Regional Medical Center Of San Jose Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Regional Medical Center Of San Jose, San Jose, CA in 2024, from traditional Medicare claims. Back to the Regional Medical Center Of San Jose profile, with quality ratings, finances and negotiated rates.
1,352
Medicare inpatient discharges
In 35 published DRGs
1.68
Case mix index
IPPS FY 2027
5%
Surgical stays
77%
Stays with complications
In DRGs with a CC or MCC
386
Medicare outpatient services
In 11 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases557 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 | 456 | $358,489 | $21,869 | $29,755 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 53 | $209,079 | $11,141 | $17,354 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 31 | $627,730 | $54,479 | $52,102 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $1,167,753 | $67,263 | $96,923 | 6.96 |
Circulatory system177 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 107 | $250,300 | $14,856 | $20,775 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 27 | $287,730 | $17,442 | $23,882 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 27 | $171,719 | $9,518 | $14,253 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 16 | $168,041 | $7,827 | $13,947 | 0.74 |
Respiratory system161 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 | 56 | $228,524 | $14,890 | $18,968 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 32 | $226,829 | $14,431 | $18,827 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 30 | $275,184 | $18,733 | $22,840 | 1.70 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 30 | $664,120 | $34,453 | $55,122 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 13 | $161,184 | $9,155 | $13,378 | 0.82 |
Nervous system141 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 51 | $419,140 | $21,886 | $34,789 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 32 | $271,448 | $11,156 | $22,530 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 18 | $199,463 | $8,315 | $16,555 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 17 | $185,937 | $10,290 | $15,433 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 12 | $419,856 | $27,043 | $34,848 | 1.98 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 11 | $327,891 | $15,110 | $27,215 | 1.32 |
Kidney and urinary tract119 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 28 | $157,802 | $9,531 | $13,098 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 27 | $163,766 | $9,085 | $13,593 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 25 | $232,112 | $18,748 | $19,265 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 22 | $181,641 | $16,052 | $15,076 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 17 | $161,467 | $13,199 | $13,402 | 1.17 |
Endocrine, nutritional and metabolic75 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 | 28 | $261,011 | $15,464 | $21,664 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 18 | $181,705 | $9,735 | $15,081 | 0.90 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 18 | $145,195 | $8,194 | $12,051 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 11 | $243,900 | $15,320 | $20,244 | 1.45 |
Musculoskeletal system and connective tissue62 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 29 | $182,425 | $10,677 | $15,141 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 19 | $434,926 | $23,464 | $36,099 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 14 | $383,606 | $20,096 | $31,839 | 1.88 |
Digestive system33 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 18 | $141,523 | $9,038 | $11,746 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 15 | $163,415 | $8,849 | $13,563 | 0.79 |
Mental diseases and disorders15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 15 | $160,375 | $17,761 | $13,311 | 1.76 |
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 with MCCMS-DRG 896, medical | 12 | $347,255 | $19,979 | $28,822 | 1.78 |
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 1 Intraocular ProceduresAPC 5491 | 82 | 69 | $60,640 | $2,577 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 79 | 79 | $102,210 | $3,058 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 46 | 46 | $98,008 | $3,573 | $2,405 |
| Level 1 Endovascular ProceduresAPC 5191 | 46 | 46 | $136,110 | $3,227 | $2,208 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 33 | $56,250 | $3,188 | $2,141 | |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 22 | 12 | $47,189 | $1,816 | $1,220 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 21 | 21 | $185,319 | $13,306 | $8,569 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 16 | 16 | $155,771 | $8,434 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 15 | 15 | $78,386 | $3,389 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 13 | 13 | $45,186 | $1,775 | $1,196 |
| Level 5 Urology and Related ServicesAPC 5375 | 13 | 12 | $135,664 | $5,805 | $3,918 |
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.