Mercy San Juan Medical Center
Mercy San Juan Medical Center in Carmichael, CA charges 7.4x the Medicare reimbursement rate on average across 105 analyzed procedures, with 24% showing significant pricing variations.
Carmichael, CA 95608 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
D
High
Avg markup vs Medicare
7.37x
Charge / Medicare rate
Max markup
13.42x
Worst procedure
Procedures analyzed
105
With pricing data
Outlier procedures
23.8%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| PNEUMOTHORAX WITH CC | 200 | $138,286 | $69,143 | — | 13.4x |
| MAJOR CHEST TRAUMA WITH CC | 184 | $94,433 | $47,216 | — | 11.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $164,307 | $82,154 | — | 10.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $91,153 | $45,577 | — | 10.2x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $92,044 | $46,022 | — | 10.2x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $166,615 | $83,308 | — | 10.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $131,801 | $65,901 | — | 10x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $102,314 | $51,157 | — | 9.9x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $169,675 | $84,837 | — | 9.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $91,615 | $45,808 | — | 9.8x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $93,533 | $46,766 | — | 9.8x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $94,276 | $47,138 | — | 9.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $61,479 | $30,739 | — | 9.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $175,505 | $87,753 | — | 9.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $74,070 | $37,035 | — | 9.6x |
| CHEST PAIN | 313 | $67,586 | $33,793 | — | 9.6x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $86,496 | $43,248 | — | 9.5x |
| DIABETES WITH MCC | 637 | $128,489 | $64,244 | — | 9.2x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $62,182 | $31,091 | — | 8.8x |
| SYNCOPE AND COLLAPSE | 312 | $72,886 | $36,443 | — | 8.7x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $212,128 | $106,064 | — | 8.6x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $94,517 | $47,258 | — | 8.5x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $371,093 | $185,546 | — | 8.4x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $66,218 | $33,109 | — | 8.3x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $65,167 | $32,584 | — | 8.2x |
| UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC | 741 | $102,826 | $51,413 | — | 8.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $62,651 | $31,325 | — | 8.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $129,399 | $64,699 | — | 8x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 219 | $713,765 | $356,882 | — | 7.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $58,624 | $29,312 | — | 7.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $59,303 | $29,651 | — | 7.9x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | 516 | $159,831 | $79,916 | — | 7.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $152,145 | $76,072 | — | 7.8x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $75,005 | $37,503 | — | 7.8x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $218,289 | $109,144 | — | 7.8x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC | 087 | $65,819 | $32,909 | — | 7.7x |
| SEIZURES WITHOUT MCC | 101 | $67,414 | $33,707 | — | 7.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $54,829 | $27,414 | — | 7.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $82,886 | $41,443 | — | 7.6x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $66,063 | $33,032 | — | 7.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $95,242 | $47,621 | — | 7.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $71,705 | $35,852 | — | 7.6x |
| COMPLICATIONS OF TREATMENT WITH MCC | 919 | $141,886 | $70,943 | — | 7.6x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | 896 | $119,782 | $59,891 | — | 7.6x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $155,639 | $77,819 | — | 7.5x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $89,334 | $44,667 | — | 7.5x |
| RENAL FAILURE WITH CC | 683 | $64,928 | $32,464 | — | 7.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $85,224 | $42,612 | — | 7.4x |
| EXTRACRANIAL PROCEDURES WITH CC | 038 | $117,440 | $58,720 | — | 7.4x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC | 085 | $157,075 | $78,538 | — | 7.4x |
Showing 50 of 105 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use