Orange Coast Memorial Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Orange Coast Memorial Medical Center, Fountain Valley, CA in 2024, from traditional Medicare claims. Back to the Orange Coast Memorial Medical Center profile, with quality ratings, finances and negotiated rates.
1,934
Medicare inpatient discharges
In 61 published DRGs
1.99
Case mix index
IPPS FY 2027
22%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,902
Medicare outpatient services
In 29 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases509 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 354 | $167,134 | $17,468 | $23,232 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 66 | $83,428 | $8,001 | $11,597 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 61 | $450,744 | $54,201 | $62,653 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 15 | $590,907 | $72,337 | $82,136 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 13 | $134,040 | $15,375 | $18,632 | 2.04 |
Circulatory system382 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 116 | $119,793 | $10,658 | $16,651 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 48 | $136,106 | $13,021 | $18,919 | 1.59 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 38 | $131,672 | $27,505 | $18,302 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 28 | $74,363 | $7,048 | $10,337 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 25 | $87,942 | $6,911 | $12,224 | 0.91 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 18 | $98,315 | $9,984 | $13,666 | 1.20 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 16 | $219,600 | $18,279 | $30,524 | 2.09 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 15 | $67,686 | $5,453 | $9,408 | 0.74 |
| Chest painMS-DRG 313, medical | 15 | $74,231 | $5,933 | $10,318 | 0.72 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 15 | $218,539 | $26,311 | $30,377 | 2.87 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 14 | $149,239 | $16,175 | $20,744 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 12 | $237,341 | $44,907 | $32,990 | 4.88 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 11 | $215,363 | $31,166 | $29,935 | 3.46 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 11 | $129,314 | $18,118 | $17,975 | 2.16 |
Respiratory system263 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 77 | $132,985 | $14,317 | $18,485 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 67 | $106,839 | $11,268 | $14,851 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 35 | $122,730 | $10,533 | $17,059 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 27 | $116,641 | $9,368 | $16,213 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 22 | $79,655 | $5,660 | $11,072 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 12 | $84,179 | $7,439 | $11,701 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 12 | $160,376 | $15,996 | $22,292 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $111,339 | $13,637 | $15,476 | 1.55 |
Digestive system191 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 47 | $88,299 | $8,445 | $12,274 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 35 | $153,454 | $20,218 | $21,330 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 28 | $139,536 | $15,178 | $19,395 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 25 | $66,061 | $5,532 | $9,182 | 0.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 21 | $376,348 | $45,962 | $52,312 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 12 | $73,532 | $6,707 | $10,221 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 12 | $91,687 | $11,576 | $12,745 | 1.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 11 | $96,159 | $13,596 | $13,366 | 1.67 |
Kidney and urinary tract185 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 49 | $72,036 | $6,687 | $10,013 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 31 | $93,993 | $9,957 | $13,065 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 30 | $131,841 | $13,270 | $18,326 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 29 | $87,993 | $12,275 | $12,231 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 29 | $80,895 | $7,027 | $11,244 | 0.90 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 17 | $219,914 | $33,533 | $30,568 | 3.70 |
Musculoskeletal system and connective tissue134 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 31 | $72,094 | $7,879 | $10,021 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 29 | $97,139 | $16,202 | $13,502 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 23 | $136,128 | $17,679 | $18,922 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 22 | $112,465 | $17,987 | $15,633 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 17 | $180,900 | $33,769 | $25,145 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 12 | $146,806 | $22,520 | $20,406 | 2.96 |
Endocrine, nutritional and metabolic93 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 40 | $74,220 | $6,338 | $10,317 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 38 | $98,247 | $10,804 | $13,656 | 1.32 |
| Diabetes with MCCMS-DRG 637, medical | 15 | $146,681 | $13,012 | $20,389 | 1.45 |
Nervous system81 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 24 | $95,128 | $8,105 | $13,223 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 23 | $146,377 | $15,796 | $20,346 | 2.00 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 22 | $86,138 | $22,749 | $11,973 | 2.43 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $72,394 | $6,422 | $10,063 | 0.80 |
Liver, gallbladder and pancreas54 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 18 | $121,356 | $13,733 | $16,869 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 13 | $154,594 | $21,356 | $21,489 | 2.32 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 12 | $148,457 | $22,063 | $20,635 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 11 | $73,243 | $8,690 | $10,181 | 1.09 |
Skin, subcutaneous tissue and breast16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 16 | $110,917 | $7,853 | $15,417 | 0.88 |
Blood and immune system15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 15 | $71,352 | $7,179 | $9,918 | 0.90 |
Factors influencing health status11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 11 | $75,027 | $6,884 | $10,429 | 0.80 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 623 | 575 | $48,325 | $2,671 | $2,090 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 143 | 142 | $43,827 | $5,534 | $4,358 |
| Level 1 Endovascular ProceduresAPC 5191 | 117 | 117 | $34,332 | $2,875 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 101 | 97 | $15,508 | $1,573 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 96 | 82 | $20,472 | $1,833 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 86 | 81 | $76,019 | $14,360 | $10,772 |
| Level 5 Urology and Related ServicesAPC 5375 | 80 | 71 | $39,311 | $5,068 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 72 | 70 | $32,711 | $3,079 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 71 | 69 | $114,324 | $27,095 | $21,117 |
| Level 4 Urology and Related ServicesAPC 5374 | 58 | 47 | $33,437 | $3,408 | $2,629 |
| Level 3 Endovascular ProceduresAPC 5193 | 45 | 37 | $90,788 | $11,869 | $8,874 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 45 | 45 | $62,782 | $10,546 | $8,164 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 38 | 38 | $28,931 | $2,778 | $2,141 |
| Level 3 Urology and Related ServicesAPC 5373 | 35 | 29 | $23,012 | $1,982 | $1,516 |
| Level 2 Vascular ProceduresAPC 5182 | 28 | 28 | $19,553 | $1,513 | $1,204 |
| Level 4 Vascular ProceduresAPC 5184 | 28 | 27 | $55,283 | $5,383 | $3,946 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 27 | 27 | $61,242 | $7,160 | $5,339 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 24 | 24 | $57,991 | $11,476 | $8,569 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 23 | 21 | $53,588 | $6,388 | $4,982 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 21 | 21 | $43,863 | $3,389 | $2,636 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 21 | 19 | $72,042 | $15,078 | $11,550 |
| Level 3 Airway EndoscopyAPC 5153 | 19 | 19 | $22,147 | $1,663 | $1,264 |
| Complex GI ProceduresAPC 5331 | 18 | 15 | $31,058 | $5,583 | $4,263 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 16 | 12 | $40,956 | $3,722 | $2,930 |
| Level 4 Airway EndoscopyAPC 5154 | 15 | 15 | $34,591 | $3,668 | $2,833 |
| Level 3 Upper GI ProceduresAPC 5303 | 15 | 15 | $26,510 | $3,501 | $2,888 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 13 | 13 | $117,509 | $21,219 | $15,763 |
| Level 2 Endovascular ProceduresAPC 5192 | 12 | 12 | $53,154 | $5,599 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 12 | 11 | $29,006 | $2,750 | $2,176 |
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.