Prime Healthcare Services · Garden Grove, CA
2 of 5
CMS star rating
167
Beds
3,781
Inpatient discharges a year
$71.6M
Net patient revenue a year
21
In-network payers
Garden Grove Hospital Medical Center is a 167-bed proprietary hospital in Garden Grove, CA, affiliated with Prime Healthcare Services. Below you'll find publicly disclosed negotiated rates and facility details, including 21 in-network payers and 125 disclosed rate categories.
The 24 services Garden Grove Hospital Medical Center 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.
Childbirth · Inpatient
MS-DRG 807
$3,933 - $9,385
from 3 insurers · median $6,758
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$5,593 - $12,263
from 3 insurers · median $9,430
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$447 - $4,890
from 3 insurers · median $488
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$3,933 - $9,385
from 3 insurers · median $6,758
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Cardiology and vascular testing
CPT 93306
$699 - $3,090
from 3 insurers · median $894
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$790 - $1,957
from 3 insurers · median $1,532
Typical for a hospital with this service line
Mammography
CPT 77067
$108 - $271
from 3 insurers · median $178
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$775 - $1,957
from 3 insurers · median $1,532
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$550 - $1,483
from 3 insurers · median $1,161
Typical for a hospital with this service line
CT imaging
CPT 70450
$134 - $281
from 3 insurers · median $238
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 460
$73,880
negotiated rate
Hospital reports neurosurgical services to CMS
Medicine & Surgery · Inpatient
MS-DRG 473
$14,241 - $73,880
from 3 insurers · median $23,347
Hospital reports neurosurgical services to CMS
Nuclear imaging
CPT 78452
$752 - $5,630
from 3 insurers · median $1,657
Hospital reports nuclear medicine services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$11,252 - $26,990
from 3 insurers · median $18,537
Hospital reports orthopedic surgery services to CMS
X-ray and bone density
CPT 71046
$43 - $703
from 3 insurers · median $111
Typical for a hospital with this service line
Digestive procedures
CPT 47563
$7,737 - $13,800
from 3 insurers · median $9,887
Typical for a hospital with this service line
Gynecology
CPT 58661
$1,800 - $9,887
from 3 insurers · median $7,737
Typical for a hospital with this service line
CT imaging
CPT 71275
$224 - $3,143
from 3 insurers · median $398
Typical for a hospital with this service line
CT imaging
CPT 74176
$248 - $4,117
from 3 insurers · median $305
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$8,379
negotiated rate
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 743
$7,238 - $16,667
from 3 insurers · median $12,076
Hospital reports inpatient surgical services to CMS
MRI imaging
CPT 70553
$379 - $792
from 3 insurers · median $447
Typical for a hospital with this service line
Ear, nose and throat
CPT 30520
$4,243 - $5,422
from 2 insurers · median $4,833
Typical for a hospital with this service line
Urology
CPT 50590
$3,500 - $8,379
from 3 insurers · median $4,511
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* | 21 | 263% | 9 | 5 |
| Insurer B* | 24 | 160% | 8 | 11 |
| Insurer C* | 22 | 125% | 0 | 19 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 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 Garden Grove Hospital Medical Center, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
2 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$71.6M net patient revenue
Ownership and leadership
Owned by Prime Healthcare Holdings Inc
The employer identification numbers (EINs) health plans and networks list for Garden Grove Hospital Medical Center 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 |
|---|---|---|
| 26-2583411Garden Grove Hospital Medical Center | 33Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Ambetter, AmeriBen, Asuris Northwest Health and 28 more | 1659538858 Prime Healthcare Services - Garden Grove LLC1588692644 Medical Center Of Garden Grove1720034143 Cep America - California |
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.
12601 Garden Grove Boulevard, Garden Grove, CA 92843
(714) 537-5160
How Garden Grove Hospital Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
2 of 5
Lower than 73% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 4 measures
0 better, 4 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 3 measures
0 better, 3 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
1 of 5
The lowest rating, shared by 2% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
54%
Lower than 95% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Penalized
Among the worst-performing 25% of US hospitals
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.87
Lower than 82% 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
134 min
Lower than 61% 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
72%
Higher than 66% 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 | 2 of 5 | |
| Death rates | No different on 4 measures | |
| Safety | No different on 3 measures | |
| Readmissions | Mixed on 5 measures | |
| Patient survey ratingCMS: Summary star rating | 1 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 54% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.87 | 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 | 134 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 72% | 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 Garden Grove Hospital Medical Center's inpatient payments for its readmissions, quality and cost results.
-1.72% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
-0.83% 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 Garden Grove Hospital Medical Center, 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 | This 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 · 901 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 · 30 cases | 8.3 | 8.5 | 8.235 | Better than 53% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 71 cases | 9.1 | 11 | 10.29 | Better than 84% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 317 cases | 12.9 | 15.2 | 14.49 | Better than 82% 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 · 1,798 cases | 0.22 | 0.51 | 0.4818 | No Different Than the National Rate | Better than 89% 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 · 2,078 cases | 0.18 | 0.2 | 0.21 | No Different Than the National Rate | Better than 76% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 2,117 cases | 0.29 | 0.27 | 0.261 | No Different Than the National Rate | Worse than 72% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 111 cases | 2.29 | 2.29 | 2.308 | No Different Than the National Rate | Worse than 49% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.668 | |||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 9.555 | |||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 130 cases | 3.21 | 3.4 | 3.521 | No Different Than the National Rate | Better than 67% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.495 | |||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 42 cases | 1.74 | 1.72 | 1.796 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 299 cases | 1.02 | 1.02 | 1.061 | No Different Than the National Rate | Better than 48% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This 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 · 74 cases | -36.2 | 1.25 | 7.901 | Better than 91% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 338 cases | 45.2 | 3.85 | 16.67 | Worse than 91% 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 · 74 cases | 12.6 | 12.9 | 12.91 | No Different Than the National Rate | Better than 69% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.39 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.546 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 1.001 | |||
| 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 · 46 cases | 19.5 | 19.8 | 19.94 | Better than 63% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 91 cases | 22.2 | 21.3 | 21.41 | Worse than 76% 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 · 349 cases | 19.4 | 17.2 | 17.7 | Worse than 96% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | This 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 | 0.326 | 0.172 | 0.2347 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 6.434 | 1.504 | 1.834 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 1,589 | 1,370 | 5,722 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 1.027 | 0.9835 | 5.638 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 2 | 0 | 3.347 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | 1.947 | 0.484 | 0.5696 | No Different than National Benchmark | Worse than 97% of US hospitals |
| 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 | 1,818 | 1,799 | 5,308 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.962 | 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 | 16 | 61 | 112 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.396 | 1.591 | 2.999 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 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 | 5 | 38 | 73.49 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.037 | 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 | 14,282 | 14,451 | 52,601 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.541 | 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 | 0.006 | 0.127 | 0.1925 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.597 | 0.747 | 0.9502 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 14,282 | 13,646 | 48,317 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 8.265 | 5.683 | 27.04 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 1 | 2 | 9.99 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.121 | 0.279 | 0.383 | Better than the National Benchmark | Better than 72% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 480 cases | 72 | 73 | 72.2 | Worse than 53% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 480 cases | 12 | 8 | 8.78 | Worse than 76% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 480 cases | 16 | 18 | 19.02 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 86 | 87 | 86.82 | Worse than 53% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 480 cases | 3 | 4 | 3.514 | Worse than 53% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 480 cases | 63 | 80 | 75.76 | Worse than 99% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 84 | 91 | 89.84 | Worse than 98% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 480 cases | 13 | 4 | 5.713 | Worse than 99% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 2.855 | The lowest rating, shared by 4% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 480 cases | 24 | 16 | 18.53 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 480 cases | 64 | 79 | 75.81 | Worse than 99% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 82 | 91 | 89.11 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 480 cases | 14 | 5 | 7.043 | Worse than 99% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 2.688 | The lowest rating, shared by 2% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 480 cases | 22 | 16 | 17.15 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 480 cases | 43 | 61 | 58.95 | Worse than 99% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 66 | 77 | 75.75 | Worse than 99% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 480 cases | 32 | 19 | 21.56 | Worse than 98% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 2.449 | The lowest rating, shared by 7% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 480 cases | 25 | 19 | 19.48 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 77 | 86 | 84.61 | Worse than 96% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 480 cases | 23 | 13 | 15.03 | Worse than 97% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 3.08 | The lowest rating, shared by 4% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 480 cases | 77 | 87 | 84.97 | Worse than 97% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 480 cases | 29 | 14 | 16.39 | Worse than 98% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 480 cases | 71 | 86 | 83.61 | Worse than 98% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 57 | 74 | 70.69 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 18 | 7 | 8.855 | Worse than 99% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 25 | 19 | 20.45 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 62 | 77 | 73.94 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 13 | 6 | 7.637 | Worse than 98% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 25 | 17 | 18.43 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 72 | 85 | 81.99 | Worse than 99% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 12 | 3 | 4.958 | Worse than 99% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 16 | 11 | 13.06 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 480 cases | 15 | 8 | 10.01 | Worse than 92% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 480 cases | 30 | 20 | 22.36 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 480 cases | 55 | 72 | 67.63 | Worse than 96% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 84 | 88 | 86.85 | Worse than 85% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 480 cases | 2 | 3 | 3.047 | Worse than 78% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 480 cases | 59 | 74 | 72.06 | Worse than 99% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 480 cases | 19 | 9 | 10.94 | Worse than 98% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 480 cases | 22 | 16 | 17 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 56 | 75 | 71.11 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 16 | 5 | 7.488 | Worse than 99% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 480 cases | 28 | 20 | 21.4 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 62 | 77 | 72.49 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 15 | 4 | 6.121 | Worse than 99% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 480 cases | 23 | 19 | 21.39 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 72 | 86 | 82.8 | Worse than 99% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 9 | 3 | 3.779 | Worse than 98% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 480 cases | 19 | 11 | 13.42 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 480 cases | 32 | 59 | 47.5 | Worse than 99% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 480 cases | 30 | 9 | 17.79 | Worse than 99% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 480 cases | 38 | 31 | 34.71 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 65 | 82 | 74.85 | Worse than 99% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 2.203 | The lowest rating, shared by 4% 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 · 480 cases | 13 | 5 | 7.623 | Worse than 95% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 480 cases | 54 | 71 | 68.6 | Worse than 95% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 480 cases | 79 | 87 | 85.85 | Worse than 93% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 480 cases | 33 | 23 | 23.77 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 480 cases | 2 | 4 | 3.431 | Worse than 85% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 480 cases | 29 | 47 | 45.33 | Worse than 99% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 480 cases | 45 | 30 | 32.51 | Worse than 98% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 480 cases | 26 | 22 | 22.16 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 480 cases | 1 | 3 | 2.859 | The lowest rating, shared by 2% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 480 cases | 17 | 12 | 13.94 | Worse than 86% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 480 cases | 83 | 88 | 86.06 | Worse than 86% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | medium | ||||
| 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 · 4,984 cases | 14 | 8 | 8.289 | Worse than 89% of US hospitals | |
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 · 1,022 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 · 600 cases | 78 | 79 | 69.96 | Worse than 52% 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 · 432 cases | 134 | 154 | 187 | Better than 67% 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 · 381 cases | 134 | 148 | 182 | Better than 61% 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 · 41 cases | 140 | 247 | 282 | Better than 91% 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 · 15 cases | 357 | 293 | 411 | Worse than 74% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 23,066 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 · 15 cases | 100 | 97 | 92.55 | The best result, shared by 27% 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 · 0 cases | Not Available | 48.75 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 400 cases | 13 | 15 | 13.67 | Better than 60% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 98 cases | 72 | 65 | 68.8 | Better than 66% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 34 cases | 85 | 73 | 76.38 | Better than 76% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 23 cases | 83 | 88 | 86.64 | Worse than 65% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 98 cases | 87 | 82 | 82.89 | Better than 69% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 66 cases | 95 | 94 | 93.98 | Better than 51% 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 | Not Available | 86.9 | |||
| 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 | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 0 | 5 | 4.959 | The best result, shared by 2% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 8.417 |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This 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 | 1.17 | 0.99 | 1.024 | Worse than 97% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 30 | 20 | 30.07 | Better than 68% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 7.5 | 5 | 7.571 | Better than 68% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 0 | 10 | 16.48 | The worst result, shared by 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 0 | 2.5 | 4.567 | The worst result, shared by 43% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 11 | 34 | 28.67 | Worse than 95% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 2.75 | 8.75 | 7.519 | Worse than 95% of US hospitals | |
| VBP safety domain scoreFY 2026 | 26.67 | 40 | 45.16 | Worse than 75% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 6.667 | 10 | 11.79 | Worse than 75% of US hospitals | |
| VBP total performance scoreFY 2026 | 16.92 | 29.5 | 30.43 | Worse than 92% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 65 | 72.5 | Not Available | 0 | 10 | 30 |
| VBP clinical outcomes weighted domain score | 16.25 | 18.13 | Not Available | 0 | 2.5 | 7.5 |
| VBP efficiency and cost reduction domain score | 0 | Not Available | 0 | 0 | 0 | 0 |
| VBP efficiency and cost reduction weighted domain score | 0 | Not Available | 0 | 0 | 0 | 0 |
| VBP person and community engagement domain score | 13 | Not Available | Not Available | 0 | 4 | 11 |
| VBP person and community engagement weighted domain score | 3.25 | Not Available | Not Available | 0 | 1 | 2.75 |
| VBP safety domain score | 90 | Not Available | Not Available | 0 | 43.33 | 26.67 |
| VBP safety weighted domain score | 22.5 | Not Available | Not Available | 0 | 10.83 | 6.667 |
| VBP total performance score | 42 | Not Available | Not Available | 0 | 14.33 | 16.92 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | This 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 | 1.003 | 0.9969 | 1.002 | Worse than 55% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 84 cases | 0.9876 | 0.9983 | 1.017 | Better than 58% 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 · 309 cases | 1.162 | 0.9955 | 1.026 | Worse than 98% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | 1.014 | 0.9926 | 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 | 1.014 | 1.006 | 0.994 | N/A | 1.042 | 1.003 |
| READM-30-HF-HRRP | 0.9987 | 1.004 | 1.066 | 1.034 | 1.03 | 0.9876 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.01 | 0.9442 | 0.9463 | 1.052 | 1.131 | 1.162 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | This hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.489 | 0.6114 | The best result, shared by 14% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.427 | 0.346 | 0.449 | Worse than 62% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 1.841 | 0.559 | 0.679 | Worse than 97% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | Yes | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | 2.844 | 0.6405 | 0.7204 | Worse than 99% of US hospitals | |
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.867 | 0.9628 | 0.9656 | Better than 82% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8116 | |||
| Total HAC scoreFY 2026 | 0.498 | -0.0453 | 0.02733 | Worse than 80% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | Yes | Yes | Yes |
| Total HAC score | -0.7963 | -1.149 | 0 | 0.4396 | 0.7583 | 0.498 |
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 2023)
Accreditation
None
Medical school affiliation
Private (for profit)
Ownership type
167
Medicare-certified beds
200
Registered nurses (full-time equivalent)
1969
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Garden Grove Hospital Medical Center reported to Medicare in its latest cost report, covering Jan 1, 2025 to Dec 31, 2025.
3,781
Inpatient discharges
Medicare 35%, Medicaid 6%
18,053
Inpatient days
30% of available bed days used
326
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 839354). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Garden Grove Hospital Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 6,477 | 1,070 | 10,506 | 18,053 |
| Discharges | 1,306 | 220 | 2,255 | 3,781 |
| Average length of stay | 5.0 days | 4.9 days | 4.7 days | 4.8 days |
| Average daily census | 17.7 | 2.9 | 28.8 | 49.5 |
3,426
Medicare Advantage days
723 discharges
4,939
Medicaid managed care days
1,058 discharges
88
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 143 | 16,382 | 5,938 | 31% |
| Intensive care unit | 12 | 1,671 | 539 | 38% |
| Other special care | 12 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Garden Grove Hospital Medical Center treats Medicare patients for most often, in 2024. 736 Medicare discharges in 22 published DRGs; 2% surgical; 77% 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 | 248 | $89,487 | $19,057 | $25,235 | 1.98 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 57 | $53,980 | $12,578 | $15,222 | 1.32 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 53 | $95,945 | $16,280 | $27,057 | 1.70 |
| Renal failure with MCCMS-DRG 682, medical | 40 | $57,034 | $14,090 | $16,084 | 1.50 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 34 | $37,233 | $7,199 | $10,500 | 0.78 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 32 | $217,634 | $61,719 | $61,373 | 6.96 |
| Heart failure and shock with MCCMS-DRG 291, medical | 30 | $44,419 | $12,408 | $12,526 | 1.28 |
| Renal failure with CCMS-DRG 683, medical | 25 | $46,708 | $8,623 | $13,172 | 0.90 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 24 | $62,906 | $12,935 | $17,739 | 1.33 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 22 | $42,867 | $9,731 | $12,088 | 1.03 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 21 | $65,056 | $16,187 | $18,346 | 1.79 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $42,316 | $12,719 | $11,933 | 1.45 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 18 | $28,127 | $7,460 | $7,932 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 14 | $93,851 | $16,105 | $26,466 | 1.65 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $43,058 | $9,909 | $12,142 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 13 | $54,516 | $9,365 | $15,374 | 1.03 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 13 | $51,740 | $11,673 | $14,591 | 1.23 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 13 | $36,973 | $6,968 | $10,426 | 0.79 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 13 | $128,144 | $41,861 | $36,137 | 5.00 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $29,350 | $8,065 | $8,277 | 0.91 |
See all 22 Medicare inpatient DRGs at Garden Grove Hospital Medical Center
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.
ZIP codes with the most Medicare inpatient stays at Garden Grove Hospital Medical Center 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 1,375 in 2020 to 1,530 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 92840 | 305 | 20% | 1,520 | $31.7M | 19% | 20% |
| 92843 | 253 | 17% | 1,181 | $23.6M | 17% | 20% |
| 92841 | 165 | 11% | 723 | $14.5M | 14% | 16% |
| 92844 | 141 | 9% | 710 | $15.1M | 18% | 15% |
| 92683 | 109 | 7% | 569 | $12.9M | 3% | 4% |
| 92703 | 90 | 6% | 490 | $10.7M | 6% | 5% |
| 92804 | 74 | 5% | 289 | $5.7M | 3% | 2% |
| 92704 | 64 | 4% | 313 | $6.7M | 3% | 2% |
| 92802 | 63 | 4% | 269 | $5.4M | 6% | 3% |
| 92868 | 60 | 4% | 259 | $5.1M | 4% | 6% |
| 92706 | 45 | 3% | 200 | $3.5M | 5% | 6% |
| 90680 | 36 | 2% | 173 | $2.8M | 3% | 4% |
| 92801 | 30 | 2% | 127 | $2.3M | 2% | 2% |
| 92708 | 28 | 2% | 133 | $3.1M | 1% | 1% |
| 92655 | 18 | 1% | 88 | $2M | 4% | 3% |
| 92647 | 16 | 1% | 90 | $1.7M | 1% | |
| 92701 | 11 | 1% | 38 | $719,275 | 1% | |
| 92842 | 11 | 1% | 57 | $1.5M | 44% | 100% |
| 92867 | 11 | 1% | 51 | $1M | 1% |
Source: CMS Hospital Service Area file. Shares are of the 1,530 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 Garden Grove Hospital Medical Center reported at its latest Medicare certification survey (2023). Counts are people, not full-time equivalents.
26
Psychiatric unit beds
200
Registered nurses
21
Licensed practical nurses
12
Pharmacists
14
Respiratory therapists
6
Physical therapists
1
Occupational therapists
18
Radiology technicians
3
Nuclear medicine technicians
13
Laboratory technicians
16
Medical technologists
1
Social workers
257
Other personnel
Source: CMS Provider of Services file.
99 clinicians who bill Medicare list Garden Grove Hospital Medical Center 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.
Geoffrey Sigmund, M.D.
Neuroradiology Physician
NPI 1710152988
See commercial rates for Geoffrey Sigmund, M.D.Karen Reuss, M.D.
Diagnostic Radiology Physician
NPI 1336190354
See commercial rates for Karen Reuss, M.D.Steven Le, M.D.
Cardiovascular Disease Physician
NPI 1780835801
See commercial rates for Steven Le, M.D.Mary Tran, D.O.
Family Medicine Physician
NPI 1144255019
See commercial rates for Mary Tran, D.O.Dean Ngo, MD
Internal Medicine Physician
NPI 1982690582
See commercial rates for Dean Ngo, MDReza Shahbaz, M.D.
Vascular & Interventional Radiology Physician
NPI 1124349980
See commercial rates for Reza Shahbaz, M.D.Mario Pacheco, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner
NPI 1568887669
See commercial rates for Mario Pacheco, NURSE PRACTITIONERHarpreet Singh, MD
Specialist
NPI 1295914216
See commercial rates for Harpreet Singh, MDAshokkumar Amin, MD
Gastroenterology Physician
NPI 1831293109
See commercial rates for Ashokkumar Amin, MDJason Wiguna, DO
Family Medicine Physician
NPI 1346731767
See commercial rates for Jason Wiguna, DOChaewon Song, MD
Geriatric Medicine (Internal Medicine) Physician
NPI 1972589687
See commercial rates for Chaewon Song, MDZavier Ahmed, M.D.
Nephrology Physician
NPI 1255677134
See commercial rates for Zavier Ahmed, M.D.Davinder Singh, M.D.
Gastroenterology Physician
NPI 1114085362
See commercial rates for Davinder Singh, M.D.Mohammad Hajjar, M.D
Interventional Cardiology Physician
NPI 1235350893
See commercial rates for Mohammad Hajjar, M.DArash Esmailzadegan, M.D.
Pain Medicine (Anesthesiology) Physician
NPI 1740573120
See commercial rates for Arash Esmailzadegan, M.D.Phong Kieu, NP
Psychiatric/Mental Health Nurse Practitioner
NPI 1295495737
See commercial rates for Phong Kieu, NPElizabeth Nghiem, M.D.
Infectious Disease Physician
NPI 1083626212
See commercial rates for Elizabeth Nghiem, M.D.Bharat Chauhan, M.D.
Infectious Disease Physician
NPI 1730243759
See commercial rates for Bharat Chauhan, M.D.Tarun Marwaha, M.D.
Nephrology Physician
NPI 1407964976
See commercial rates for Tarun Marwaha, M.D.Essam Mostafa, M.D.
Nephrology Physician
NPI 1316932270
See commercial rates for Essam Mostafa, M.D.Harishchandra Patel, MD
Cardiovascular Disease Physician
NPI 1619908134
See commercial rates for Harishchandra Patel, MDHitesh Patel, MD
Sports Medicine (Family Medicine) Physician
NPI 1902833734
See commercial rates for Hitesh Patel, MDVuong Nguyen, M.D.
Internal Medicine Physician
NPI 1093701690
See commercial rates for Vuong Nguyen, M.D.Dat Nguyen, MD
Internal Medicine Physician
NPI 1720092315
See commercial rates for Dat Nguyen, MDSource: 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 Garden Grove Hospital Medical Center reported to Medicare for Jan 1, 2025 to Dec 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $470.3M | 657.3% |
| Inpatient | $343.4M | 480.0% |
| Outpatient | $126.9M | 177.4% |
| Contractual allowances and discounts | -$398.8M | -557.3% |
| Net patient revenue | $71.6M | 100.0% |
| Operating expenses | -$73.1M | -102.2% |
| Operating income from patient care | -$1.6M | -2.2% |
| Other income | $1M | 1.4% |
| Contributions and donations | $882,825 | 1.2% |
| Other | $144,668 | 0.2% |
| Net income | -$557,495 | -0.8% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $100.3M | 21.3% |
| Medicaid (including managed care) | $183.4M | 39.0% |
| Other payers and self-pay | $186.7M | 39.7% |
| Total charges | $470.3M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, 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 Garden Grove Hospital Medical Center's latest cost report.
-2.2%
Operating margin
Operating income from patient care / net patient revenue
-0.8%
Total margin
Net income / net patient revenue plus other income
2.5%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
58% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$47.47
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-1.0%
Return on assets
Net income for a year / total assets
-1.0%
Return on equity
Net income for a year / fund balance
-0.48
Current ratio
Current assets / current liabilities
-0.39
Quick ratio
Cash, temporary investments and net receivables / current liabilities
1 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
54 days
Days in patient receivables
Net patient receivables / daily net patient revenue
-142 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.29
Asset turnover
Total revenue for a year / total assets
16.0 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Garden Grove Hospital Medical Center owned and owed at the end of its reporting period (Dec 2025), across all fund types: $56.3M in total assets and a $56.9M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $174,824 | 0.3% |
| Patient receivables, net | $10.6M | 18.8% |
| Inventory | $991,948 | 1.8% |
| Total current assets | $13.2M | 23.4% |
| Property and equipment, net of depreciation | $43.1M | 76.6% |
| Investments and other assets | $7,193 | 0.0% |
| Total assets | $56.3M | 100.0% |
| Current liabilities | -$27.6M | -49.0% |
| Total liabilities | -$695,808 | -1.2% |
| Fund balance (net assets) | $56.9M | 101.2% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Garden Grove Hospital Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$443,837
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$8.4M
Bad debt
Patient bills written off as uncollectible, at charges
$6.5M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$7.7M
Total unreimbursed and uncompensated care
10.5% 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 839354, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Garden Grove Hospital Medical Center'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 | $72.3M | $76.8M | $78.9M | $70.7M | $60.1M | $71.6M |
| Operating expenses | $78.3M | $72.7M | $76.7M | $75.4M | $78.1M | $73.1M |
| Operating margin | -8.3% | 5.4% | 2.8% | -6.7% | -29.9% | -2.2% |
| Net income | $978,682 | $9.6M | $3.5M | -$3.6M | -$17M | -$557,495 |
| Total assets | $118.2M | $124.3M | $119M | $67.8M | $59.6M | $56.3M |
| Discharges | 3,582 | 2,955 | 3,303 | 3,322 | 3,156 | 3,781 |
| Inpatient days | 18,587 | 15,744 | 16,192 | 14,802 | 13,881 | 18,053 |
| Medicare Advantage days | 2,597 | 3,241 | 3,646 | 3,178 | 2,973 | 3,426 |
| Beds | 167 | 167 | 167 | 167 | 167 | 167 |
| Employees (FTE) | 403 | 341 | 331 | 291 | 324 | 326 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Garden Grove Hospital Medical Center 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 |
|---|---|---|---|---|---|
| Emergency | $3.8M | $8.1M | $97M | 0.08 | 5,259 |
| Drugs charged to patients | $4.5M | $27.3M | 0.16 | ||
| Operating room | $1.4M | $4.1M | $24.5M | 0.17 | 11,529 |
| Laboratory | $1.5M | $3.3M | $76.3M | 0.04 | 2,538 |
| Medical supplies charged to patient | $3.2M | $7.1M | 0.46 | ||
| Respiratory therapy | $1.3M | $2.6M | $37.4M | 0.07 | 1,844 |
| Radiology-diagnostic | $991,322 | $2.2M | $12.6M | 0.18 | 4,161 |
| Ultrasound | $545,570 | $927,089 | $10.5M | 0.09 | 290 |
| Ct scan | $452,225 | $913,345 | $30.8M | 0.03 | 516 |
| Impl. dev. charged to patients | $639,175 | $4.2M | 0.15 | ||
| Physical therapy | $311,967 | $628,811 | $3.6M | 0.17 | 483 |
| Renal dialysis | $616,370 | $4.7M | 0.13 | ||
| Blood storing processing & trans. | $69,867 | $513,306 | $7.1M | 0.07 | |
| Op wound care | $184,988 | $426,891 | $740,386 | 0.58 | |
| Electrocardiology | $205,407 | $406,908 | $14.5M | 0.03 | |
| Radioisotope | $154,506 | $342,910 | $2.3M | 0.15 | 599 |
| Pathology | $89,441 | $319,992 | $1.4M | 0.23 | 708 |
| Speech pathology | $211,556 | $1.8M | 0.12 | ||
| Mri | $168,187 | $2.5M | 0.07 | ||
| Observation beds (non-distinct part | $151,817 | $1.1M | 0.14 | ||
| Electroencephalography | $35,095 | $457,649 | 0.08 | ||
| Occupational therapy | $6,759 | $10,151 | $59,607 | 0.17 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $11.2M | $28.4M | $85.2M | 0.33 | 47,427 |
| Intensive care unit | $2.8M | $6.1M | $17.2M | 0.36 | 3,671 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.7M | $12.9M | 76,988 | $35.05 | 13,632 |
| Operation of plant | $1.1M | $3.8M | 34,215 | $30.69 | 35,809 |
| Cap rel costs-bldg & fixt | $2.5M | 144,375 | |||
| Nursing administration | $1.9M | $2.3M | 33,281 | $56.38 | 1,291 |
| Cap rel costs-mvble equip | $1.9M | ||||
| Pharmacy | $1.5M | $1.7M | 24,224 | $62.27 | 1,230 |
| Housekeeping | $1.1M | $1.7M | 47,102 | $23.97 | 1,122 |
| Medical records & library | $287,769 | $1.2M | 9,647 | $29.83 | 1,861 |
| Employee benefits department | $374,229 | $1.1M | 8,175 | $45.78 | 687 |
| Dietary | $804,964 | $911,067 | 16,036 | $26.26 | 2,378 |
| Cafeteria | $747,467 | 14,618 | $26.26 | 4,224 | |
| Maintenance & repairs | $647,868 | 209 | |||
| Laundry & linen service | $251,687 | ||||
| Central services & supply | $75,810 | $82,222 | 2,894 | $26.20 | 2,688 |
| Social service | $58,804 | $77,162 | 1,442 | $40.78 | 219 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839354, 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 Garden Grove Hospital Medical Center for an inpatient stay.
1.66
Case mix index
Higher than 47% 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).
71.0%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
1,212
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 | 1.76 | 1.76 | 2.05 | 1.88 | 1.88 | 1.74 | 1.66 |
| Wage index | 1.275 | 1.271 | 1.277 | 1.519 | 1.451 | 1.431 | 1.399 |
| Readmissions adjustment | -0.44% | -0.01% | 0.00% | -0.07% | -0.41% | -1.24% | -1.72% |
| Value-based purchasing adjustment | +0.34% | +0.69% | +0.69% | +0.82% | -2.00% | -0.72% | -0.83% |
| Medicare inpatient stays | 1,425 | 1,425 | 969 | 1,102 | 1,073 | 1,138 | 1,212 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Garden Grove Hospital Medical Center reports to Medicare as owners or with operational control.
Prime Healthcare Holdings Inc
5% or greater indirect ownership interest, 100%, since 2010
Prime Healthcare Services - Garden Grove LLC
5% or greater direct ownership interest, 100%, since 2008
Prime Healthcare Services, Inc
5% or greater indirect ownership interest, 100%, since 2008
Sources: CMS Hospital All Owners.
The officers and board members on Garden Grove Hospital Medical Center'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 4 of 6 are shown.
Garden grove psych
CCN 05S230, certified 2025, Medicare prospective payment
Source: Worksheet S-2 Part I of Garden Grove Hospital Medical Center's latest Medicare cost report (HCRIS).
About Garden Grove Hospital Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Garden Grove Hospital Medical Center range from $379 to $792 across 3 insurers. Aetna's rate is $379. The median at nearby comparable hospitals is $792. 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 Garden Grove Hospital Medical Center range from $447 to $4,890 across 3 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $447. The median at nearby comparable hospitals is $685. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Garden Grove Hospital Medical Center range from $790 to $1,957 across 3 insurers. UnitedHealthcare's rate is $790. The median at nearby comparable hospitals is $3,236. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Garden Grove Hospital Medical Center range from $3,933 to $9,385 across 3 insurers. Aetna's rate is $9,385. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Garden Grove Hospital Medical Center range from $108 to $271 across 3 insurers. Aetna's rate is $178. The median at nearby comparable hospitals is $237. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Garden Grove Hospital Medical Center range from $11,252 to $26,990 across 3 insurers. Aetna's rate is $26,990. The median at nearby comparable hospitals is $27,168. What a patient pays depends on their plan's deductible, coinsurance and network status.
Garden Grove Hospital Medical Center has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.
CMS reports no Medicare-funded interns or residents at Garden Grove Hospital Medical Center for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Garden Grove Hospital Medical Center's base inpatient payments by an estimated 1.72% 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 (248 discharges), miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc (57 discharges), respiratory infections and inflammations with mcc (53 discharges).
Garden Grove Hospital Medical Center's Medicare case mix index is 1.66 for fiscal year 2027, higher than 47% of hospitals paid under the inpatient prospective payment system.
Garden Grove Hospital Medical Center reported 3,781 inpatient discharges and 18,053 inpatient days from Jan 1, 2025 to Dec 31, 2025.
Garden Grove Hospital Medical Center reported 326 full-time-equivalent employees on payroll from Jan 1, 2025 to Dec 31, 2025.
Garden Grove Hospital Medical Center reported $71.6M in net patient revenue on $470.3M of gross charges for Jan 1, 2025 to Dec 31, 2025, an operating margin of -2.2%, and net income of -$557,495.
Garden Grove Hospital Medical Center reported $7.7M of unreimbursed and uncompensated care for Jan 1, 2025 to Dec 31, 2025, including $443,837 of charity care at cost.
Garden Grove Hospital Medical Center's Medicare enrollment lists Dan Brothman as Chief Executive Officer since 2023.
Insurers' price transparency files list Garden Grove Hospital Medical Center under employer identification number 26-2583411 (Garden Grove Hospital Medical Center). 33 health plans and networks list 26-2583411 for it.
99 clinicians who bill Medicare list Garden Grove Hospital Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are emergency medicine physician (14), internal medicine physician (11), nephrology physician (6).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Garden Grove Hospital Medical Center, effective 2023.
In its Medicare enrollment, Garden Grove Hospital Medical Center reports Prime Healthcare Holdings Inc as 5% or greater indirect ownership interest (100%).
CMS lists 33 services at Garden Grove Hospital Medical Center, including Acute Renal Dialysis, Audiology, Cardiac Catheterization Lab, Clinical Laboratory, CT Scan, Dental Care.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Garden Grove Hospital Medical Center came from ZIP codes 92840 (305), 92843 (253), 92841 (165).
Garden Grove Hospital Medical Center has 167 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. Facility type: Short Term Acute Care Hospital.
Garden Grove Hospital Medical Center is located at 12601 Garden Grove Boulevard, Garden Grove, CA 92843. Its main phone number is (714) 537-5160.
Garden Grove Hospital Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 050230.
The National Provider Identifier (NPI) on file for Garden Grove Hospital Medical Center is 1659538858.
Garden Grove Hospital Medical Center is affiliated with Prime Healthcare Services.
Garden Grove Hospital Medical Center lists 21 in-network payers, including Aetna, Ambetter, Ameri Health, 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.
125 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