Adventist Health Sonora Medicare inpatient and outpatient services

Every DRG and outpatient service group CMS publishes for Adventist Health Sonora, Sonora, CA in 2024, from traditional Medicare claims. Back to the Adventist Health Sonora profile, with quality ratings, finances and negotiated rates.

1,427
Medicare inpatient discharges
In 45 published DRGs
1.78
Case mix index
IPPS FY 2027
17%
Surgical stays
81%
Stays with complications
In DRGs with a CC or MCC
3,448
Medicare outpatient services
In 32 service groups

Inpatient stays by major diagnostic category

Infectious and parasitic diseases524 discharges in 4 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical	395	$114,170	$20,352	$17,468	1.98
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	76	$75,426	$10,106	$11,540	1.03
Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical	36	$309,003	$56,890	$47,277	5.00
Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical	17	$131,366	$20,862	$20,099	2.04

Circulatory system249 discharges in 9 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	68	$93,924	$13,008	$14,370	1.28
Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical	66	$91,753	$15,697	$14,038	1.59
Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical	30	$92,707	$8,924	$14,184	0.91
Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical	20	$99,269	$11,865	$15,188	1.20
Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical	17	$61,665	$6,877	$9,435	0.74
Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical	15	$192,156	$18,468	$29,400	1.82
Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical	11	$82,183	$6,675	$12,574	0.72
Syncope and collapseMS-DRG 312, medical	11	$104,876	$8,091	$16,046	0.86
Other circulatory system diagnoses with CCMS-DRG 315, medical	11	$83,896	$9,863	$12,836	0.97

Respiratory system153 discharges in 5 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	45	$90,273	$12,707	$13,812	1.33
Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical	39	$77,522	$10,720	$11,861	1.10
Respiratory infections and inflammations with MCCMS-DRG 177, medical	30	$81,219	$16,873	$12,426	1.70
Pulmonary edema and respiratory failureMS-DRG 189, medical	24	$74,418	$11,775	$11,386	1.23
Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical	15	$111,852	$14,316	$17,113	1.40

Kidney and urinary tract143 discharges in 6 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Kidney and urinary tract infections with MCCMS-DRG 689, medical	35	$82,940	$11,330	$12,690	1.17
Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical	34	$91,291	$17,125	$13,968	1.65
Renal failure with CCMS-DRG 683, medical	25	$53,815	$8,773	$8,234	0.90
Renal failure with MCCMS-DRG 682, medical	23	$108,196	$15,370	$16,554	1.50
Kidney and urinary tract infections without MCCMS-DRG 690, medical	15	$63,410	$7,808	$9,702	0.81
Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical	11	$71,535	$10,190	$10,945	1.02

Musculoskeletal system and connective tissue129 discharges in 7 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Hip and femur procedures except major joint with CCMS-DRG 481, surgical	38	$144,006	$20,699	$22,033	2.07
Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical	19	$152,217	$21,367	$23,289	2.11
Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical	18	$382,092	$45,352	$58,460	4.61
Hip and femur procedures except major joint with MCCMS-DRG 480, surgical	18	$186,624	$30,271	$28,553	2.95
Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical	14	$465,996	$67,273	$71,297	6.12
Spinal fusion except cervical without MCCMS-DRG 460, surgical	11	$308,739	$34,518	$47,237	3.66
Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical	11	$111,513	$15,837	$17,061	1.59

Digestive system111 discharges in 6 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Gastrointestinal hemorrhage with CCMS-DRG 378, medical	32	$83,936	$9,344	$12,842	0.98
Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical	20	$69,405	$7,089	$10,619	0.79
Major small and large bowel procedures with CCMS-DRG 330, surgical	16	$162,013	$24,180	$24,788	2.37
Gastrointestinal hemorrhage with MCCMS-DRG 377, medical	15	$120,310	$18,325	$18,407	1.79
Gastrointestinal obstruction with CCMS-DRG 389, medical	15	$45,455	$7,353	$6,955	0.80
Major small and large bowel procedures with MCCMS-DRG 329, surgical	13	$349,104	$53,442	$53,413	4.52

Endocrine, nutritional and metabolic62 discharges in 4 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical	20	$82,971	$12,989	$12,695	1.32
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical	16	$66,925	$6,828	$10,240	0.78
Diabetes with CCMS-DRG 638, medical	14	$81,904	$7,859	$12,531	0.90
Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical	12	$112,617	$20,148	$17,230	1.98

Nervous system33 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical	18	$97,068	$20,450	$14,851	2.00
Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical	15	$80,284	$9,659	$12,284	1.02

Alcohol and drug use12 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical	12	$67,092	$8,054	$10,265	0.86

Skin, subcutaneous tissue and breast11 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cellulitis without MCCMS-DRG 603, medical	11	$77,513	$8,011	$11,859	0.88

Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.

Outpatient services

Service group	Services	Patients	Average charges	Average Medicare payment	US average payment
Level 2 Urology and Related ServicesAPC 5372	556	398	$1,923	$711	$502
Comprehensive Observation ServicesAPC 8011	464	430	$36,321	$2,852	$2,090
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	313	298	$8,115	$1,684	$1,220
Level 5 Musculoskeletal ProceduresAPC 5115	256	242	$147,471	$15,240	$10,772
Level 1 Nerve ProceduresAPC 5431	210	194	$12,906	$2,023	$1,407
Level 3 Urology and Related ServicesAPC 5373	205	181	$6,654	$2,108	$1,516
Level 4 Musculoskeletal ProceduresAPC 5114	145	141	$84,059	$7,735	$5,339
Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073	125	116	$13,965	$2,861	$2,141
Level 2 Musculoskeletal ProceduresAPC 5112	120	116	$8,799	$1,657	$1,196
Level 1 Laparoscopy and Related ServicesAPC 5361	84	82	$88,638	$6,053	$4,358
Level 2 Upper GI ProceduresAPC 5302	82	63	$19,142	$2,012	$1,445
Level 4 Urology and Related ServicesAPC 5374	80	71	$44,279	$3,565	$2,629
Level 5 Urology and Related ServicesAPC 5375	79	76	$56,046	$5,428	$3,918
Level 3 Musculoskeletal ProceduresAPC 5113	77	74	$43,922	$3,308	$2,373
Level 3 Airway EndoscopyAPC 5153	77	44	$7,465	$1,781	$1,264
Level 3 Vascular ProceduresAPC 5183	76	76	$21,980	$3,255	$2,405
Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341	63	61	$40,744	$3,628	$2,636
Level 1 Endovascular ProceduresAPC 5191	50	50	$34,099	$3,023	$2,208
Level 3 Lower GI ProceduresAPC 5313	50	50	$17,991	$3,057	$2,176
Level 5 ENT ProceduresAPC 5165	47	47	$63,012	$6,013	$4,436
Level 2 Vascular ProceduresAPC 5182	35	35	$13,123	$1,680	$1,204
Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092	34	34	$59,721	$6,758	$4,982
Level 6 Musculoskeletal ProceduresAPC 5116	33	33	$169,364	$22,840	$15,763
Level 4 ENT ProceduresAPC 5164	31	30	$21,323	$3,378	$2,217
Level 3 ENT ProceduresAPC 5163	29	22	$3,324	$1,545	$1,106
Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091	26	25	$21,027	$3,999	$2,930
Level 3 Pacemaker and Similar ProceduresAPC 5223	26	26	$64,747	$12,404	$8,569
Level 4 Gynecologic ProceduresAPC 5414	23	21	$17,771	$2,994	$2,389
Level 4 Airway EndoscopyAPC 5154	14	14	$27,014	$3,929	$2,833
Level 2 Pacemaker and Similar ProceduresAPC 5222	14	14	$33,968	$9,542	$6,514
Level 2 Laparoscopy and Related ServicesAPC 5362	13	13	$176,207	$10,984	$8,164
Level 2 ICD and Similar ProceduresAPC 5232	11	11	$245,652	$41,544	$29,375

Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.