Sierra Vista Regional Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Sierra Vista Regional Medical Center, San Luis Obispo, CA in 2024, from traditional Medicare claims. Back to the Sierra Vista Regional Medical Center profile, with quality ratings, finances and negotiated rates.
520
Medicare inpatient discharges
In 23 published DRGs
2.05
Case mix index
IPPS FY 2027
23%
Surgical stays
80%
Stays with complications
In DRGs with a CC or MCC
831
Medicare outpatient services
In 23 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases153 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 | 122 | $213,178 | $17,483 | $25,581 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 16 | $117,365 | $9,025 | $14,084 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 15 | $511,176 | $50,883 | $61,341 | 5.00 |
Musculoskeletal system and connective tissue98 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cervical spinal fusion with CCMS-DRG 472, surgical | 19 | $236,812 | $27,327 | $28,417 | 2.96 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 19 | $198,616 | $18,551 | $23,834 | 2.07 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 18 | $521,970 | $54,499 | $62,636 | 6.12 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 18 | $208,023 | $18,948 | $24,963 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 13 | $104,774 | $7,670 | $12,573 | 0.90 |
| Medical back problems without MCCMS-DRG 552, medical | 11 | $102,331 | $7,981 | $12,280 | 0.97 |
Respiratory system78 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 39 | $155,896 | $11,478 | $18,708 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 20 | $151,027 | $14,610 | $18,123 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 19 | $120,926 | $10,876 | $14,511 | 1.23 |
Nervous system68 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 28 | $417,727 | $41,483 | $50,127 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 21 | $271,496 | $18,168 | $32,580 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 19 | $149,035 | $8,659 | $17,884 | 1.02 |
Kidney and urinary tract39 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 16 | $102,107 | $6,502 | $12,253 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 12 | $116,072 | $7,542 | $13,929 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 11 | $196,410 | $14,171 | $23,569 | 1.50 |
Digestive system36 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 13 | $124,145 | $8,144 | $14,897 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 12 | $148,843 | $11,651 | $17,861 | 1.28 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 11 | $89,848 | $6,380 | $10,782 | 0.79 |
Circulatory system29 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 29 | $151,364 | $11,556 | $18,164 | 1.28 |
Endocrine, nutritional and metabolic19 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 | 19 | $190,256 | $10,856 | $22,831 | 1.32 |
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 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 103 | 101 | $16,159 | $1,554 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 92 | 85 | $23,085 | $3,088 | $2,405 |
| Comprehensive Observation ServicesAPC 8011 | 83 | 81 | $70,408 | $2,641 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 65 | 60 | $26,014 | $1,862 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 58 | 58 | $65,189 | $5,652 | $4,358 |
| Level 3 Urology and Related ServicesAPC 5373 | 44 | 26 | $18,417 | $1,987 | $1,516 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 41 | 39 | $146,111 | $14,516 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 38 | 38 | $91,511 | $7,160 | $5,339 |
| Level 2 Vascular ProceduresAPC 5182 | 35 | 35 | $8,064 | $1,560 | $1,204 |
| Level 4 Airway EndoscopyAPC 5154 | 33 | 32 | $67,713 | $3,668 | $2,833 |
| Level 4 Urology and Related ServicesAPC 5374 | 30 | 29 | $40,140 | $3,301 | $2,629 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 28 | 27 | $52,583 | $3,386 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 22 | 22 | $24,565 | $1,574 | $1,196 |
| Level 2 Endovascular ProceduresAPC 5192 | 22 | 17 | $61,340 | $5,595 | $4,338 |
| Level 5 Urology and Related ServicesAPC 5375 | 21 | 20 | $54,565 | $5,069 | $3,918 |
| Level 3 Endovascular ProceduresAPC 5193 | 20 | 17 | $106,806 | $11,853 | $8,874 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 20 | 20 | $87,794 | $11,005 | $8,164 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 14 | 14 | $47,000 | $3,171 | $2,373 |
| Level 5 Airway EndoscopyAPC 5155 | 14 | 14 | $80,511 | $6,781 | $5,183 |
| Level 4 Vascular ProceduresAPC 5184 | 14 | 14 | $88,706 | $5,383 | $3,946 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 12 | 12 | $213,655 | $19,455 | $15,763 |
| Complex GI ProceduresAPC 5331 | 11 | $59,745 | $5,583 | $4,263 | |
| Level 4 Gynecologic ProceduresAPC 5414 | 11 | 11 | $32,455 | $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.