▸ Hospital · CA · CCN 050567
Providence Mission Hospital
27700 MEDICAL CENTER ROAD, MISSION VIEJO, CA, 92691
311 bedsAcute Care Hospitals2
Compliance grade
C
77/100
Procedures tracked
47
of 209 target codes
Payers
20
with negotiated rates
Rates published
1,495
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 20 | — | — | $13,856 | $13,856 | $33,783 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 20 | — | — | $19,705 | $19,705 | $47,675 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 20 | — | — | $10,176 | $10,176 | $24,375 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 20 | — | — | $7,072.52 | $7,072.52 | $16,497 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 20 | — | — | $15,436 | $15,436 | $38,744 |
| COPD w MCC | MS-DRG | 190 | 20 | — | — | $11,103 | $11,103 | $26,923 |
| COPD w CC | MS-DRG | 191 | 20 | — | — | $8,582.74 | $8,582.74 | $20,591 |
| COPD w/o CC/MCC | MS-DRG | 192 | 20 | — | — | $6,668.78 | $6,668.78 | $15,512 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 20 | — | — | $8,229.47 | $8,229.47 | $19,654 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 20 | — | — | $6,540.23 | $6,540.23 | $14,927 |
| AMI discharged alive w MCC | MS-DRG | 280 | 20 | — | — | $15,830 | $15,830 | $39,343 |
| AMI discharged alive w CC | MS-DRG | 281 | 20 | — | — | $9,307.38 | $9,307.38 | $22,094 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 20 | — | — | $7,441.03 | $7,441.03 | $17,379 |
| Heart failure & shock w MCC | MS-DRG | 291 | 20 | — | — | $12,780 | $12,780 | $31,276 |
| Heart failure & shock w CC | MS-DRG | 292 | 20 | — | — | $8,639.88 | $8,639.88 | $20,644 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 20 | — | — | $5,945.09 | $5,945.09 | $13,158 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 20 | — | — | $12,020 | $12,020 | $28,905 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 20 | — | — | $7,561.01 | $7,561.01 | $17,720 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 20 | — | — | $5,946.05 | $5,946.05 | $13,410 |
| GI hemorrhage w CC | MS-DRG | 378 | 20 | — | — | $9,893.95 | $9,893.95 | $23,630 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 20 | — | — | $6,558.32 | $6,558.32 | $15,258 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 20 | — | — | $7,979.03 | $7,979.03 | $18,702 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 20 | — | — | $15,483 | $15,483 | $36,546 |
| Kidney/UTI w MCC | MS-DRG | 689 | 20 | — | — | $11,604 | $11,604 | $28,052 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 20 | — | — | $8,263.75 | $8,263.75 | $19,237 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 20 | — | — | $19,052 | $19,052 | $47,032 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 20 | — | — | $10,300 | $10,300 | $24,711 |
| surgery | ||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 4 | — | — | $16,552 | $42,216 | $71,794 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 4 | — | — | $16,552 | $26,853 | $45,767 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 20 | — | — | $44,324 | $44,324 | $110,054 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 20 | — | — | $23,382 | $23,382 | $56,653 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 20 | — | — | $16,580 | $16,580 | $39,571 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 20 | — | — | $16,663 | $16,663 | $39,751 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 20 | — | — | $13,561 | $13,561 | $31,580 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 20 | — | — | $32,999 | $32,999 | $84,588 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 4 | — | — | $10,137 | $90,920 | $158,963 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 4 | — | — | $10,137 | $53,115 | $87,673 |
| Major joint replacement w MCC | MS-DRG | 469 | 20 | — | — | $28,839 | $29,438 | $78,339 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 20 | — | — | $18,923 | $18,923 | $45,192 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 20 | — | — | $10,137 | $28,287 | $70,490 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 20 | — | — | $10,137 | $20,500 | $49,731 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 20 | — | — | $10,137 | $16,086 | $38,023 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 20 | — | — | $28,050 | $28,050 | $65,346 |
| OR procedure for obesity w CC | MS-DRG | 620 | 20 | — | — | $15,794 | $15,794 | $38,275 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 20 | — | — | $14,919 | $14,919 | $35,034 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 20 | — | — | $9,565 | $12,370 | $28,728 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 20 | — | — | $20,067 | $20,067 | $46,831 |
Payer mix (top 20)
| Payer | Codes covered | Median rate |
|---|---|---|
| Health Net | 47 | $21,468 |
| Blue Cross Blue Shield | 47 | $17,896 |
| UnitedHealthcare | 47 | $23,382 |
| providence | 47 | $15,484 |
| Cigna | 43 | $16,086 |
| Empire BCBS | 43 | $12,780 |
| healthcare partners | 43 | $12,780 |
| heritage provider network | 43 | $12,780 |
| Humana | 43 | $12,780 |
| Kaiser Permanente | 43 | $12,780 |
| Molina | 43 | $12,780 |
| monarch health plan | 43 | $12,780 |
| one care | 43 | $12,780 |
| providence health plan | 43 | $12,780 |
| scan | 43 | $12,780 |
| Aetna | 43 | $12,780 |
| WellCare | 43 | $12,780 |
| brand new day | 43 | $12,780 |
| caremore | 43 | $12,780 |
| central health plan | 43 | $12,780 |