Adventist Health Simi Valley Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Adventist Health Simi Valley, Simi Valley, CA in 2024, from traditional Medicare claims. Back to the Adventist Health Simi Valley profile, with quality ratings, finances and negotiated rates.
1,680
Medicare inpatient discharges
In 55 published DRGs
1.57
Case mix index
IPPS FY 2027
11%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,026
Medicare outpatient services
In 18 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases371 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 270 | $139,998 | $16,791 | $23,520 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 52 | $75,657 | $8,124 | $12,710 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 38 | $354,931 | $47,784 | $59,628 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 11 | $135,102 | $17,073 | $22,697 | 2.04 |
Circulatory system323 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 112 | $105,743 | $10,680 | $17,765 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 52 | $125,206 | $13,809 | $21,035 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 23 | $102,506 | $10,403 | $17,221 | 1.20 |
| Syncope and collapseMS-DRG 312, medical | 22 | $76,381 | $6,778 | $12,832 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 20 | $68,778 | $5,743 | $11,555 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 20 | $232,541 | $25,316 | $39,067 | 2.87 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 19 | $42,587 | $3,638 | $7,155 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 19 | $154,771 | $15,571 | $26,002 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 13 | $73,272 | $6,689 | $12,310 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 12 | $106,866 | $8,524 | $17,954 | 1.08 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 11 | $159,320 | $17,040 | $26,766 | 2.16 |
Respiratory system253 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 65 | $132,137 | $13,985 | $22,199 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 63 | $92,389 | $10,700 | $15,521 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 48 | $104,267 | $9,335 | $17,517 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 41 | $104,543 | $10,563 | $17,563 | 1.23 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $88,031 | $7,633 | $14,789 | 0.96 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 12 | $93,096 | $6,499 | $15,640 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 11 | $189,720 | $24,458 | $31,873 | 2.70 |
Kidney and urinary tract179 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 52 | $93,869 | $9,211 | $15,770 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 38 | $61,347 | $6,065 | $10,306 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 31 | $116,200 | $12,214 | $19,522 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 30 | $69,151 | $7,363 | $11,617 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 17 | $116,912 | $12,961 | $19,641 | 1.65 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 11 | $95,090 | $11,018 | $15,975 | 1.35 |
Digestive system161 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 32 | $144,004 | $14,619 | $24,193 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 32 | $66,106 | $5,953 | $11,106 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 23 | $74,120 | $8,093 | $12,452 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 18 | $57,524 | $5,905 | $9,664 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 16 | $62,276 | $7,713 | $10,462 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 15 | $84,442 | $11,117 | $14,186 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 14 | $93,858 | $13,372 | $15,768 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 11 | $270,011 | $34,512 | $45,362 | 4.52 |
Musculoskeletal system and connective tissue137 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 46 | $98,524 | $7,698 | $16,552 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 37 | $129,283 | $16,107 | $21,720 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 16 | $159,708 | $17,222 | $26,831 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 15 | $141,825 | $17,605 | $23,827 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 12 | $221,402 | $25,957 | $37,195 | 2.95 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 11 | $57,859 | $6,006 | $9,720 | 0.79 |
Nervous system106 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 36 | $101,647 | $7,908 | $17,077 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 23 | $121,625 | $15,745 | $20,433 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 18 | $97,190 | $6,464 | $16,328 | 0.80 |
| Seizures with MCCMS-DRG 100, medical | 15 | $102,288 | $16,125 | $17,184 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 14 | $86,193 | $5,558 | $14,480 | 0.69 |
Endocrine, nutritional and metabolic72 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 36 | $87,900 | $11,272 | $14,767 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 24 | $61,232 | $5,880 | $10,287 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 12 | $59,870 | $7,390 | $10,058 | 0.90 |
Skin, subcutaneous tissue and breast37 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 25 | $56,758 | $6,850 | $9,535 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $110,890 | $12,114 | $18,629 | 1.49 |
Blood and immune system26 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 13 | $121,664 | $12,391 | $20,440 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 13 | $52,498 | $7,887 | $8,820 | 0.90 |
Injuries, poisonings and toxic effects of drugs15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $88,930 | $12,909 | $14,940 | 1.60 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 469 | 425 | $29,963 | $2,640 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 95 | 95 | $102,617 | $14,363 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 73 | 73 | $47,855 | $5,573 | $4,358 |
| Level 1 Endovascular ProceduresAPC 5191 | 69 | 67 | $30,087 | $2,834 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 61 | 55 | $5,426 | $1,562 | $1,220 |
| Level 4 Urology and Related ServicesAPC 5374 | 42 | 38 | $28,384 | $3,415 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 31 | 25 | $12,443 | $1,811 | $1,445 |
| Level 5 Urology and Related ServicesAPC 5375 | 30 | 30 | $33,237 | $5,069 | $3,918 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 24 | 23 | $152,100 | $26,402 | $21,117 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 20 | 20 | $68,736 | $11,004 | $8,164 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 16 | 16 | $71,625 | $7,160 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 16 | 15 | $93,008 | $11,871 | $8,874 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 15 | 15 | $14,773 | $1,469 | $1,196 |
| Level 2 Vascular ProceduresAPC 5182 | 15 | 15 | $29,103 | $1,412 | $1,204 |
| Level 3 Airway EndoscopyAPC 5153 | 14 | 14 | $10,373 | $1,590 | $1,264 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 13 | 11 | $23,912 | $3,734 | $2,930 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 12 | 12 | $75,544 | $11,468 | $8,569 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 11 | 11 | $45,864 | $6,388 | $4,982 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.