▸ Hospital · CA · CCN 050128
Tri-city Medical Center
4002 VISTA WAY, OCEANSIDE, CA, 92056-4506
252 bedsAcute Care Hospitals11
Compliance grade
A
100/100
Procedures tracked
150
of 209 target codes
Payers
14
with negotiated rates
Rates published
2,672
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 13 | $37,399 | $22,439 | $1,110 | $12,315 | $16,206 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $549 | $329.4 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $277 | $166.2 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $369 | $221.4 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $369 | $221.4 | — | — | — |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 0 | $425 | $255 | — | — | — |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 0 | $750 | $450 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $1,250 | $750 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $2,300 | $1,380 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $4,000 | $2,400 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $5,750 | $3,450 | — | — | — |
| Critical care, first hour | CPT | 99291 | 0 | $7,500 | $4,500 | — | — | — |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 0 | $3,320 | $1,992 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $4,028 | $2,416.8 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $4,843 | $2,905.8 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $3,495 | $2,097 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $3,751 | $2,250.6 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $3,879 | $2,327.4 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $495 | $297 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $624 | $374.4 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $810 | $486 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $2,996 | $1,797.6 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $3,296 | $1,977.6 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $3,961 | $2,376.6 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $2,906 | $1,743.6 | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $3,296 | $1,977.6 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $3,879 | $2,327.4 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $711 | $426.6 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $2,716 | $1,629.6 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $2,716 | $1,629.6 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $2,716 | $1,629.6 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $3,751 | $2,250.6 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $3,879 | $2,327.4 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $3,879 | $2,327.4 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $2,716 | $1,629.6 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $3,296 | $1,977.6 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $1,285 | $771 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $543 | $325.8 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $1,091 | $654.6 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $1,858 | $1,114.8 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $2,934 | $1,760.4 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $1,087 | $652.2 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $1,140 | $684 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $3,879 | $2,327.4 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $1,715 | $1,029 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $3,442 | $2,065.2 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $3,961 | $2,376.6 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $4,432 | $2,659.2 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $6,738 | $4,042.8 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $7,374 | $4,424.4 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $3,493 | $2,095.8 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $3,879 | $2,327.4 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $658 | $394.8 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $673 | $403.8 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $646 | $387.6 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $834 | $500.4 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $740 | $444 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $1,086 | $651.6 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $784 | $470.4 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $581 | $348.6 | — | — | — |
| Diagnostic mammography unilateral | CPT | 77065 | 0 | $338 | $202.8 | — | — | — |
| Diagnostic mammography bilateral | CPT | 77066 | 0 | $432 | $259.2 | — | — | — |
| Screening mammography bilateral | CPT | 77067 | 0 | $358 | $214.8 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $385 | $231 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $3,358 | $2,014.8 | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $1,511 | $906.6 | — | — | — |
| Stress echocardiogram | CPT | 93350 | 0 | $2,137 | $1,282.2 | — | — | — |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 12 | $72,046 | $43,228 | $15,870 | $20,629 | $23,805 |
| COPD w MCC | MS-DRG | 190 | 12 | $50,451 | $30,271 | $9,854.3 | $12,552 | $14,781 |
| COPD w CC | MS-DRG | 191 | 12 | $39,791 | $23,875 | $7,853.39 | $9,865.25 | $11,780 |
| COPD w/o CC/MCC | MS-DRG | 192 | 12 | $36,621 | $21,972 | $6,285.4 | $7,760.11 | $9,428.11 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 12 | $48,384 | $29,030 | $7,683.88 | $9,637.67 | $11,526 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 12 | $26,219 | $15,731 | $6,037.78 | $7,427.66 | $9,056.68 |
| AMI discharged alive w MCC | MS-DRG | 280 | 12 | $76,160 | $45,696 | $13,858 | $17,927 | $20,787 |
| AMI discharged alive w CC | MS-DRG | 281 | 12 | $43,270 | $25,962 | $8,238.12 | $10,382 | $12,357 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 12 | $40,711 | $24,427 | $6,538.84 | $8,100.37 | $9,808.26 |
| Heart failure & shock w MCC | MS-DRG | 291 | 12 | $47,445 | $28,467 | $11,044 | $14,149 | $16,566 |
| Heart failure & shock w CC | MS-DRG | 292 | 12 | $29,511 | $17,707 | $7,680.56 | $9,633.21 | $11,521 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 12 | $20,670 | $12,402 | $5,407.1 | $6,580.92 | $8,110.65 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 12 | $66,352 | $39,811 | $10,484 | $13,397 | $15,726 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 12 | $34,517 | $20,710 | $6,741.59 | $8,372.58 | $10,112 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 12 | $24,732 | $14,839 | $5,152 | $6,238.44 | $7,728 |
| GI hemorrhage w CC | MS-DRG | 378 | 12 | $44,470 | $26,682 | $8,760.78 | $11,083 | $13,141 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 12 | $30,019 | $18,011 | $5,800.13 | $7,108.6 | $8,700.2 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 12 | $33,480 | $20,088 | $6,868.73 | $8,543.26 | $10,303 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 12 | — | — | $12,273 | $15,799 | $18,410 |
| Kidney/UTI w MCC | MS-DRG | 689 | 12 | $38,612 | $23,167 | $9,763.73 | $12,430 | $14,646 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 12 | $38,381 | $23,028 | $7,103.05 | $8,857.86 | $10,655 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 12 | $81,395 | $48,837 | $16,062 | $20,886 | $24,093 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 12 | $41,576 | $24,945 | $9,033.33 | $11,449 | $13,550 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $384 | $230.4 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $384 | $230.4 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $384 | $230.4 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $301 | $180.6 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $384 | $230.4 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $384 | $230.4 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $172 | $103.2 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $172 | $103.2 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $158 | $94.8 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $205 | $123 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $186 | $111.6 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $149 | $89.4 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $195 | $117 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $400 | $240 | — | — | — |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 0 | $515 | $309 | — | — | — |
| Vaginal delivery only | CPT | 59409 | 0 | $4,740 | $2,844 | — | — | — |
| Cesarean section w CC/MCC | MS-DRG | 765 | 1 | — | — | $2,748 | $3,012.5 | $3,277 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 1 | — | — | $2,748 | $3,012.5 | $3,277 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 1 | — | — | $2,748 | $3,012.5 | $3,277 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 1 | — | — | $2,748 | $3,012.5 | $3,277 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $249 | $149.4 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $345 | $207 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $399 | $239.4 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $419 | $251.4 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $210 | $126 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $249 | $149.4 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $345 | $207 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $399 | $239.4 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $419 | $251.4 | — | — | — |
| surgery | ||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 13 | — | — | $7,345 | $26,467 | $39,700 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 13 | — | — | $7,345 | $16,902 | $25,352 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 12 | $190,659 | $114,396 | $41,107 | $54,510 | $61,660 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 12 | $123,988 | $74,393 | $21,689 | $28,440 | $32,533 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 12 | $111,061 | $66,637 | $14,719 | $19,082 | $22,078 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 12 | $70,887 | $42,532 | $14,540 | $18,842 | $21,810 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 12 | $59,983 | $35,990 | $11,435 | $14,673 | $17,152 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 12 | $45,361 | $27,217 | $29,725 | $39,230 | $44,588 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 12 | $225,308 | $135,185 | $56,457 | $75,119 | $84,685 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 12 | $183,964 | $110,378 | $33,167 | $43,851 | $49,751 |
| Major joint replacement w MCC | MS-DRG | 469 | 12 | $48,994 | $29,397 | $26,147 | $34,426 | $39,221 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 12 | $88,572 | $53,143 | $16,296 | $21,200 | $24,444 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 12 | $87,266 | $52,359 | $25,648 | $33,756 | $38,472 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 12 | $77,821 | $46,693 | $17,923 | $23,384 | $26,884 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 12 | $58,059 | $34,836 | $14,181 | $18,361 | $21,272 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 12 | — | — | $25,946 | $34,156 | $38,919 |
| OR procedure for obesity w CC | MS-DRG | 620 | 12 | — | — | $15,152 | $19,665 | $22,729 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 12 | $46,038 | $27,623 | $13,776 | $17,817 | $20,665 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 12 | $56,073 | $33,644 | $9,918.28 | $12,638 | $14,877 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 12 | — | — | $15,424 | $20,029 | $23,136 |
| PCI single major coronary artery | CPT | 92920 | 0 | $11,630 | $6,978 | — | — | — |
| PCI with drug-eluting stent | CPT | 92928 | 0 | $19,648 | $11,789 | — | — | — |
| PCI bypass graft | CPT | 92937 | 0 | $19,648 | $11,789 | — | — | — |
| Left heart catheterization | CPT | 93452 | 0 | $7,058 | $4,234.8 | — | — | — |
| Coronary angiography with cath | CPT | 93455 | 0 | $7,058 | $4,234.8 | — | — | — |
| Coronary angiography with bypass cath | CPT | 93458 | 0 | $7,058 | $4,234.8 | — | — | — |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 44 | $11,854 |
| prospect health | 44 | $11,854 |
| Aetna | 44 | $11,854 |
| astiva health clever care of ca | 44 | $11,854 |
| Blue Cross Blue Shield | 44 | $15,236 |
| First Health | 44 | $16,612 |
| Health Net | 44 | $17,781 |
| hn bronze and communitycare | 44 | $16,596 |
| Kaiser Permanente | 44 | $11,854 |
| Molina | 44 | $14,167 |
| Multiplan | 44 | $16,951 |
| phn / oscar | 44 | $16,596 |
| Cigna | 6 | $3,277 |
| Anthem BCBS | 1 | $1,110 |