Petaluma, CA, 94954
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 | 10 | — | — | $12,256 | $15,225 | 1.2× | $33,509 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $18,952 | $21,502 | 1.1× | $47,289 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $10,087 | $11,275 | 1.1× | $24,178 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $7,042.89 | $7,944.96 | 1.0× | $16,364 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $16,582 | $16,921 | 1.1× | $38,431 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $11,134 | $12,271 | 1.1× | $26,705 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $8,748.87 | $9,565.76 | 1.1× | $20,424 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $6,884.37 | $7,511.66 | 1.1× | $15,387 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $8,549.74 | $9,186.62 | 1.1× | $19,495 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $6,588.16 | $7,373.7 | 1.1× | $14,806 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $16,111 | $17,344 | 1.1× | $39,025 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $9,234.31 | $10,343 | 1.1× | $21,915 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $7,187.53 | $8,340.45 | 1.1× | $17,239 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $13,284 | $14,070 | 1.1× | $31,023 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $8,867.76 | $9,627.08 | 1.1× | $20,477 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $6,465.31 | $6,734.98 | 1.1× | $13,052 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $11,881 | $13,255 | 1.1× | $28,671 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $7,424.31 | $8,469.22 | 1.1× | $17,576 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $5,532.07 | $6,736.01 | 1.1× | $13,302 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $9,839.63 | $10,973 | 1.1× | $23,439 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $6,311.75 | $7,393.11 | 1.1× | $15,135 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $7,572.91 | $8,917.85 | 1.1× | $18,551 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $13,995 | $16,972 | 1.1× | $36,251 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $11,010 | $12,808 | 1.1× | $27,825 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $7,848.33 | $9,223.41 | 1.1× | $19,081 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $18,508 | $20,802 | 1.1× | $46,652 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $10,121 | $11,408 | 1.1× | $24,511 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $14,171 | $20,370 | 0.74× | $37,402 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $14,171 | $19,697 | 1.1× | $23,791 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $46,966 | $47,924 | 1.1× | $109,163 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $24,940 | $25,449 | 1.1× | $56,195 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $16,942 | $18,149 | 1.1× | $39,251 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $16,724 | $18,238 | 1.1× | $39,429 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $13,030 | $14,908 | 1.1× | $31,325 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $34,814 | $35,769 | 1.1× | $83,903 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $14,122 | $20,298 | 0.41× | $80,553 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $14,122 | $20,298 | 0.60× | $47,059 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $30,557 | $31,948 | 1.1× | $77,705 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $18,822 | $20,663 | 1.1× | $44,826 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $14,122 | $30,713 | 1.1× | $69,919 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $14,122 | $22,355 | 1.1× | $49,329 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $14,122 | $17,619 | 1.1× | $37,715 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $29,849 | $30,458 | 1.1× | $64,817 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $16,959 | $17,305 | 1.1× | $37,965 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $15,816 | $16,366 | 1.1× | $34,750 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $11,126 | $13,630 | 1.1× | $28,496 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $17,773 | $21,891 | 1.1× | $46,452 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 47 | $15,738 |
| Cigna | 43 | $14,070 |
| Empire BCBS | 43 | $14,070 |
| Health Net | 43 | $17,424 |
| Humana | 43 | $14,070 |
| Kaiser Permanente | 43 | $14,070 |
| scan health plan | 43 | $14,070 |
| UnitedHealthcare | 43 | $21,524 |
| Aetna | 43 | $19,959 |
| western health advantage | 43 | $14,070 |
