San Ramon Regional Medical Center
San Ramon Regional Medical Center, a for-profit hospital in San Ramon, CA, charges 15.4x the Medicare reimbursement rate across 29 analyzed procedures.
San Ramon, CA 94583 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
15.44x
Charge / Medicare rate
Max markup
24.63x
Worst procedure
Procedures analyzed
29
With pricing data
Outlier procedures
96.6%
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 |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $158,091 | $79,045 | — | 24.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $150,381 | $75,190 | — | 22.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $135,656 | $67,828 | — | 19.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $211,556 | $105,778 | — | 19.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $137,823 | $68,911 | — | 19.1x |
| CELLULITIS WITHOUT MCC | 603 | $156,070 | $78,035 | — | 18.7x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $141,176 | $70,588 | — | 18.6x |
| SYNCOPE AND COLLAPSE | 312 | $148,454 | $74,227 | — | 18.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $137,012 | $68,506 | — | 17.8x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $134,577 | $67,289 | — | 17.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $165,692 | $82,846 | — | 16.9x |
| RENAL FAILURE WITH CC | 683 | $135,196 | $67,598 | — | 16.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $207,344 | $103,672 | — | 15.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $168,136 | $84,068 | — | 15.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $221,432 | $110,716 | — | 15.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $266,424 | $133,212 | — | 15x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $130,877 | $65,438 | — | 14.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $155,580 | $77,790 | — | 13.4x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $247,739 | $123,869 | — | 13.2x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $112,815 | $56,407 | — | 13.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $268,335 | $134,167 | — | 12.9x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $239,525 | $119,762 | — | 12.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $143,052 | $71,526 | — | 12.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $162,012 | $81,006 | — | 12.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $247,590 | $123,795 | — | 12.6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $302,411 | $151,206 | — | 12.6x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $191,085 | $95,542 | — | 10.3x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $312,875 | $156,438 | — | 7.5x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $469,287 | $234,643 | — | 7.5x |
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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