Santa Rosa, CA, 95405-
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 | 13 | — | — | $15,609 | $15,928 | 1.2× | $46,381 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 13 | — | — | $22,144 | $22,596 | 1.1× | $65,453 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 13 | — | — | $11,497 | $11,731 | 1.1× | $33,465 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 13 | — | — | $8,029.35 | $8,193.21 | 1.1× | $22,716 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 13 | — | — | $17,374 | $17,729 | 1.1× | $58,965 |
| COPD w MCC | MS-DRG | 190 | 13 | — | — | $12,533 | $12,789 | 1.1× | $36,963 |
| COPD w CC | MS-DRG | 191 | 13 | — | — | $9,716.78 | $9,915.08 | 1.1× | $28,270 |
| COPD w/o CC/MCC | MS-DRG | 192 | 13 | — | — | $7,578.23 | $7,732.89 | 1.1× | $22,205 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 13 | — | — | $9,322.05 | $9,512.3 | 1.1× | $27,576 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 13 | — | — | $7,434.59 | $7,586.32 | 1.1× | $21,249 |
| AMI discharged alive w MCC | MS-DRG | 280 | 13 | — | — | $17,815 | $18,178 | 1.2× | $54,015 |
| AMI discharged alive w CC | MS-DRG | 281 | 13 | — | — | $10,526 | $10,741 | 1.1× | $30,333 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 13 | — | — | $8,441.1 | $8,613.37 | 1.1× | $23,860 |
| Heart failure & shock w MCC | MS-DRG | 291 | 13 | — | — | $14,407 | $14,701 | 1.1× | $42,939 |
| Heart failure & shock w CC | MS-DRG | 292 | 13 | — | — | $9,780.62 | $9,980.22 | 1.1× | $28,602 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 13 | — | — | $6,769.62 | $6,907.78 | 1.1× | $20,853 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 13 | — | — | $13,558 | $13,834 | 1.1× | $39,685 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 13 | — | — | $8,575.16 | $8,750.16 | 1.1× | $24,327 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 13 | — | — | $6,770.68 | $6,908.86 | 1.1× | $18,411 |
| GI hemorrhage w CC | MS-DRG | 378 | 13 | — | — | $11,182 | $11,410 | 1.1× | $32,442 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 13 | — | — | $7,454.81 | $7,606.95 | 1.1× | $20,948 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 13 | — | — | $9,042.23 | $9,226.77 | 1.1× | $25,677 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 13 | — | — | $17,427 | $17,783 | 1.2× | $50,175 |
| Kidney/UTI w MCC | MS-DRG | 689 | 13 | — | — | $13,093 | $13,360 | 1.2× | $38,513 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 13 | — | — | $9,360.35 | $9,551.38 | 1.1× | $26,410 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 13 | — | — | $21,415 | $21,852 | 1.2× | $64,571 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 13 | — | — | $11,635 | $11,873 | 1.1× | $33,926 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $15,236 | $21,858 | 0.79× | $99,879 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $15,236 | $21,858 | 1.2× | $63,531 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 13 | — | — | $49,652 | $50,666 | 1.2× | $154,986 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 13 | — | — | $26,253 | $26,789 | 1.2× | $81,131 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 13 | — | — | $18,653 | $19,034 | 1.2× | $54,645 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 13 | — | — | $18,746 | $19,128 | 1.2× | $54,575 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 13 | — | — | $15,279 | $15,591 | 1.2× | $43,357 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 13 | — | — | $36,998 | $37,753 | 1.2× | $116,132 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 3 | — | — | $15,184 | $182,090 | 3.7× | $218,242 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 3 | — | — | $15,184 | $100,428 | 3.0× | $125,666 |
| Major joint replacement w MCC | MS-DRG | 469 | 13 | — | — | $33,020 | $33,693 | 1.1× | $107,553 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 13 | — | — | $21,270 | $21,704 | 1.1× | $62,044 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 13 | — | — | $15,184 | $32,381 | 1.2× | $96,777 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 13 | — | — | $15,184 | $23,502 | 1.2× | $68,277 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 13 | — | — | $15,184 | $18,470 | 1.2× | $52,622 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 13 | — | — | $31,468 | $32,111 | 1.2× | $97,814 |
| OR procedure for obesity w CC | MS-DRG | 620 | 13 | — | — | $17,774 | $18,137 | 1.1× | $56,274 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 13 | — | — | $16,796 | $17,139 | 1.1× | $51,011 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 13 | — | — | $11,964 | $14,233 | 1.2× | $39,441 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 13 | — | — | $22,549 | $23,009 | 1.2× | $64,295 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 47 | $24,530 |
| Aetna | 45 | $24,094 |
| Health Net | 45 | $22,090 |
| caremore | 43 | $14,701 |
| central health plan | 43 | $14,701 |
| Cigna | 43 | $14,701 |
| western health advantage | 43 | $14,701 |
| Humana | 43 | $14,701 |
| Kaiser Permanente | 43 | $14,701 |
| providence health plan | 43 | $14,701 |
| scan health plan | 43 | $14,701 |
| UnitedHealthcare | 43 | $22,137 |
| brand new day | 43 | $14,701 |
