal Disorders And Peritoneal Infections With Complications
 California 1726 $59926 $10745 $49181
Major Joint Replacement Of Lower Extremity No Major Complications
 California 29731 $88239 $17187 $71052
Major Joint Replacement Of Lower Extremity With Major Complications
 California 1048 $155449 $27698 $127751
Major Small And Large Bowel Procedures With Complications
 California 3272 $124615 $22968 $101647
Major Small And Large Bowel Procedures With Major Complications
 California 2439 $258767 $49384 $209383
Medical Back Problems No Major Complications
 California 4346 $42156 $6908 $35248
Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications
 California 10497 $32424 $5974 $26450
Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications
 California 4449 $49218 $10092 $39126
Other Circulatory System Diagnoses With Complications
 California 851 $51984 $9172 $42812
Other Circulatory System Diagnoses With Major Complications
 California 3957 $89034 $17349 $71685
Other Digestive System Diagnoses With Complications
 California 3150 $49604 $8812 $40792
Other Kidney And Urinary Tract Diagnoses With Complications
 California 1508 $47223 $9528 $37695
Other Kidney And Urinary Tract Diagnoses With Major Complications
 California 1608 $76730 $15378 $61352
Other Vascular Procedures No Complications
 California 1413 $82284 $13731 $68553
Other Vascular Procedures With Complications
 California 2087 $124507 $21685 $102822
Other Vascular Procedures With Major Complications
 California 2675 $141530 $28554 $112976
Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications
 California 1981 $102162 $16151 $86011
Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications
 California 6636 $102086 $16769 $85317
Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications
 California 1985 $166637 $28878 $137759
Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications
 California 1406 $97514 $14973 $82541
Peripheral Vascular Disorders No Complications
 California 481 $31600 $5403 $26197
Peripheral Vascular Disorders With Complications
 California 2157 $46464 $8334 $38130
Permanent Cardiac Pacemaker Implant No Complications
 California 1953 $78140 $16377 $61763
Permanent Cardiac Pacemaker Implant With Complications
 California 2212 $107281 $22071 $85210
Poisoning And Toxic Effects Of Drugs No Major Complications
 California 1680 $32752 $5599 $27153
Poisoning And Toxic Effects Of Drugs With Major Complications
 California 1393 $68498 $12969 $55529
Psychoses
 California 10994 $24503 $8916 $15587
Pulmonary Edema And Respiratory Failure
 California 5469 $64758 $11179 $53579
Pulmonary Embolism No Major Complications
 California 1398 $51386 $8854 $42532
Red Blood Cell Disorders No Major Complications
 California 5733 $35878 $7039 $28839
Red Blood Cell Disorders With Major Complications
 California 1701 $54654 $11520 $43134
Renal Failure No Complications
 California 584 $34982 $5448 $29534
Renal Failure With Complications
 California 9016 $48439 $8967 $39472
Renal Failure With Major Complications
 California 7009 $72128 $14548 $57580
Respiratory Infections And Inflammations With Complications
 California 4920 $70949 $12543 $58406
Respiratory Infections And Inflammations With Major Complications
 California 6151 $101885 $17925 $83960
Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs
 California 2104 $262024 $48700 $213324
Respiratory System Diagnosis With Ventilator Support Less 96 Hrs
 California 4354 $120888 $21006 $99882
Seizures No Major Complications
 California 2822 $38638 $6930 $31708
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications
 California 11162 $50353 $9612 $40741
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications
 California 34284 $90122 $16747 $73375
Septicemia Or Severe Sepsis With Mv 96 Plus Hrs
 California 3057 $277153 $53048 $224105
Signs And Symptoms No Major Complications
 California 2522 $35628 $6112 $29516
Simple Pneumonia And Pleurisy No Complications
 California 4586 $34477 $5838 $28639
Simple Pneumonia And Pleurisy With Complications
 California 13067 $48729 $8696 $40033
Simple Pneumonia And Pleurisy With Major Complications
 California 9003 $70326 $12495 $57831
Spinal Fusion Except Cervical No Major Complications
 California 3926 $154326 $32547 $121779
Syncope And Collapse
 California 7631 $36987 $6233 $30754
Transient Ischemia
 California 4441 $37396 $6120 $31276


Source: CMS

As part of the Obama administration’s goal to make our healthcare more accountable, transparent and affordable the CMS.gov has released data from more then 3000 hospitals that receive payments for the 100 highest frequently billed charges under Medicare. For more information visit CMS.gov.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

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