Adventist Health St. Helena Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Adventist Health St. Helena, Saint Helena, CA in 2024, from traditional Medicare claims. Back to the Adventist Health St. Helena profile, with quality ratings, finances and negotiated rates.
829
Medicare inpatient discharges
In 33 published DRGs
2.91
Case mix index
IPPS FY 2027
44%
Surgical stays
56%
Stays with complications
In DRGs with a CC or MCC
2,028
Medicare outpatient services
In 27 service groups
Inpatient stays by major diagnostic category
Circulatory system468 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 82 | $202,217 | $32,471 | $29,726 | 3.24 |
| Heart failure and shock with MCCMS-DRG 291, medical | 52 | $129,508 | $12,886 | $19,038 | 1.28 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 39 | $284,105 | $32,291 | $41,763 | 3.18 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 39 | $241,724 | $49,904 | $35,533 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 33 | $121,429 | $15,406 | $17,850 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 33 | $170,726 | $17,842 | $25,097 | 1.82 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 20 | $608,039 | $53,759 | $89,382 | 5.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $85,521 | $8,746 | $12,572 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $253,675 | $27,678 | $37,290 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 17 | $848,636 | $89,543 | $124,749 | 7.71 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 17 | $509,564 | $64,801 | $74,906 | 6.25 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 14 | $554,447 | $61,551 | $81,504 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $318,685 | $37,680 | $46,847 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 12 | $144,667 | $22,138 | $21,266 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 12 | $109,661 | $10,087 | $16,120 | 1.08 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 12 | $73,325 | $11,757 | $10,779 | 1.20 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 12 | $59,567 | $6,961 | $8,756 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 12 | $130,794 | $21,411 | $19,227 | 2.09 |
| Other vascular procedures with CCMS-DRG 253, surgical | 11 | $293,320 | $25,990 | $43,118 | 2.55 |
Infectious and parasitic diseases126 discharges in 3 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 | 97 | $151,262 | $19,078 | $22,235 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 16 | $76,098 | $9,848 | $11,186 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 13 | $631,715 | $65,652 | $92,862 | 5.00 |
Mental diseases and disorders73 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 73 | $81,253 | $12,968 | $11,944 | 1.37 |
Respiratory system60 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 18 | $117,456 | $16,093 | $17,266 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 16 | $126,537 | $12,767 | $18,601 | 1.33 |
| Major chest procedures with MCCMS-DRG 163, surgical | 14 | $252,720 | $48,353 | $37,150 | 4.71 |
| Major chest procedures with CCMS-DRG 164, surgical | 12 | $334,804 | $25,522 | $49,216 | 2.55 |
Endocrine, nutritional and metabolic25 discharges in 1 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 | 25 | $87,785 | $12,699 | $12,904 | 1.32 |
Kidney and urinary tract25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 14 | $125,089 | $14,458 | $18,388 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 11 | $133,684 | $15,557 | $19,652 | 1.65 |
Digestive system22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 22 | $84,516 | $9,274 | $12,424 | 0.98 |
Musculoskeletal system and connective tissue16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 16 | $234,889 | $18,695 | $34,529 | 1.88 |
Other14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 14 | $386,262 | $64,084 | $56,781 |
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 5 Musculoskeletal ProceduresAPC 5115 | 626 | 572 | $191,731 | $15,035 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 217 | 216 | $49,598 | $2,978 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 202 | 193 | $209,822 | $28,361 | $21,117 |
| Level 2 Upper GI ProceduresAPC 5302 | 82 | 79 | $21,325 | $1,943 | $1,445 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 79 | 79 | $103,074 | $12,049 | $8,569 |
| Level 2 Urology and Related ServicesAPC 5372 | 79 | 60 | $13,665 | $690 | $502 |
| Level 4 Endovascular ProceduresAPC 5194 | 60 | 48 | $163,503 | $19,769 | $14,606 |
| Level 5 Urology and Related ServicesAPC 5375 | 59 | 58 | $83,840 | $5,290 | $3,918 |
| Comprehensive Observation ServicesAPC 8011 | 57 | 54 | $49,043 | $2,799 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 52 | 49 | $37,528 | $2,905 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 51 | 50 | $54,110 | $3,258 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 48 | 48 | $160,969 | $5,799 | $4,358 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 47 | 43 | $40,433 | $1,643 | $1,196 |
| Level 3 Endovascular ProceduresAPC 5193 | 47 | 46 | $124,634 | $12,182 | $8,874 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 45 | 43 | $21,552 | $1,657 | $1,220 |
| Level 4 Vascular ProceduresAPC 5184 | 37 | 28 | $34,972 | $5,619 | $3,946 |
| Level 4 Urology and Related ServicesAPC 5374 | 35 | 28 | $49,281 | $3,559 | $2,629 |
| Level 3 Urology and Related ServicesAPC 5373 | 34 | 32 | $26,055 | $2,070 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 30 | 29 | $82,625 | $3,310 | $2,373 |
| Level 1 Nerve ProceduresAPC 5431 | 25 | 22 | $24,702 | $1,972 | $1,407 |
| Level 4 Airway EndoscopyAPC 5154 | 22 | 22 | $156,149 | $3,829 | $2,833 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 19 | 19 | $312,797 | $40,451 | $29,375 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 17 | 17 | $116,713 | $7,545 | $5,339 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 16 | 16 | $67,698 | $3,898 | $2,930 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 15 | 15 | $100,815 | $3,525 | $2,636 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 14 | 13 | $70,056 | $7,940 | $5,682 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 13 | 13 | $133,985 | $6,736 | $4,982 |
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.