Santa Clara Valley Medical Center Medicare inpatient and outpatient services

Every DRG and outpatient service group CMS publishes for Santa Clara Valley Medical Center, San Jose, CA in 2024, from traditional Medicare claims. Back to the Santa Clara Valley Medical Center profile, with quality ratings, finances and negotiated rates.

4,108
Medicare inpatient discharges
In 114 published DRGs
1.77
Case mix index
IPPS FY 2027
11%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
2,211
Medicare outpatient services
In 32 service groups

Inpatient stays by major diagnostic category

Infectious and parasitic diseases959 discharges in 5 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	654	$177,462	$32,960	$55,901	1.98
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	137	$81,150	$15,127	$25,562	1.03
Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical	82	$516,081	$116,964	$162,566	5.00
Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical	58	$659,122	$136,385	$207,624	6.96
Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical	28	$193,347	$35,880	$60,904	2.04

Circulatory system683 discharges in 17 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	285	$114,368	$20,269	$36,026	1.28
Syncope and collapseMS-DRG 312, medical	62	$72,816	$13,788	$22,937	0.86
Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical	48	$72,688	$11,749	$22,897	0.74
Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical	41	$129,415	$19,497	$40,766	1.20
Other circulatory system diagnoses with MCCMS-DRG 314, medical	37	$184,601	$35,977	$58,149	2.09
Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical	36	$165,490	$25,751	$52,129	1.59
Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical	23	$184,093	$26,360	$57,989	1.82
Other vascular procedures with MCCMS-DRG 252, surgical	21	$274,883	$58,298	$86,588	3.35
Heart failure and shock with CCMS-DRG 292, medical	17	$91,695	$13,916	$28,884	0.86
Peripheral vascular disorders with CCMS-DRG 300, medical	17	$58,638	$15,805	$18,471	1.07
Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical	17	$263,646	$46,165	$83,049	2.87
Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical	16	$210,120	$32,383	$66,188	2.28
Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical	15	$51,026	$9,125	$16,073	0.55
Hypertension without MCCMS-DRG 305, medical	13	$58,168	$11,996	$18,323	0.75
Chest painMS-DRG 313, medical	13	$69,461	$11,874	$21,880	0.72
Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical	11	$97,293	$13,948	$30,647	0.91
Hypertension with MCCMS-DRG 304, medical	11	$79,964	$17,042	$25,189	1.15

Respiratory system539 discharges in 15 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Respiratory infections and inflammations with MCCMS-DRG 177, medical	105	$139,298	$28,013	$43,879	1.70
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	93	$134,256	$22,424	$42,291	1.33
Pulmonary edema and respiratory failureMS-DRG 189, medical	72	$164,856	$24,682	$51,930	1.23
Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical	53	$118,284	$17,129	$37,260	1.10
Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical	32	$319,542	$57,141	$100,656	2.70
Respiratory infections and inflammations with CCMS-DRG 178, medical	28	$72,655	$14,386	$22,886	0.99
Simple pneumonia and pleurisy with CCMS-DRG 194, medical	24	$80,564	$12,789	$25,378	0.82
Major chest trauma with CCMS-DRG 184, medical	21	$74,768	$15,571	$23,552	1.05
Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical	20	$148,453	$20,615	$46,763	1.40
Chronic obstructive pulmonary disease with CCMS-DRG 191, medical	20	$82,678	$12,391	$26,044	0.85
Bronchitis and asthma with cc/mccMS-DRG 202, medical	20	$94,082	$13,923	$29,636	0.96
Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical	16	$465,168	$85,965	$146,528	6.91
Pulmonary embolism without MCCMS-DRG 176, medical	12	$63,552	$11,365	$20,019	0.82
Major chest trauma with MCCMS-DRG 183, medical	12	$196,483	$33,319	$61,892	1.57
Respiratory neoplasms with MCCMS-DRG 180, medical	11	$232,611	$40,604	$73,272	1.74

Nervous system371 discharges in 16 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	55	$119,092	$16,558	$37,514	1.02
Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical	54	$172,116	$29,546	$54,216	2.00
Transient ischemia without thrombolyticMS-DRG 069, medical	27	$70,898	$12,337	$22,333	0.80
Seizures without MCCMS-DRG 101, medical	26	$68,070	$13,730	$21,442	0.91
Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical	24	$95,830	$19,885	$30,187	1.36
Degenerative nervous system disorders without MCCMS-DRG 057, medical	23	$158,256	$24,566	$49,851	1.36
Other cerebrovascular disorders with MCCMS-DRG 070, medical	22	$162,951	$28,364	$51,330	1.79
Other disorders of nervous system with CCMS-DRG 092, medical	21	$66,524	$14,622	$20,955	1.03
Other cerebrovascular disorders with CCMS-DRG 071, medical	18	$130,187	$23,049	$41,009	1.06
Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical	17	$344,840	$74,464	$108,625	4.42
Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical	17	$88,054	$19,156	$27,737	1.32
Seizures with MCCMS-DRG 100, medical	17	$147,795	$27,011	$46,556	1.98
Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical	13	$49,754	$15,817	$15,673	1.03
Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical	13	$80,513	$12,558	$25,362	0.89
Other disorders of nervous system with MCCMS-DRG 091, medical	13	$250,451	$50,715	$78,892	1.79
Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical	11	$165,901	$40,815	$52,259	2.28

Kidney and urinary tract349 discharges in 7 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Kidney and urinary tract infections without MCCMS-DRG 690, medical	76	$62,359	$12,198	$19,643	0.81
Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical	69	$159,760	$30,031	$50,324	1.65
Renal failure with CCMS-DRG 683, medical	65	$76,563	$13,516	$24,117	0.90
Kidney and urinary tract infections with MCCMS-DRG 689, medical	50	$111,548	$20,005	$35,137	1.17
Renal failure with MCCMS-DRG 682, medical	40	$144,981	$24,550	$45,669	1.50
Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical	34	$83,845	$17,107	$26,411	1.02
Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical	15	$370,702	$90,561	$116,771	3.70

Digestive system316 discharges in 13 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Gastrointestinal hemorrhage with CCMS-DRG 378, medical	52	$70,145	$14,827	$22,096	0.98
Gastrointestinal hemorrhage with MCCMS-DRG 377, medical	47	$149,418	$28,901	$47,067	1.79
Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical	44	$63,509	$12,137	$20,005	0.79
Gastrointestinal obstruction with CCMS-DRG 389, medical	26	$51,385	$12,150	$16,186	0.80
Other digestive system diagnoses with CCMS-DRG 394, medical	24	$76,645	$13,760	$24,143	0.94
Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical	22	$89,252	$16,881	$28,114	1.04
Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical	19	$119,526	$25,771	$37,651	1.28
Other digestive system diagnoses with MCCMS-DRG 393, medical	16	$156,772	$35,272	$49,383	1.62
Digestive malignancy with CCMS-DRG 375, medical	15	$103,693	$18,690	$32,663	1.20
Gastrointestinal obstruction without cc/mccMS-DRG 390, medical	14	$45,382	$9,362	$14,295	0.56
Major small and large bowel procedures with MCCMS-DRG 329, surgical	13	$418,020	$94,761	$131,676	4.52
Major small and large bowel procedures with CCMS-DRG 330, surgical	12	$236,738	$40,464	$74,573	2.37
Gastrointestinal obstruction with MCCMS-DRG 388, medical	12	$166,094	$27,273	$52,320	1.45

Musculoskeletal system and connective tissue255 discharges in 12 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	51	$143,760	$28,049	$45,285	2.07
Medical back problems without MCCMS-DRG 552, medical	28	$71,018	$14,498	$22,371	0.97
Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical	26	$133,438	$29,142	$42,033	2.11
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical	25	$67,677	$12,886	$21,318	0.90
Hip and femur procedures except major joint with MCCMS-DRG 480, surgical	19	$247,491	$46,523	$77,960	2.95
Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical	18	$91,504	$26,300	$28,824	1.88
Fractures of hip and pelvis without MCCMS-DRG 536, medical	18	$62,454	$12,169	$19,673	0.79
Medical back problems with MCCMS-DRG 551, medical	18	$151,974	$33,471	$47,872	1.70
Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical	17	$93,766	$22,413	$29,536	1.59
Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical	13	$206,548	$38,676	$65,063	2.40
Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical	11	$212,348	$42,211	$66,889	2.99
Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical	11	$69,060	$15,590	$21,754	1.09

Endocrine, nutritional and metabolic249 discharges in 7 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	84	$103,855	$20,012	$32,714	1.32
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical	67	$73,955	$11,962	$23,296	0.78
Diabetes with CCMS-DRG 638, medical	43	$72,417	$14,008	$22,811	0.90
Diabetes with MCCMS-DRG 637, medical	16	$122,462	$21,836	$38,575	1.45
Endocrine disorders with CCMS-DRG 644, medical	16	$78,248	$15,947	$24,648	1.06
Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical	12	$103,996	$22,472	$32,759	1.98
Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical	11	$110,676	$25,423	$34,863	1.86

Liver, gallbladder and pancreas112 discharges in 8 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical	16	$83,383	$14,296	$26,265	1.03
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical	16	$125,832	$30,344	$39,637	1.83
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical	15	$115,317	$14,059	$36,325	0.95
Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical	14	$175,780	$33,379	$55,371	2.32
Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical	14	$128,697	$24,025	$40,540	1.63
Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical	13	$183,773	$31,599	$57,888	1.76
Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical	12	$333,238	$64,006	$104,970	1.92
Disorders of the biliary tract with CCMS-DRG 445, medical	12	$77,025	$15,867	$24,263	1.09

Skin, subcutaneous tissue and breast87 discharges in 3 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cellulitis without MCCMS-DRG 603, medical	50	$67,543	$14,410	$21,276	0.88
Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical	19	$71,942	$13,410	$22,662	0.91
Cellulitis with MCCMS-DRG 602, medical	18	$150,427	$23,584	$47,384	1.49

Blood and immune system61 discharges in 3 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Red blood cell disorders without MCCMS-DRG 812, medical	24	$69,991	$14,122	$22,047	0.90
Coagulation disordersMS-DRG 813, medical	22	$96,244	$22,730	$30,317	1.56
Red blood cell disorders with MCCMS-DRG 811, medical	15	$86,556	$19,406	$27,265	1.40

Mental diseases and disorders40 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Organic disturbances and intellectual disabilityMS-DRG 884, medical	27	$94,184	$20,714	$29,668	1.76
PsychosesMS-DRG 885, medical	13	$136,012	$26,797	$42,844	1.37

Injuries, poisonings and toxic effects of drugs37 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Complications of treatment with MCCMS-DRG 919, medical	22	$136,695	$30,429	$43,059	1.82
Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical	15	$186,022	$25,791	$58,597	1.60

Alcohol and drug use16 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	16	$100,251	$13,263	$31,579	0.86

Multiple significant trauma12 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical	12	$376,980	$83,618	$118,749	3.88

Ear, nose, mouth and throat11 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
DysequilibriumMS-DRG 149, medical	11	$58,708	$11,470	$18,493	0.74

Factors influencing health status11 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	11	$56,437	$12,389	$17,778	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	594	562	$29,327	$3,071	$2,090
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	244	164	$13,582	$1,816	$1,220
Level 1 Intraocular ProceduresAPC 5491	142	122	$17,771	$2,585	$1,752
Level 2 Urology and Related ServicesAPC 5372	140	86	$4,516	$760	$502
Level 3 Vascular ProceduresAPC 5183	112	101	$24,832	$3,572	$2,405
Level 3 Urology and Related ServicesAPC 5373	112	83	$17,499	$2,280	$1,516
Level 2 Upper GI ProceduresAPC 5302	78	68	$19,461	$2,141	$1,445
Level 5 Urology and Related ServicesAPC 5375	74	72	$32,594	$5,763	$3,918
Level 2 Endovascular ProceduresAPC 5192	67	48	$44,223	$6,416	$4,338
Level 4 Urology and Related ServicesAPC 5374	59	55	$23,352	$3,877	$2,629
Level 1 Laparoscopy and Related ServicesAPC 5361	58	57	$29,843	$6,381	$4,358
Level 2 Musculoskeletal ProceduresAPC 5112	52	50	$14,254	$1,789	$1,196
Level 1 Endovascular ProceduresAPC 5191	51	51	$28,491	$3,231	$2,208
Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341	47	43	$26,372	$3,836	$2,636
Level 2 Vascular ProceduresAPC 5182	43	41	$16,131	$1,790	$1,204
Level 3 Endovascular ProceduresAPC 5193	41	38	$116,414	$13,829	$8,874
Level 3 Musculoskeletal ProceduresAPC 5113	31	31	$22,041	$3,627	$2,373
Level 4 Vascular ProceduresAPC 5184	29	25	$31,597	$5,740	$3,946
Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073	26	25	$19,297	$3,182	$2,141
Level 3 Lower GI ProceduresAPC 5313	26	26	$23,108	$3,171	$2,176
Level 3 Upper GI ProceduresAPC 5303	23	23	$36,481	$4,297	$2,888
Level 4 Musculoskeletal ProceduresAPC 5114	21	21	$39,792	$8,423	$5,339
Level 5 Musculoskeletal ProceduresAPC 5115	19	18	$61,423	$16,858	$10,772
Level 3 Pacemaker and Similar ProceduresAPC 5223	19	19	$89,691	$13,374	$8,569
Level 4 Endovascular ProceduresAPC 5194	14	13	$219,132	$22,992	$14,606
Level 2 Laparoscopy and Related ServicesAPC 5362	14	13	$57,328	$11,920	$8,164
Level 4 Gynecologic ProceduresAPC 5414	14	14	$21,693	$3,508	$2,389
Level 1 Nerve ProceduresAPC 5431	14	14	$14,719	$2,075	$1,407
Level 3 Electrophysiologic ProceduresAPC 5213	13	13	$171,897	$31,709	$21,117
Level 4 Airway EndoscopyAPC 5154	12	12	$35,141	$4,202	$2,833
Level 5 Gynecologic ProceduresAPC 5415	11		$36,343	$5,580	$3,792
Level 4 Neurostimulator and Related ProceduresAPC 5464	11	11	$57,441	$29,080	$18,465

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.