Barton Healthcare System · South Lake Tahoe, CA
3 of 5
CMS star rating
111
Beds
1,814
Inpatient discharges a year
$261.4M
Net patient revenue a year
36
In-network payers
Barton Memorial Hospital is a 111-bed voluntary non-profit - private hospital in South Lake Tahoe, CA, affiliated with Barton Healthcare System. Below you'll find publicly disclosed negotiated rates and facility details, including 36 in-network payers and 215 disclosed rate categories.
The 24 services Barton Memorial Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Medicine & Surgery
CPT 47562
$43,151 - $102,052
from 4 insurers · median $75,583
36 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 49650
$1,800 - $95,178
from 4 insurers · median $58,829
36 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 47563
$64,779 - $115,454
from 3 insurers · median $69,639
36 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74177
$6,508
negotiated rate
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$3,359 - $4,450
from 2 insurers · median $3,905
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 29881
$1,666 - $32,491
from 4 insurers · median $21,329
64 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
Gynecology
CPT 58571
$33,748 - $99,691
from 4 insurers · median $59,427
Typical for a hospital with this service line
Orthopedics and pain
CPT 63030
$28,326 - $51,620
from 4 insurers · median $42,988
83 Medicare claims in Level 4 Musculoskeletal Procedures (CMS 2024)
Digestive procedures
CPT 45380
$797 - $7,335
from 4 insurers · median $5,249
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$690 - $7,677
from 4 insurers · median $3,944
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 49505
$13,599 - $23,113
from 3 insurers · median $21,717
15 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
X-ray and bone density
CPT 71046
$595 - $1,058
from 4 insurers · median $932
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$484 - $882
from 4 insurers · median $808
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$1,391 - $3,937
from 4 insurers · median $2,333
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$792 - $6,585
from 3 insurers · median $4,317
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$5,178 - $9,436
from 4 insurers · median $8,520
Common here, based on CMS Medicare volume
Ultrasound
CPT 76705
$108 - $1,918
from 4 insurers · median $1,376
Common here, based on CMS Medicare volume
Ultrasound
CPT 76830
$122 - $1,918
from 4 insurers · median $1,468
Common here, based on CMS Medicare volume
MRI imaging
CPT 72197
$824 - $6,867
from 3 insurers · median $6,746
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 42820
$13,330 - $22,653
from 3 insurers · median $21,288
Typical for a hospital with this service line
CT imaging
CPT 74178
$5,157 - $6,667
from 2 insurers · median $5,912
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93970
$1,838 - $3,267
from 4 insurers · median $2,959
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 27446
$56,218 - $105,671
from 4 insurers · median $98,998
136 Medicare claims in Level 5 Musculoskeletal Procedures (CMS 2024)
Gynecology
CPT 58662
$1,800 - $47,440
from 4 insurers · median $28,044
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 945% | 24 | 0 |
| Insurer B* | 19 | 666% | 9 | 1 |
| Insurer C* | 23 | 480% | 22 | 1 |
| Insurer D* | 18 | 332% | 9 | 5 |
How we chose these services: 7 appear in this hospital's own Medicare claims, 14 are common here based on CMS Medicare volume, and 3 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Barton Memorial Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
3 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$261.4M net patient revenue
Ownership and leadership
Owned by Barton Healthcare System
The employer identification numbers (EINs) health plans and networks list for Barton Memorial Hospital in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 94-6050274(multi-state) Barton Memorial Hospital | 65Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ameri Health and 60 more | 1003867565 Barton Healthcare System1356348890 Barton Healthcare System1306931357 Barton Healthcare Systemand 14 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
2170 South Avenue, South Lake Tahoe, CA 96150
(530) 541-3420
How Barton Memorial Hospital compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
3 of 5
Lower than 42% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 3 measures
0 better, 3 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Mixed on 5 measures
1 better, 3 no different, 1 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
4 of 5
Higher than 60% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
78%
Higher than 72% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.88
Lower than 78% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
132 min
Lower than 63% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
66%
Higher than 50% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 3 of 5 | |
| Death rates | No different on 3 measures | |
| Safety | No different on 2 measures | |
| Readmissions | Mixed on 5 measures | |
| Patient survey ratingCMS: Summary star rating | 4 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 78% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.88 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 132 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 66% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts Barton Memorial Hospital's inpatient payments for its readmissions, quality and cost results.
-0.04% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+1.24% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for Barton Memorial Hospital, beside the US median and the average of CA hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.075 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 419 cases | 3.8 | 3.9 | 3.81 | Better than 56% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.57 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.379 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.235 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 44 cases | 11.7 | 11 | 10.29 | Worse than 64% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 102 cases | 13.7 | 15.2 | 14.49 | Better than 72% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 11.57 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 639 cases | 0.49 | 0.51 | 0.4818 | No Different Than the National Rate | Better than 53% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 171 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 858 cases | 0.2 | 0.2 | 0.21 | No Different Than the National Rate | Better than 46% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 828 cases | 0.26 | 0.27 | 0.261 | No Different Than the National Rate | Better than 54% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 261 cases | 2.23 | 2.29 | 2.308 | No Different Than the National Rate | Better than 61% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 140 cases | 1.65 | 1.63 | 1.668 | No Different Than the National Rate | Worse than 55% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 143 cases | 7.87 | 8.88 | 9.555 | No Different Than the National Rate | Better than 73% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 269 cases | 3.05 | 3.4 | 3.521 | No Different Than the National Rate | Better than 78% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 126 cases | 4.91 | 5.105 | 5.495 | No Different Than the National Rate | Better than 65% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 86 cases | 1.72 | 1.72 | 1.796 | No Different Than the National Rate | Better than 48% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 161 cases | 1 | 1.02 | 1.061 | No Different Than the National Rate | Better than 57% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.09 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 47 cases | 62.5 | 1.25 | 7.901 | Worse than 95% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 99 cases | -7.9 | 3.85 | 16.67 | Better than 66% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 · 579 cases | 12.4 | 12.9 | 12.91 | No Different Than the National Rate | Better than 79% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.39 | Number of Cases Too Small | ||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.546 | Number of Cases Too Small | ||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 335 cases | 1.1 | 1 | 1.001 | No Different than expected | Worse than 69% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.43 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.19 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 25 cases | 19.2 | 19.8 | 19.94 | Better than 77% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 49 cases | 21.5 | 21.3 | 21.41 | Worse than 55% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.612 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 100 cases | 17.3 | 17.2 | 17.7 | Worse than 50% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2347 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.834 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 468 | 1,370 | 5,722 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.281 | 0.9835 | 5.638 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.347 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5696 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2147 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.749 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 553 | 1,799 | 5,308 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.282 | 1.377 | 6.105 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.273 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5366 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.32 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.433 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 19 | 61 | 112 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.456 | 1.591 | 2.999 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 2 | 1 | 2.368 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.8107 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2606 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.273 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 7 | 38 | 73.49 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.05 | 0.328 | 0.6136 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.5911 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.7863 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3103 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.305 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 8,073 | 14,451 | 52,601 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.143 | 0.567 | 3.111 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.166 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.7784 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1925 | No Different than National Benchmark | ||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 1.29 | 0.747 | 0.9502 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 7,371 | 13,646 | 48,317 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 2.322 | 5.683 | 27.04 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 0 | 2 | 9.99 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0 | 0.279 | 0.383 | No Different than National Benchmark | The best result, shared by 19% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 366 cases | 77 | 73 | 72.2 | Better than 64% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 366 cases | 5 | 8 | 8.78 | Better than 73% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 366 cases | 18 | 18 | 19.02 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 90 | 87 | 86.82 | Better than 74% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 4 | 3.514 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 366 cases | 82 | 80 | 75.76 | Better than 63% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 93 | 91 | 89.84 | Better than 69% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 366 cases | 4 | 4 | 5.713 | Worse than 42% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 2.855 | Better than 51% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 366 cases | 14 | 16 | 18.53 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 366 cases | 83 | 79 | 75.81 | Better than 71% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 93 | 91 | 89.11 | Better than 77% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 366 cases | 4 | 5 | 7.043 | Better than 62% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 2.688 | Better than 63% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 366 cases | 13 | 16 | 17.15 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 366 cases | 68 | 61 | 58.95 | Better than 79% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 83 | 77 | 75.75 | Better than 88% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 366 cases | 14 | 19 | 21.56 | Better than 78% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 2.449 | Better than 79% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 366 cases | 18 | 19 | 19.48 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 89 | 86 | 84.61 | Better than 78% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 366 cases | 10 | 13 | 15.03 | Better than 78% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 3.08 | Better than 55% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 366 cases | 90 | 87 | 84.97 | Better than 78% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 366 cases | 12 | 14 | 16.39 | Better than 68% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 366 cases | 88 | 86 | 83.61 | Better than 68% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 78 | 74 | 70.69 | Better than 72% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 6 | 7 | 8.855 | Better than 53% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 16 | 19 | 20.45 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 82 | 77 | 73.94 | Better than 76% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 4 | 6 | 7.637 | Better than 70% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 14 | 17 | 18.43 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 89 | 85 | 81.99 | Better than 77% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 3 | 3 | 4.958 | Better than 49% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 8 | 11 | 13.06 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 366 cases | 8 | 8 | 10.01 | Worse than 48% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 366 cases | 13 | 20 | 22.36 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 366 cases | 79 | 72 | 67.63 | Better than 77% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 91 | 88 | 86.85 | Better than 77% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 3.047 | Better than 55% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 366 cases | 80 | 74 | 72.06 | Better than 80% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 366 cases | 5 | 9 | 10.94 | Better than 86% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 366 cases | 15 | 16 | 17 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 79 | 75 | 71.11 | Better than 75% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 5 | 5 | 7.488 | Better than 49% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 366 cases | 16 | 20 | 21.4 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 78 | 77 | 72.49 | Better than 56% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 3 | 4 | 6.121 | Better than 64% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 366 cases | 19 | 19 | 21.39 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 89 | 86 | 82.8 | Better than 70% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 2 | 3 | 3.779 | Better than 50% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 366 cases | 9 | 11 | 13.42 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 366 cases | 62 | 59 | 47.5 | Better than 58% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 366 cases | 9 | 9 | 17.79 | Worse than 47% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 366 cases | 29 | 31 | 34.71 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 83 | 82 | 74.85 | Better than 56% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 2.203 | Better than 56% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 366 cases | 3 | 5 | 7.623 | Better than 70% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 366 cases | 78 | 71 | 68.6 | Better than 72% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 366 cases | 91 | 87 | 85.85 | Better than 76% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 366 cases | 19 | 23 | 23.77 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 366 cases | 5 | 4 | 3.431 | The top rating, shared by 24% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 366 cases | 56 | 47 | 45.33 | Better than 83% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 366 cases | 22 | 30 | 32.51 | Better than 84% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 366 cases | 22 | 22 | 22.16 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 366 cases | 4 | 3 | 2.859 | Better than 60% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 366 cases | 9 | 12 | 13.94 | Better than 80% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 366 cases | 91 | 88 | 86.06 | Better than 80% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 8.289 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 · 216 cases | 0 | 1 | 1.008 | The best result, shared by 34% of US hospitals | |
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.1852 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 1,106 cases | 67 | 79 | 69.96 | Worse than 68% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 381 cases | 136 | 154 | 187 | Better than 65% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 365 cases | 132 | 148 | 182 | Better than 63% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 · 15 cases | 295 | 247 | 282 | Worse than 66% of US hospitals | |
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 411 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 19,141 cases | 1 | 1 | 2.162 | Better than 42% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 75.06 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 87 cases | 93 | 97 | 92.55 | Worse than 69% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 80 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 48.75 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 621 cases | 12 | 15 | 13.67 | Better than 69% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 91 cases | 66 | 65 | 68.8 | Better than 50% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 40 cases | 80 | 73 | 76.38 | Better than 65% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 29 cases | 79 | 88 | 86.64 | Worse than 75% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 91 cases | 92 | 82 | 82.89 | Better than 88% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 72 cases | 89 | 94 | 93.98 | Worse than 76% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 93.4 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 70.68 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 89.93 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 667 cases | 98 | 90 | 86.9 | Better than 84% of US hospitals | |
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 94.78 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 8 | 5 | 4.959 | Worse than 77% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 2.5 | 6.6 | 8.417 | Better than 95% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.87 | 0.99 | 1.024 | Better than 92% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 15 | 20 | 30.07 | Worse than 59% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 3.75 | 5 | 7.571 | Worse than 60% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 80 | 10 | 16.48 | Better than 94% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 20 | 2.5 | 4.567 | Better than 93% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 68 | 34 | 28.67 | Better than 91% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 17 | 8.75 | 7.519 | Better than 90% of US hospitals | |
| VBP safety domain scoreFY 2026 | 25 | 40 | 45.16 | Worse than 78% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 6.25 | 10 | 11.79 | Worse than 78% of US hospitals | |
| VBP total performance scoreFY 2026 | 47 | 29.5 | 30.43 | Better than 90% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 37.5 | 42.5 | 36.67 | 10 | 0 | 15 |
| VBP clinical outcomes weighted domain score | 12.5 | 10.63 | 9.167 | 3.333 | 0 | 3.75 |
| VBP efficiency and cost reduction domain score | 60 | Not Available | 30 | 60 | 70 | 80 |
| VBP efficiency and cost reduction weighted domain score | 20 | Not Available | 7.5 | 20 | 17.5 | 20 |
| VBP person and community engagement domain score | 59 | Not Available | Not Available | 49 | 42 | 68 |
| VBP person and community engagement weighted domain score | 19.67 | Not Available | Not Available | 16.33 | 10.5 | 17 |
| VBP safety domain score | Not Available | Not Available | Not Available | Not Available | 85 | 25 |
| VBP safety weighted domain score | Not Available | Not Available | Not Available | Not Available | 21.25 | 6.25 |
| VBP total performance score | 52.17 | Not Available | Not Available | 39.67 | 49.25 | 47 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.015 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 1.005 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | N/A | 1.002 | |||
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 1.02 | 0.9983 | 1.017 | Worse than 64% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9788 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 | 0.9144 | 0.9955 | 1.026 | Better than 93% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9345 | 0.9638 | 0.9654 | N/A | N/A | N/A |
| READM-30-HF-HRRP | 1.006 | 0.9738 | 0.9352 | 0.9994 | 1.032 | 1.02 |
| READM-30-HIP-KNEE-HRRP | 0.875 | 0.939 | 1.017 | N/A | N/A | N/A |
| READM-30-PN-HRRP | 0.9434 | 1.008 | 0.9987 | 0.9907 | 0.9543 | 0.9144 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | Barton Memorial Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.6114 | |||
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.765 | 0.346 | 0.449 | Worse than 90% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.679 | |||
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.7204 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.8826 | 0.9628 | 0.9656 | Better than 78% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 0.502 | 0.7945 | 0.8116 | Better than 69% of US hospitals | |
| Total HAC scoreFY 2026 | 0.0548 | -0.0453 | 0.02733 | Worse than 56% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | Yes | N/A | Yes | Yes | No |
| Total HAC score | 0.2069 | 0.6293 | 0 | 0.9947 | 0.4606 | 0.0548 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 2024)
Accreditation
Limited
Medical school affiliation
Private (not for profit)
Ownership type
64
Medicare-certified beds
139
Registered nurses (full-time equivalent)
1966
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Barton Memorial Hospital reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
1,814
Inpatient discharges
Medicare 28%, Medicaid 5%
6,023
Inpatient days
26% of available bed days used
618
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 838357). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Barton Memorial Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,818 | 232 | 3,973 | 6,023 |
| Discharges | 514 | 99 | 1,201 | 1,814 |
| Average length of stay | 3.5 days | 2.3 days | 3.3 days | 3.3 days |
| Average daily census | 5.0 | 0.6 | 10.9 | 16.5 |
664
Medicare Advantage days
177 discharges
1,208
Medicaid managed care days
358 discharges
1,184
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 55 | 4,807 | 1,663 | 24% |
| Intensive care unit | 8 | 641 | 155 | 22% |
| Nursery | 575 | |||
| Skilled nursing facility | 3 | 730 | 696 | 67% |
| Nursing facility | 45 | 15,691 | 96% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Barton Memorial Hospital treats Medicare patients for most often, in 2024. 119 Medicare discharges in 7 published DRGs; 0% surgical; 80% in DRGs with complications (CC or MCC).
| 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 | 36 | $110,102 | $25,418 | $22,681 | 1.98 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 17 | $73,847 | $9,929 | $15,213 | 0.82 |
| Heart failure and shock with MCCMS-DRG 291, medical | 17 | $105,133 | $17,186 | $21,657 | 1.28 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 14 | $76,950 | $21,477 | $15,852 | 1.70 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 13 | $92,066 | $12,687 | $18,966 | 1.03 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 11 | $122,277 | $20,365 | $25,189 | 1.33 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 11 | $89,705 | $8,321 | $18,479 | 0.79 |
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.
The comprehensive outpatient service groups (APCs) Barton Memorial Hospital billed Medicare for most in 2024: 792 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 220 | 206 | $41,028 | $2,759 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 136 | 131 | $150,475 | $14,834 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 83 | 83 | $83,280 | $7,408 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 64 | 59 | $46,102 | $3,214 | $2,373 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 37 | 33 | $20,361 | $1,560 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 36 | 36 | $135,443 | $5,708 | $4,358 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 33 | 32 | $168,009 | $22,105 | $15,763 |
| Level 5 Urology and Related ServicesAPC 5375 | 31 | 28 | $68,914 | $5,265 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 28 | 24 | $52,126 | $3,547 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 25 | 23 | $24,709 | $1,945 | $1,445 |
See all 17 Medicare outpatient services at Barton Memorial Hospital
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.
ZIP codes with the most Medicare inpatient stays at Barton Memorial Hospital in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 395 in 2020 to 513 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 96150 | 287 | 56% | 1,003 | $37.7M | 61% | 64% |
| 96151 | 79 | 15% | 305 | $10.6M | 62% | 54% |
| 96158 | 65 | 13% | 326 | $8.7M | 65% | 63% |
| 89448 | 38 | 7% | 166 | $5.4M | 46% | 43% |
| 89449 | 22 | 4% | 86 | $3.5M | 38% | 55% |
| 96155 | 22 | 4% | 82 | $3.4M | 100% | 100% |
Source: CMS Hospital Service Area file. Shares are of the 513 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Barton Memorial Hospital reported at its latest Medicare certification survey (2024). Counts are people, not full-time equivalents.
139
Registered nurses
5
Licensed practical nurses
5
Nurse practitioners
4
Physician assistants
4
Pharmacists
6
Respiratory therapists
11
Physical therapists
4
Occupational therapists
1
Speech pathologists and audiologists
16
Radiology technicians
1
Nuclear medicine technicians
14
Laboratory technicians
11
Medical technologists
2
Dietitians
4
Social workers
45
Other personnel
Source: CMS Provider of Services file.
242 clinicians who bill Medicare list Barton Memorial Hospital as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Randall Nixon, M.D.
Urology Physician
NPI 1346379187
See commercial rates for Randall Nixon, M.D.Olivia Franke, PA-C
Medical Physician Assistant
NPI 1881097988
See commercial rates for Olivia Franke, PA-CEdmund Pillsbury, MD
Diagnostic Radiology Physician
NPI 1871793380
See commercial rates for Edmund Pillsbury, MDJames Cunningham, M.D.
Urology Physician
NPI 1912036740
See commercial rates for James Cunningham, M.D.Nicholas Dirig, DO
Orthopaedic Surgery Physician
NPI 1801193883
See commercial rates for Nicholas Dirig, DOHarry Meisenbach, MD
Diagnostic Radiology Physician
NPI 1619923984
See commercial rates for Harry Meisenbach, MDPaul Knight, MD
Diagnostic Radiology Physician
NPI 1932189024
See commercial rates for Paul Knight, MDMichael Edmunds
Orthopaedic Surgery Physician
NPI 1538150131
See commercial rates for Michael EdmundsFarres Ahmed, M.D.
Vascular & Interventional Radiology Physician
NPI 1851646657
See commercial rates for Farres Ahmed, M.D.Michael Moore, M.D., M.S.
Neurological Surgery Physician
NPI 1306136452
See commercial rates for Michael Moore, M.D., M.S.Celine Ord, M.D.
Radiation Oncology Physician
NPI 1457526048
See commercial rates for Celine Ord, M.D.Arika Gupta, M.D.
Nephrology Physician
NPI 1831171735
See commercial rates for Arika Gupta, M.D.Robert Silk, M.D.
Diagnostic Radiology Physician
NPI 1497726905
See commercial rates for Robert Silk, M.D.Colt Williams, M.D.
Hematology & Oncology Physician
NPI 1740712108
See commercial rates for Colt Williams, M.D.Chad Watts, MD
Adult Reconstructive Orthopaedic Surgery Physician
NPI 1124314935
See commercial rates for Chad Watts, MDVerena Samara, M.D.
Neurology Physician
NPI 1376886846
See commercial rates for Verena Samara, M.D.Kinsey Pillsbury, MD
Diagnostic Radiology Physician
NPI 1477715944
See commercial rates for Kinsey Pillsbury, MDNael Aboul-Hosn, D.O.
Cardiovascular Disease Physician
NPI 1164715272
See commercial rates for Nael Aboul-Hosn, D.O.Leonard Holmgren, MD
Diagnostic Radiology Physician
NPI 1114906088
See commercial rates for Leonard Holmgren, MDDavid Smith, M.D.
Clinical Cardiac Electrophysiology Physician
NPI 1487674362
See commercial rates for David Smith, M.D.Leah Walsh, FNP-BC
Nurse Practitioner
NPI 1922643386
See commercial rates for Leah Walsh, FNP-BCGuy Foster, MD
Pulmonary Disease Physician
NPI 1871674861
See commercial rates for Guy Foster, MDRam Challapalli, M.D.
Cardiovascular Disease Physician
NPI 1154313815
See commercial rates for Ram Challapalli, M.D.Christopher Vlasek
Family Medicine Physician
NPI 1518351089
See commercial rates for Christopher VlasekSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Barton Memorial Hospital reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $895.2M | 342.5% |
| Inpatient | $231.9M | 88.7% |
| Outpatient | $663.3M | 253.8% |
| Contractual allowances and discounts | -$633.8M | -242.5% |
| Net patient revenue | $261.4M | 100.0% |
| Operating expenses | -$201.8M | -77.2% |
| Operating income from patient care | $59.6M | 22.8% |
| Other income | $35.5M | 13.6% |
| Contributions and donations | $25,085 | 0.0% |
| Investment income | $3.7M | 1.4% |
| Other | $31.8M | 12.2% |
| Net income | $95M | 36.4% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $189.4M | 22.4% |
| Medicaid (including managed care) | $181.1M | 21.4% |
| Other payers and self-pay | $476.1M | 56.2% |
| Total charges | $846.6M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Barton Memorial Hospital's latest cost report.
22.8%
Operating margin
Operating income from patient care / net patient revenue
32.0%
Total margin
Net income / net patient revenue plus other income
31.3%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
48% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$54.86
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
17.5%
Return on assets
Net income for a year / total assets
26.3%
Return on equity
Net income for a year / fund balance
0.42
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
3.07
Current ratio
Current assets / current liabilities
2.69
Quick ratio
Cash, temporary investments and net receivables / current liabilities
51 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
58 days
Days in patient receivables
Net patient receivables / daily net patient revenue
47 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
0.55
Asset turnover
Total revenue for a year / total assets
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Barton Memorial Hospital owned and owed at the end of its reporting period (Dec 2025), across all fund types: $544.2M in total assets and a $362.1M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $28.4M | 5.2% |
| Patient receivables, net | $41.6M | 7.6% |
| Inventory | $3.4M | 0.6% |
| Total current assets | $79.9M | 14.7% |
| Property and equipment, net of depreciation | $86.9M | 16.0% |
| Investments and other assets | $377.4M | 69.3% |
| Total assets | $544.2M | 100.0% |
| Current liabilities | $26M | 4.8% |
| Long-term debt | $150.8M | 27.7% |
| Total liabilities | $182.1M | 33.5% |
| Fund balance (net assets) | $362.1M | 66.5% |
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Barton Memorial Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$5.7M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$2M
Bad debt
Patient bills written off as uncollectible, at charges
$8.7M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$7.1M
Total unreimbursed and uncompensated care
3.5% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Barton Memorial Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Dec 2020 | Dec 2021 | Dec 2022 | Dec 2023 | Dec 2024 | Dec 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $127.7M | $147.4M | $165.8M | $170.5M | $196.3M | $261.4M |
| Operating expenses | $157.5M | $181.1M | $210.1M | $207.4M | $217.2M | $201.8M |
| Operating margin | -23.3% | -22.9% | -26.7% | -21.7% | -10.7% | 22.8% |
| Net income | $27M | $19.8M | $11.1M | $19.7M | $42.7M | $95M |
| Total assets | $336.9M | $357.6M | $346.7M | $390.9M | $471.4M | $544.2M |
| Discharges | 1,555 | 1,637 | 1,699 | 1,594 | 1,742 | 1,814 |
| Inpatient days | 5,737 | 6,343 | 6,657 | 5,758 | 6,176 | 6,023 |
| Medicare Advantage days | 302 | 546 | 751 | 668 | 651 | 664 |
| Beds | 111 | 111 | 111 | 111 | 111 | 111 |
| Employees (FTE) | 622 | 628 | 669 | 655 | 621 | 618 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Barton Memorial Hospital reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Operating room | $9.1M | $21.9M | $215.4M | 0.10 | 12,802 |
| Impl. dev. charged to patients | $15M | $42.1M | 0.36 | ||
| Emergency | $5.9M | $11.9M | $121.8M | 0.10 | 6,129 |
| Laboratory | $3.5M | $11.4M | $80.4M | 0.14 | 5,244 |
| Rural health clinic | $3.3M | $11M | $8.3M | 1.33 | 7,379 |
| Medical supplies charged to patient | $9.5M | $12.4M | 0.76 | ||
| Drugs charged to patients | $7.4M | $57.2M | 0.13 | ||
| Physical therapy | $2.5M | $5.6M | $14.3M | 0.39 | 7,796 |
| Radiology-diagnostic | $1.8M | $5.4M | $23.6M | 0.23 | 3,535 |
| Home health agency | $2.1M | $4M | $1.6M | 2.54 | 2,397 |
| Ct scan | $1.1M | $3.6M | $77.2M | 0.05 | 817 |
| Delivery room & labor room | $2.4M | $3.6M | $9.8M | 0.36 | 4,255 |
| Respiratory therapy | $1.9M | $3.4M | $9M | 0.38 | 405 |
| Observation beds (non-distinct part | $3.1M | $10.7M | 0.29 | ||
| Ultrasound | $786,162 | $1.5M | $13.9M | 0.11 | 644 |
| Radioisotope | $403,185 | $1.4M | $8.3M | 0.17 | 536 |
| Electrocardiology | $603,991 | $1.3M | $10.7M | 0.12 | 1,201 |
| Mri | $397,088 | $1.1M | $20.7M | 0.05 | 1,034 |
| Occupational therapy | $490,510 | $890,069 | $2.2M | 0.41 | |
| Sleep lab | $313,535 | $603,351 | $3.6M | 0.17 | |
| Anesthesiology | $580,956 | $28.8M | 0.02 | 628 | |
| Speech pathology | $258,613 | $481,162 | $957,042 | 0.50 | 248 |
| Whole blood & packed red blood cell | $438,360 | $614,062 | 0.71 | 412 | |
| Wound care | $4,411 | $105,554 | $355,814 | 0.30 | 254 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $5.1M | $15.5M | $46M | 0.34 | 15,650 |
| Nursing facility | $4.4M | $11.3M | $11.9M | 0.95 | |
| Intensive care unit | $1.8M | $4.2M | $11.3M | 0.38 | 3,656 |
| Skilled nursing facility | $125,116 | $1.7M | $1M | 1.67 | 15,222 |
| Nursery | $948,408 | $1.7M | 0.54 | 1,027 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.3M | $41.9M | 90,605 | $25.01 | 103,336 |
| Operation of plant | $2.3M | $7.8M | 58,760 | $38.41 | 32,824 |
| Pharmacy | $1.8M | $6.4M | 26,311 | $69.07 | 1,392 |
| Employee benefits department | $6.2M | ||||
| Cap rel costs-bldg & fixt | $4.3M | 344,888 | |||
| Nursing administration | $2.2M | $2.9M | 23,804 | $94.36 | 138 |
| Housekeeping | $1.8M | $2.9M | 63,761 | $28.24 | 340 |
| Dietary | $1.8M | $2.7M | 54,365 | $32.95 | 5,337 |
| Central services & supply | $1.1M | $2.2M | 37,527 | $29.54 | 2,497 |
| Social service | $1.3M | $1.8M | 17,810 | $74.50 | 492 |
| Medical records & library | $494,908 | $718,899 | 13,885 | $35.64 | 5,498 |
| Laundry & linen service | $573,723 | 748 |
Source: CMS cost report (HCRIS, Form 2552-10), report 838357, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays Barton Memorial Hospital for an inpatient stay.
1.67
Case mix index
Higher than 49% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
29.3%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
527
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.57 | 1.57 | 1.76 | 1.70 | 1.80 | 1.70 | 1.67 |
| Wage index | 1.624 | 1.638 | 1.631 | 1.604 | 1.524 | 1.450 | 1.461 |
| Readmissions adjustment | -1.01% | -0.05% | -0.06% | -0.11% | 0.00% | -0.05% | -0.04% |
| Value-based purchasing adjustment | +1.37% | +1.35% | +1.35% | +0.05% | +1.76% | +2.41% | +1.24% |
| Medicare inpatient stays | 652 | 652 | 443 | 460 | 473 | 432 | 527 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Barton Memorial Hospital reports to Medicare as owners or with operational control. 2 individuals also hold ownership interests; they are not listed here.
Barton Healthcare System
5% or greater direct ownership interest, 100%, since 2005
Sources: CMS Hospital All Owners.
The officers and board members on Barton Memorial Hospital's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 5 of 7 are shown.
Barton Healthcare System files the Form 990 for the tax ID insurers list for Barton Memorial Hospital, so these people may lead the wider organization rather than Barton Memorial Hospital alone.
| Name | Title |
|---|---|
| Clinton Purvance MD | CEO |
| David Young MD | CMO |
| Kelly Neiger | CFO |
| Carla Adams | CNO |
| Karen Conant | VP Of Ambulatory Operations |
| Polly Birdsong | Admin Dir Of Surgical Svcs |
| Thomas Davis | Director Of Medical Imaging |
| Abby Killebrew | Chair |
| Patrick Fry | Vice Chair |
Board members: Jonathon Cefalu, Peter DiGrande MD, Stefan Schunk MD, Shawn Anderson, Kathryn Biasotti, Kirk Ledbetter, Sherry Mlynsky, Jeff Rahbeck, Scott Weavil, Wendy David, Baghdassar Pat Baghdikian MD.
Source: IRS Form 990 Part VII filed by Barton Healthcare System (EIN 94-6050274), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2023
340B ID SCH050352-00, registered as a sole community hospital; 2 registered outpatient sites; 21 active contract pharmacies. Authorizing official: Kelly Shea Neiger, CFO.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Helipad
Barton Meml Hospital
FAA location ID CA43, a medical-use heliport at the hospital.
Source: FAA National Airspace System Resource data, cycle 2026-10-01.
Barton memorial hospital
CCN 05U352, certified 2002, Medicare prospective payment
Barton memorial snf
CCN 555698, certified 1997, Medicare prospective payment
Barton memorial hha
CCN 057226, certified 1979, Medicare prospective payment
Barton memorial hospice
CCN 051711, certified 1997
Bmh community clinic
CCN 058580, certified 2002, Medicare cost reimbursed
Source: Worksheet S-2 Part I of Barton Memorial Hospital's latest Medicare cost report (HCRIS).
About Barton Memorial Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Barton Memorial Hospital range from $792 to $6,585 across 3 insurers. UnitedHealthcare's rate is $792. The median at nearby comparable hospitals is $1,736. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Barton Memorial Hospital range from $6,508 to $6,508 across 1 insurers. Aetna's rate is $6,508. The median at nearby comparable hospitals is $1,014. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Barton Memorial Hospital range from $797 to $7,335 across 4 insurers. Aetna's rate is $7,335. The median at nearby comparable hospitals is $3,793. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Barton Memorial Hospital range from $484 to $882 across 4 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $484. The median at nearby comparable hospitals is $311. What a patient pays depends on their plan's deductible, coinsurance and network status.
Barton Memorial Hospital has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.
CMS reports no Medicare-funded interns or residents at Barton Memorial Hospital for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Barton Memorial Hospital's base inpatient payments by an estimated 0.04% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (36 discharges), simple pneumonia and pleurisy with cc (17 discharges), heart failure and shock with mcc (17 discharges).
Barton Memorial Hospital's Medicare case mix index is 1.67 for fiscal year 2027, higher than 49% of hospitals paid under the inpatient prospective payment system.
Barton Memorial Hospital reported 1,814 inpatient discharges and 6,023 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Barton Memorial Hospital reported 618 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Barton Memorial Hospital reported $261.4M in net patient revenue on $895.2M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of 22.8%, and net income of $95M.
Barton Memorial Hospital reported $7.1M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $5.7M of charity care at cost.
Barton Memorial Hospital's Medicare enrollment lists Clinton D Purvance as President/ceo since 2015.
Insurers' price transparency files list Barton Memorial Hospital under employer identification number 94-6050274 ((multi-state) Barton Memorial Hospital). 65 health plans and networks list 94-6050274 for it.
Yes. HRSA's 340B database lists Barton Memorial Hospital (340B ID SCH050352-00) as a participating sole community hospital since 2023, with 21 active contract pharmacies.
242 clinicians who bill Medicare list Barton Memorial Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are emergency medicine physician (27), family medicine physician (26), nurse practitioner (16).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Barton Memorial Hospital, effective 2024.
In its Medicare enrollment, Barton Memorial Hospital reports Barton Healthcare System as 5% or greater direct ownership interest (100%).
CMS lists 41 services at Barton Memorial Hospital, including Adult Inpatient Psychiatric Care, Anesthesia, Audiology, CARF Inpatient Rehabilitation (Commission On Accreditation Of Rehabilitation Facilities Inpatient Rehabilitation), Clinical Laboratory, CT Scan.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Barton Memorial Hospital came from ZIP codes 96150 (287), 96151 (79), 96158 (65).
Barton Memorial Hospital has 111 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 64 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Barton Memorial Hospital is located at 2170 South Avenue, South Lake Tahoe, CA 96150. Its main phone number is (530) 541-3420.
Barton Memorial Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 050352.
The National Provider Identifier (NPI) on file for Barton Memorial Hospital is 1003867565.
Barton Memorial Hospital is affiliated with Barton Healthcare System.
Barton Memorial Hospital lists 36 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
215 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers