CA CMS Medicare PUF 2023 Avg payment #1 of 56

California procedure costs

378 hospitals · 15,736 Medicare providers · 6,723 procedure codes with California locality adjustments.

The short answer

California has 378 hospitals and 15,736 Medicare-billing providers across 6,723 procedure codes. The average Medicare payment per procedure is $347.40; the average submitted (billed) charge is $1,972.60.

Procedure codes
6,723
Providers per hospital
41.6
Billed-to-Medicare ratio
5.7x
Markup rank
#24 of 56

Source: CMS Medicare Physician & Other Practitioners, 2023.

About this dataset, nationwide

According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.

378
Hospitals
15,736
Providers
$347.40
Avg Medicare Payment
$1,972.60
Avg Billed Charge

California against every US state

Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions

$347 higher than 98% of 56 states

$75–$100: 3 states (5%). Below this entry. $100–$125: 1 states (2%). Below this entry. $125–$150: 2 states (4%). Below this entry. $150–$175: 5 states (9%). Below this entry. $175–$200: 7 states (13%). Below this entry. $200–$225: 9 states (16%). Below this entry. $225–$250: 9 states (16%). Below this entry. $250–$275: 11 states (20%). Below this entry. $275–$300: 4 states (7%). Below this entry. $300–$325: 4 states (7%). Below this entry. $325–$350: 1 states (2%). This entry sits in this band. This state $75 $350 every US state, bucketed by value

Each bar is a $25-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners, 2023

The priciest procedures in California

Highest average Medicare payment per procedure billed in California. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.

Top procedures by Medicare payment - California

Sipuleucel-T, Minimum Of 50 …41946Revascularization, Endovascu…10205Removal Of Plaque And Insert…9003Insertion Of Spinal Neurosti…8805Removal Of Plaque And Insert…8001Arthroscopy, Shoulder, Surgi…7936Catheter Removal Of Plaque F…7656Cochlear Implant, External S…7192
Top procedures by Medicare payment - California-Average Medicare payment per procedure (CMS 2023)

The cost spread in California

The highest- and lowest-paying procedures Medicare reimbursed in California, side by side.

Top Procedures by Volume

Procedure Medicare Services
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $11.57 14.1M
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.12 10.7M
Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specified $1.15 10.5M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $93.56 9.5M
Injection, Testosterone Cypionate, 1 Mg $0.02 8.8M
Injection, Onabotulinumtoxina, 1 Unit $4.87 8.1M
Factor Viia (antihemophilic Factor, Recombinant), (novoseven Rt), 1 Microgram $1.86 7.7M
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $66.00 7.0M
Ground Mileage, Per Statute Mile $7.11 6.7M
Injection, Ferric Carboxymaltose, 1 Mg $0.87 6.3M
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $19.41 6.0M
Injection, Denosumab, 1 Mg $18.00 5.9M
Injection, Factor Viii Fc Fusion Protein (recombinant), Per Iu $1.69 5.9M
Injection, Factor Ix, Fc Fusion Protein, (recombinant), Alprolix, 1 I.u. $2.67 5.0M
Injection, Factor Ix (antihemophilic Factor, Recombinant) Per Iu, Not Otherwise Specified $1.32 4.8M
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $3.87 4.8M
Injection, Von Willebrand Factor Complex (humate-P), Per Iu Vwf:rco $1.02 4.8M
Injection, Gadoterate Meglumine, 0.1 Ml $0.11 4.6M
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.26 4.1M
Injection, Tocilizumab, 1 Mg $4.60 3.9M
Therapy Procedure Using Functional Activities $27.08 3.8M
Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Miles Actually Travelled $1.10 3.7M
Therapy Procedure Using Manual Technique, Each 15 Minutes $17.22 3.7M
Injection, Pembrolizumab, 1 Mg $42.14 3.7M
Injection, Romosozumab-Aqqg, 1 Mg $7.85 3.6M
Injection, Gadobutrol, 0.1 Ml $0.26 3.5M
Injection, Darbepoetin Alfa, 1 Microgram (non-Esrd Use) $2.35 3.5M
Injection, Faricimab-Svoa, 0.1 Mg $28.91 3.2M
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $65.25 3.1M
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes $98.70 3.1M

California Healthcare Cost Landscape

CMS lists 378 hospitals in California across 236 cities. LOS ANGELES holds 19 (5%). The three densest cities together hold 11% of the state roster. Statewide that is 15,736 Medicare-billing providers, 41.6 per listed hospital.

266 hospitals carry a CMS overall star rating (25 five-star, 71 four-star, 83 three-star, 56 two-star, 31 one-star) ; five-star share among rated facilities is 9%. 112 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 277 (73%); Psychiatric 40 (11%); Critical Access Hospitals 38 (10%); Childrens 10 (3%).

Among the 30 highest-volume procedure codes billed in California, Drugs (Administered) leads with 90.4M services (52% of this top-volume slice) across 16 codes. Next is Office Visit at 10%.

Submitted charges average $1,972.60 against $347.40 Medicare payment (5.7x billed-to-Medicare). That ratio ranks #24 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #1 of 56.

Volume leaders are not the high-payment codes. Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count is in the top volume slice but not the highest Medicare payments; Sipuleucel-T, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-Gm-Csf, Including Leukapheresis And All Other Preparatory Procedures, Per Infusion is in the high-payment set without matching volume rank.

These are CMS roster and claims aggregates for California, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.

Where California hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 236 distinct cities appear on 378 listed facilities.

City Hospitals Share of state roster
LOS ANGELES 19 5%
SAN FRANCISCO 13 3%
SACRAMENTO 10 3%
SAN DIEGO 8 2%
BAKERSFIELD 6 2%
LONG BEACH 6 2%
ANAHEIM 5 1%
FRESNO 5 1%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for California: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.

Similar CMS hospital count

Nearest states with ≥5 hospitals (378 here).

Similar average Medicare payment

Nearest states with published averages ($347.40 here).

Hospitals in California

60th Medical Group (Travis AFB)
Travis AFB · -
ADVENTIST HEALTH AND RIDEOUT
MARYSVILLE · ★★☆☆☆
ADVENTIST HEALTH BAKERSFIELD
BAKERSFIELD · ★☆☆☆☆
ADVENTIST HEALTH CLEARLAKE
CLEARLAKE · ★☆☆☆☆
ADVENTIST HEALTH DELANO
DELANO · -
ADVENTIST HEALTH HANFORD
HANFORD · ★★☆☆☆
ADVENTIST HEALTH HOWARD MEMORIAL
WILLITS · ★★★★★
ADVENTIST HEALTH LODI MEMORIAL
LODI · ★★★☆☆
ADVENTIST HEALTH MENDOCINO COAST
FORT BRAGG · ★☆☆☆☆
ADVENTIST HEALTH REEDLEY
REEDLEY · -
ADVENTIST HEALTH SIERRA VISTA
SAN LUIS OBISPO · ★★★☆☆
ADVENTIST HEALTH SIMI VALLEY
SIMI VALLEY · ★★☆☆☆
ADVENTIST HEALTH SONORA
SONORA · ★★★☆☆
ADVENTIST HEALTH ST HELENA
SAINT HELENA · ★★★★☆
ADVENTIST HEALTH TEHACHAPI VALLEY
TEHACHAPI · -
ADVENTIST HEALTH TULARE
TULARE · -
ADVENTIST HEALTH TWIN CITIES
TEMPLETON · ★★☆☆☆
ADVENTIST HEALTH UKIAH VALLEY
UKIAH · ★★★★☆
ADVENTIST HEALTH VALLEJO
VALLEJO · -
ADVENTIST HEALTH WHITE MEMORIAL
LOS ANGELES · ★★★☆☆
ADVENTIST HEALTH WHITE MEMORIAL MONTEBELLO
MONTEBELLO · ★★☆☆☆
AHMC ANAHEIM REGIONAL MEDICAL CENTER
ANAHEIM · ★★★☆☆
AHMC SETON MEDICAL CENTER
DALY CITY · ★☆☆☆☆
ALAMEDA HOSPITAL
ALAMEDA · ★★★☆☆
ALHAMBRA HOSPITAL MEDICAL CENTER
ALHAMBRA · ★★★☆☆
ALISO RIDGE BEHAVIORAL HEALTH, LLC
ALISO VIEJO · -
ALTA BATES SUMMIT MEDICAL CENTER
OAKLAND · ★★★★★
ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP
BERKELEY · ★★★☆☆
ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTE
LA MESA · -
ANAHEIM COMMUNITY HOSPITAL, LLC
ANAHEIM · -

View all 378 hospitals in California →

How California Compares Nationally

California's average Medicare payment is #1 of 56 in this extract. Submitted-over-Medicare markup ranks #24 of 56 (5.7x). Hospital-count peers (nearest CMS roster size to 378): Texas 465, Florida 222, Ohio 196, Illinois 194. Payment peers (nearest average Medicare payment to $347.40): New York $313.07, Maryland $310.43, Arizona $286.66, Pennsylvania $284.85.

Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for California, not an out-of-pocket quote.

Related registry pages

California averages sit on two maps: Medicare payment and submitted-over-Medicare markup.

Figures here are California CMS averages, not a quote for any patient, plan, or visit.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure  · Verify with CMS →

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.