Orange, CA, 92863-5600
The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.
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vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | vs nat'l | Neg max |
|---|---|---|---|---|---|---|---|---|---|
| behavioral | |||||||||
| Psychoses | MS-DRG | 885 | 11 | — | — | $15,260 | $15,260 | 1.2× | $45,826 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $21,761 | $21,761 | 1.1× | $64,670 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $11,170 | $11,170 | 1.0× | $33,065 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $7,720.31 | $7,720.31 | 1.0× | $22,378 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $17,016 | $17,016 | 1.1× | $52,556 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $12,200 | $12,200 | 1.1× | $36,521 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $9,398.91 | $9,398.91 | 1.1× | $27,931 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $7,271.56 | $7,271.56 | 1.0× | $21,042 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $9,006.25 | $9,006.25 | 1.1× | $26,660 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $7,128.68 | $7,128.68 | 1.1× | $20,248 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $17,454 | $17,454 | 1.1× | $53,368 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $10,204 | $10,204 | 1.1× | $29,970 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $8,129.91 | $8,129.91 | 1.0× | $23,574 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $14,064 | $14,064 | 1.1× | $42,425 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $9,462.41 | $9,462.41 | 1.1× | $28,003 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $6,467.19 | $6,467.19 | 1.0× | $17,849 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $13,220 | $13,220 | 1.1× | $39,209 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $8,263.26 | $8,263.26 | 1.1× | $24,036 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $6,468.25 | $6,468.25 | 1.0× | $18,190 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $10,856 | $10,856 | 1.1× | $32,054 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $7,148.79 | $7,148.79 | 1.0× | $20,697 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $8,727.89 | $8,727.89 | 1.1× | $25,369 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $17,069 | $17,069 | 1.1× | $49,574 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $12,757 | $12,757 | 1.1× | $38,052 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $9,044.35 | $9,044.35 | 1.1× | $26,094 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $21,036 | $21,036 | 1.1× | $63,798 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $11,307 | $11,307 | 1.1× | $33,520 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 3 | — | — | $20,251 | $75,072 | 2.7× | $97,386 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 3 | — | — | $20,251 | $47,811 | 2.6× | $62,082 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $49,125 | $49,125 | 1.1× | $149,285 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $25,848 | $25,848 | 1.1× | $76,849 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $18,288 | $18,288 | 1.1× | $53,677 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 11 | — | — | $18,380 | $18,380 | 1.1× | $53,921 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $14,932 | $14,932 | 1.1× | $42,838 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $36,537 | $36,537 | 1.1× | $114,741 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 3 | — | — | $31,542 | $164,250 | 3.3× | $215,629 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 3 | — | — | $31,542 | $92,884 | 2.8× | $118,926 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $32,580 | $32,580 | 1.1× | $106,265 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $20,892 | $20,892 | 1.1× | $61,301 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $19,288 | $31,300 | 1.1× | $95,618 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $19,288 | $22,645 | 1.1× | $67,459 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $17,739 | $17,739 | 1.1× | $51,577 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $31,036 | $31,036 | 1.1× | $88,641 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $17,414 | $17,414 | 1.1× | $51,918 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $16,441 | $16,441 | 1.1× | $47,523 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $13,608 | $13,608 | 1.1× | $38,969 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $22,164 | $22,164 | 1.2× | $63,525 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Health Net | 47 | $24,703 |
| Blue Cross Blue Shield | 47 | $20,813 |
| UnitedHealthcare | 47 | $29,223 |
| Aetna | 43 | $14,064 |
| Humana | 43 | $14,064 |
| Kaiser Permanente | 43 | $14,064 |
| Molina | 43 | $14,064 |
| scan | 43 | $14,064 |
| healthcare partners | 43 | $14,064 |
| central health plan | 43 | $14,064 |
| Empire BCBS | 43 | $14,064 |
