San Antonio Regional Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for San Antonio Regional Hospital, Upland, CA in 2024, from traditional Medicare claims. Back to the San Antonio Regional Hospital profile, with quality ratings, finances and negotiated rates.
2,247
Medicare inpatient discharges
In 70 published DRGs
1.82
Case mix index
IPPS FY 2027
10%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
1,568
Medicare outpatient services
In 26 service groups
Inpatient stays by major diagnostic category
Circulatory system474 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 157 | $107,286 | $11,845 | $12,874 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 58 | $144,005 | $13,734 | $17,281 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 27 | $64,404 | $6,598 | $7,728 | 0.74 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 27 | $49,200 | $4,180 | $5,904 | 0.55 |
| Syncope and collapseMS-DRG 312, medical | 25 | $75,015 | $6,969 | $9,002 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $210,090 | $16,488 | $25,211 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 23 | $97,999 | $10,870 | $11,760 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 22 | $122,151 | $9,426 | $14,658 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $84,679 | $7,474 | $10,162 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 16 | $162,939 | $20,099 | $19,553 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 15 | $324,851 | $28,234 | $38,982 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 14 | $161,474 | $18,960 | $19,377 | 2.09 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 13 | $68,440 | $5,630 | $8,213 | 0.72 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 12 | $160,416 | $31,858 | $19,250 | 3.35 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 11 | $278,739 | $45,862 | $33,449 | 4.88 |
| Chest painMS-DRG 313, medical | 11 | $44,141 | $5,907 | $5,297 | 0.72 |
Respiratory system372 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 125 | $138,046 | $15,186 | $16,565 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 109 | $108,976 | $11,448 | $13,077 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 29 | $63,859 | $6,854 | $7,663 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 26 | $87,889 | $10,561 | $10,547 | 1.23 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 26 | $392,942 | $57,993 | $47,153 | 6.91 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 24 | $269,841 | $10,178 | $32,381 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 19 | $109,696 | $11,175 | $13,164 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $171,022 | $23,306 | $20,523 | 2.70 |
Infectious and parasitic diseases361 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 | 253 | $158,124 | $17,854 | $18,975 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 44 | $88,274 | $8,494 | $10,593 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 33 | $402,728 | $44,321 | $48,327 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 31 | $551,089 | $64,637 | $66,131 | 6.96 |
Digestive system289 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 41 | $57,268 | $6,548 | $6,872 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 38 | $68,607 | $8,417 | $8,233 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $61,586 | $6,743 | $7,390 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 26 | $121,507 | $16,809 | $14,581 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 25 | $178,513 | $21,602 | $21,422 | 2.37 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 22 | $51,494 | $4,265 | $6,179 | 0.56 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 21 | $143,053 | $15,203 | $17,166 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 19 | $76,132 | $8,003 | $9,136 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 15 | $79,551 | $8,993 | $9,546 | 1.04 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 14 | $137,094 | $11,504 | $16,451 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 13 | $343,965 | $39,852 | $41,276 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 12 | $114,884 | $15,332 | $13,786 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $121,440 | $13,473 | $14,573 | 1.45 |
Kidney and urinary tract237 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 | 74 | $93,512 | $10,506 | $11,221 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 66 | $60,703 | $6,820 | $7,284 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 35 | $135,754 | $13,414 | $16,290 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 27 | $125,422 | $15,033 | $15,051 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 24 | $68,831 | $7,518 | $8,260 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 11 | $63,176 | $8,554 | $7,581 | 1.02 |
Nervous system152 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 51 | $106,178 | $8,552 | $12,741 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 40 | $211,589 | $18,004 | $25,391 | 2.00 |
| Seizures with MCCMS-DRG 100, medical | 18 | $150,290 | $17,432 | $18,035 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 17 | $95,493 | $8,746 | $11,459 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 15 | $78,449 | $8,445 | $9,414 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 11 | $161,527 | $16,067 | $19,383 | 1.79 |
Endocrine, nutritional and metabolic148 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 | 75 | $94,404 | $11,506 | $11,328 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 35 | $57,328 | $6,497 | $6,879 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $91,778 | $12,143 | $11,013 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 17 | $78,150 | $7,314 | $9,378 | 0.90 |
Musculoskeletal system and connective tissue79 discharges in 5 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 | 21 | $154,442 | $18,866 | $18,533 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 19 | $126,195 | $18,286 | $15,143 | 2.11 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $70,276 | $6,681 | $8,433 | 0.79 |
| Medical back problems without MCCMS-DRG 552, medical | 14 | $71,730 | $7,653 | $8,608 | 0.97 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 11 | $121,989 | $14,311 | $14,639 | 1.59 |
Blood and immune system43 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 16 | $74,631 | $11,725 | $8,956 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 16 | $38,225 | $8,277 | $4,587 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $77,133 | $11,237 | $9,256 | 1.20 |
Liver, gallbladder and pancreas33 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 21 | $135,904 | $12,790 | $16,308 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 12 | $116,900 | $16,500 | $14,028 | 1.83 |
Skin, subcutaneous tissue and breast32 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 32 | $61,860 | $7,273 | $7,423 | 0.88 |
Other14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 14 | $299,668 | $43,415 | $35,960 | 4.74 |
Factors influencing health status13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 13 | $45,865 | $7,054 | $5,504 | 0.80 |
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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 449 | 410 | $46,302 | $2,668 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 170 | 169 | $70,002 | $2,877 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 121 | 114 | $17,820 | $1,137 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 116 | 108 | $26,121 | $3,120 | $2,405 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 77 | 76 | $90,725 | $14,327 | $10,772 |
| Level 3 Endovascular ProceduresAPC 5193 | 70 | 64 | $145,711 | $11,556 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 56 | 56 | $56,182 | $5,395 | $4,358 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 53 | 53 | $28,632 | $2,510 | $2,141 |
| Level 4 Vascular ProceduresAPC 5184 | 43 | 35 | $47,318 | $5,374 | $3,946 |
| Level 5 Urology and Related ServicesAPC 5375 | 42 | 42 | $49,140 | $5,060 | $3,918 |
| Level 2 Endovascular ProceduresAPC 5192 | 40 | 38 | $84,157 | $5,594 | $4,338 |
| Level 2 Vascular ProceduresAPC 5182 | 37 | 37 | $15,512 | $1,542 | $1,204 |
| Level 2 Upper GI ProceduresAPC 5302 | 37 | 34 | $15,594 | $1,859 | $1,445 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 33 | 33 | $62,392 | $6,724 | $5,339 |
| Level 4 Endovascular ProceduresAPC 5194 | 25 | 24 | $163,190 | $19,871 | $14,606 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 22 | 22 | $62,506 | $6,388 | $4,982 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 22 | 21 | $41,387 | $3,171 | $2,373 |
| Level 3 Urology and Related ServicesAPC 5373 | 21 | 16 | $25,501 | $1,805 | $1,516 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 19 | 19 | $47,142 | $3,734 | $2,930 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 19 | 19 | $14,950 | $1,558 | $1,196 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 18 | 18 | $66,809 | $8,803 | $6,514 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 18 | 16 | $40,501 | $3,380 | $2,636 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 17 | 17 | $93,354 | $11,476 | $8,569 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 16 | 16 | $98,558 | $19,893 | $15,763 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 15 | 15 | $186,207 | $27,482 | $21,117 |
| Level 4 Gynecologic ProceduresAPC 5414 | 12 | 12 | $32,923 | $3,062 | $2,389 |
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.