INTEGRIS Health · Ponca City, OK
2 of 5
CMS star rating
47
Beds
1,847
Inpatient discharges a year
$54.2M
Net patient revenue a year
30
In-network payers
Ponca City Hospital is a 47-bed proprietary hospital in Ponca City, OK, affiliated with INTEGRIS Health. Below you'll find publicly disclosed negotiated rates and facility details, including 30 in-network payers and 167 disclosed rate categories.
The 24 services Ponca City 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.
Childbirth · Inpatient
MS-DRG 807
$9,264 - $11,777
from 2 insurers · median $10,520
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
$13,950 - $16,863
from 2 insurers · median $15,406
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
Medicine & Surgery · Inpatient
MS-DRG 470
$30,958 - $44,824
from 2 insurers · median $37,891
24 Medicare discharges for this DRG in CMS hospital data
Medicine & Surgery
CPT 47562
$5,170 - $50,642
from 4 insurers · median $15,486
35 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 66984
$990 - $9,698
from 4 insurers · median $6,624
210 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Digestive procedures
CPT 49650
$2,346 - $36,482
from 4 insurers · median $15,134
35 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Childbirth · Inpatient
MS-DRG 807
$9,264 - $11,777
from 2 insurers · median $10,520
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
Digestive procedures
CPT 47563
$5,225 - $54,352
from 4 insurers · median $16,161
35 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 473
$34,534 - $56,731
from 2 insurers · median $45,633
Hospital reports orthopedic surgery services to CMS
X-ray and bone density
CPT 71046
$82 - $1,321
from 4 insurers · median $856
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$183 - $777
from 4 insurers · median $467
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78815
$4,137 - $12,302
from 4 insurers · median $7,184
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$239 - $2,985
from 4 insurers · median $1,554
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 743
$17,090 - $28,831
from 2 insurers · median $22,961
Hospital reports inpatient surgical services to CMS
Nuclear imaging
CPT 78452
$1,693 - $5,886
from 4 insurers · median $3,495
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$689 - $7,653
from 4 insurers · median $4,401
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$15,100 - $17,922
from 2 insurers · median $16,511
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$571 - $9,834
from 4 insurers · median $2,969
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$400 - $4,508
from 4 insurers · median $2,133
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$792 - $6,327
from 4 insurers · median $3,112
Common here, based on CMS Medicare volume
MRI imaging
CPT 73721
$393 - $4,493
from 4 insurers · median $2,185
Common here, based on CMS Medicare volume
Lung function and sleep
CPT 95810
$675 - $9,421
from 4 insurers · median $5,215
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93971
$478 - $2,129
from 4 insurers · median $1,542
Common here, based on CMS Medicare volume
Lung function and sleep
CPT 95811
$775 - $9,995
from 4 insurers · median $5,457
Common here, based on CMS Medicare volume
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* | 17 | 894% | 17 | 0 |
| Insurer B* | 17 | 607% | 11 | 2 |
| Insurer C* | 24 | 256% | 18 | 0 |
| Insurer D* | 24 | 231% | 14 | 2 |
How we chose these services: 5 appear in this hospital's own Medicare claims, 13 are common here based on CMS Medicare volume, and 6 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 Ponca City Hospital, 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
$54.2M net patient revenue
Ownership and leadership
Owned by INTEGRIS Health Inc
The employer identification numbers (EINs) health plans and networks list for Ponca City 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 |
|---|---|---|
| 20-4052936Kay County Oklahoma Hospital Company LLC | 28Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Asuris Northwest Health, BCBS and 23 more | 1225077035 Kay County Oklahoma Hospital Company LLC1629018932 Kay County Oklahoma Hospital Company LLC1407075161 Kay County Oklahoma Hospital Company LLCand 4 more |
| 93-2949739INTEGRIS Health Ponca City Hospital INC. | 23Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Aspirus Health Plan, Asuris Northwest Health and 18 more | 1548047616 Integris Health Ponca City Hospital Inc1225077035 Kay County Oklahoma Hospital Company LLC1528830163 Integris Health Ponca City Hospital Incand 2 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.
1900 North 14th Street, Ponca City, OK 74601
(580) 765-3301
How Ponca City Hospital 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
Worse on 2 of 5 measures
0 better, 3 no different, 2 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 5 measures
0 better, 5 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Worse on 1 of 7 measures
0 better, 6 no different, 1 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
3 of 5
Lower than 40% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
51%
Lower than 97% 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)
1.08
Higher than 79% 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
128 min
Lower than 66% 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
20%
Lower than 99% 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 | Worse on 2 of 5 measures | |
| Safety | No different on 5 measures | |
| Readmissions | Worse on 1 of 7 measures | |
| Patient survey ratingCMS: Summary star rating | 3 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 51% | 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) | 1.08 | 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 | 128 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 20% | 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 Ponca City Hospital's inpatient payments for its readmissions, quality and cost results.
-0.01% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
-0.39% 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 Ponca City Hospital, beside the US median and the average of OK 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 | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 · 47 cases | 4.7 | 4.1 | 4.5 | Worse than 75% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 524 cases | 4.9 | 3.9 | 4.206 | Worse than 87% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 12.36 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.611 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 47 cases | 9.7 | 8.5 | 8.722 | Worse than 79% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 77 cases | 10.6 | 11 | 11.31 | Better than 57% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 143 cases | 20.6 | 15.2 | 15.57 | Worse than 97% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 44 cases | 19.8 | 11.6 | 13.28 | Worse than 98% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 931 cases | 0.45 | 0.51 | 0.5362 | No Different Than the National Rate | Better than 59% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 176 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 1,144 cases | 0.2 | 0.2 | 0.2122 | No Different Than the National Rate | Better than 46% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 1,055 cases | 0.26 | 0.27 | 0.2762 | No Different Than the National Rate | Better than 54% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 256 cases | 2.25 | 2.29 | 2.34 | No Different Than the National Rate | Better than 57% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 124 cases | 1.64 | 1.63 | 1.699 | No Different Than the National Rate | Worse than 50% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 122 cases | 12.9 | 8.88 | 9.965 | No Different Than the National Rate | Worse than 89% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 270 cases | 3.56 | 3.4 | 3.378 | No Different Than the National Rate | Worse than 64% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 96 cases | 6.51 | 5.105 | 5.356 | No Different Than the National Rate | Worse than 88% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 78 cases | 1.7 | 1.72 | 1.757 | No Different Than the National Rate | Better than 58% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 151 cases | 0.99 | 1.02 | 1.052 | No Different Than the National Rate | Better than 61% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 7.121 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 72 cases | -14 | 1.25 | -3.734 | Better than 71% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 143 cases | 5.2 | 3.85 | -8.01 | Worse than 52% 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 · 375 cases | 12.8 | 12.9 | 13.2 | No Different Than the National Rate | Better than 55% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 10.88 | Number of Cases Too Small | ||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.711 | Number of Cases Too Small | ||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 70 cases | 0.9 | 1 | 1.026 | No Different than expected | Better than 68% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.57 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.24 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 80 cases | 19.5 | 19.8 | 20.02 | Better than 63% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 93 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 · 46 cases | 6.3 | 5.8 | 6.068 | Worse than 76% of US hospitals | |
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 185 cases | 17 | 17.2 | 17.29 | Better than 59% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.213 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.152 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 509 | 1,370 | 3,613 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.313 | 0.9835 | 3.643 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 1.722 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.6454 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.186 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.84 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 1,620 | 1,799 | 2,933 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.827 | 1.377 | 3.323 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 1.291 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.3961 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.4004 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.687 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 36 | 61 | 102 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.995 | 1.591 | 2.76 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 1 | 1 | 2.978 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.9026 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3225 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.641 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 10 | 38 | 117 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.098 | 0.328 | 1.033 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 1.021 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.7021 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3557 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.404 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 6,628 | 14,451 | 22,964 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.165 | 0.567 | 1.566 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 1.121 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.772 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.144 | Better than the National Benchmark | ||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.897 | 0.747 | 1.37 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 6,628 | 13,646 | 20,916 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 3.341 | 5.683 | 13.63 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 0 | 2 | 3.489 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0 | 0.279 | 0.3156 | Better than the 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 | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 302 cases | 75 | 73 | 74.33 | Better than 56% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 302 cases | 7 | 8 | 8.534 | Better than 56% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 302 cases | 18 | 18 | 17.14 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 89 | 87 | 86.41 | Better than 66% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 302 cases | 4 | 4 | 3.426 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 302 cases | 75 | 80 | 80.77 | Worse than 78% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 90 | 91 | 91.63 | Worse than 66% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 302 cases | 6 | 4 | 3.602 | Worse than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 302 cases | 3 | 3 | 3.556 | Worse than 49% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 302 cases | 19 | 16 | 15.63 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 302 cases | 77 | 79 | 80.72 | Worse than 63% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 90 | 91 | 91.11 | Worse than 55% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 302 cases | 7 | 5 | 5.239 | Worse than 72% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 302 cases | 3 | 3 | 3.222 | Worse than 37% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 302 cases | 16 | 16 | 14.05 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 302 cases | 61 | 61 | 63.34 | Worse than 47% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 77 | 77 | 77.35 | Better than 47% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 302 cases | 20 | 19 | 17.88 | Worse than 50% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 302 cases | 3 | 3 | 2.741 | Better than 47% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 302 cases | 19 | 19 | 18.78 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 82 | 86 | 85.52 | Worse than 82% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 302 cases | 17 | 13 | 13.5 | Worse than 79% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 302 cases | 2 | 3 | 3.259 | Worse than 82% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 302 cases | 83 | 87 | 86.5 | Worse than 79% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 302 cases | 16 | 14 | 15.01 | Worse than 60% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 302 cases | 84 | 86 | 84.99 | Worse than 60% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 72 | 74 | 75.68 | Worse than 60% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 8 | 7 | 6.382 | Worse than 63% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 20 | 19 | 17.94 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 74 | 77 | 78.63 | Worse than 70% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 8 | 6 | 5.824 | Worse than 77% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 18 | 17 | 15.54 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 85 | 85 | 86.24 | Worse than 47% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 5 | 3 | 3.456 | Worse than 73% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 10 | 11 | 10.31 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 302 cases | 14 | 8 | 7.42 | Worse than 89% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 302 cases | 28 | 20 | 19.27 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 302 cases | 58 | 72 | 73.31 | Worse than 93% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 84 | 88 | 89 | Worse than 85% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 302 cases | 2 | 3 | 3.537 | Worse than 78% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 302 cases | 72 | 74 | 75.53 | Worse than 62% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 302 cases | 12 | 9 | 8.985 | Worse than 73% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 302 cases | 16 | 16 | 15.49 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 70 | 75 | 75.5 | Worse than 80% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 9 | 5 | 5.485 | Worse than 86% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 302 cases | 21 | 20 | 19.01 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 73 | 77 | 77.97 | Worse than 70% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 7 | 4 | 4.029 | Worse than 81% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 302 cases | 20 | 19 | 18 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 83 | 86 | 87.06 | Worse than 72% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 4 | 3 | 2.397 | Worse than 72% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 302 cases | 13 | 11 | 10.54 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 302 cases | 69 | 59 | 66.14 | Better than 80% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 302 cases | 7 | 9 | 6.398 | Better than 61% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 302 cases | 24 | 31 | 27.47 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 86 | 82 | 84.83 | Better than 79% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 302 cases | 4 | 3 | 3.981 | 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 · 302 cases | 10 | 5 | 5.466 | Worse than 87% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 302 cases | 51 | 71 | 73.73 | Worse than 97% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 302 cases | 79 | 87 | 87.91 | Worse than 93% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 302 cases | 39 | 23 | 20.81 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 302 cases | 2 | 4 | 3.815 | Worse than 85% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 302 cases | 49 | 47 | 49.99 | Better than 58% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 302 cases | 29 | 30 | 28.22 | Better than 55% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 302 cases | 22 | 22 | 21.79 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 302 cases | 3 | 3 | 3.407 | Worse than 40% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 302 cases | 18 | 12 | 12.72 | Worse than 90% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 302 cases | 82 | 88 | 87.28 | Worse than 90% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | Ponca City Hospital | US median | OK 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 | 8.19 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.1 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.35 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 245 cases | 87 | 79 | 78.33 | Better than 64% 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 · 419 cases | 130 | 154 | 128 | Better than 70% 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 · 401 cases | 128 | 148 | 123 | Better than 66% 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 · 11 cases | 130 | 247 | 202 | Better than 93% 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 | 254 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 4,818 cases | 3 | 1 | 1.222 | Worse than 78% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 65.13 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 77 cases | 92 | 97 | 91.94 | Worse than 72% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 88 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 64.29 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 750 cases | 13 | 15 | 14.31 | Better than 60% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 60 cases | 20 | 65 | 60.29 | Worse than 99% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 12 cases | 42 | 73 | 68.47 | Worse than 94% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 84.07 | |||
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 60 cases | 60 | 82 | 77.55 | Worse than 95% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 26 cases | 42 | 94 | 90.37 | Worse than 99% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 96.36 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 70.67 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 88.07 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 1,058 cases | 87 | 90 | 77.99 | Worse than 57% of US hospitals | |
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 350 cases | 89 | 97 | 95.81 | Worse than 83% of US hospitals |
How often scans were ordered when they may not be needed; lower is better.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 2.5 | 5 | 8.305 | Better than 80% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 6.3 | 6.6 | 7.093 | Better than 53% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 1 | 0.99 | 0.9841 | Worse than 53% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 12.5 | 20 | 16.07 | Worse than 66% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 3.125 | 5 | 4.053 | Worse than 66% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 10 | 10 | 19.27 | Better than 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 2.5 | 2.5 | 4.817 | Worse than 44% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 36 | 34 | 44.48 | Better than 52% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 9 | 8.75 | 11.31 | Better than 52% of US hospitals | |
| VBP safety domain scoreFY 2026 | 35 | 40 | 44.23 | Worse than 58% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 8.75 | 10 | 11.26 | Worse than 58% of US hospitals | |
| VBP total performance scoreFY 2026 | 23.38 | 29.5 | 31.23 | Worse than 71% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 28 | 25 | 23.33 | 12.5 | 10 | 12.5 |
| VBP clinical outcomes weighted domain score | 7 | 6.25 | 5.833 | 3.125 | 2.5 | 3.125 |
| VBP efficiency and cost reduction domain score | 10 | Not Available | 20 | 40 | 20 | 10 |
| VBP efficiency and cost reduction weighted domain score | 2.5 | Not Available | 5 | 10 | 5 | 2.5 |
| VBP person and community engagement domain score | 16 | Not Available | Not Available | 13 | 18 | 36 |
| VBP person and community engagement weighted domain score | 4 | Not Available | Not Available | 3.25 | 4.5 | 9 |
| VBP safety domain score | 80 | Not Available | Not Available | 75 | 20 | 35 |
| VBP safety weighted domain score | 20 | Not Available | Not Available | 18.75 | 5 | 8.75 |
| VBP total performance score | 33.5 | Not Available | Not Available | 35.13 | 17 | 23.38 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.004 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9873 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | 0.9514 | 0.9969 | 0.9972 | Better than 88% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 0.9487 | 0.9983 | 0.9917 | Better than 81% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | 0.9982 | 0.9916 | 1.029 | Worse than 52% of US hospitals | |
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 128 cases | 0.9938 | 0.9955 | 0.9843 | Better than 52% 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 | 0.9855 | 0.9969 | 1.002 | 0.9546 | 0.9246 | 0.9514 |
| READM-30-HF-HRRP | 0.995 | 1.016 | 1.039 | 1.002 | 0.9977 | 0.9487 |
| READM-30-HIP-KNEE-HRRP | 1.306 | 1.181 | 1.252 | 0.9872 | 0.9575 | 0.9982 |
| READM-30-PN-HRRP | 0.9782 | 1.029 | 1.025 | 1.005 | 1.001 | 0.9938 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | Ponca City Hospital | US median | OK average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.37 | 0.489 | 0.6091 | Better than 63% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.498 | 0.346 | 0.3355 | Worse than 72% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.559 | 0.5548 | The best result, shared by 14% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.963 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 1.084 | 0.9628 | 0.9791 | Worse than 79% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 0.548 | 0.7945 | 0.8412 | Better than 67% of US hospitals | |
| Total HAC scoreFY 2026 | -0.2442 | -0.0453 | -0.05508 | Better than 64% 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 | No | No | No |
| Total HAC score | -0.5287 | -0.0848 | 0 | -0.7246 | -0.563 | -0.2442 |
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
Other
Ownership type
140
Medicare-certified beds
68
Registered nurses (full-time equivalent)
1970
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Ponca City Hospital reported to Medicare in its latest cost report, covering Jul 1, 2024 to Jun 30, 2025.
1,847
Inpatient discharges
Medicare 28%, Medicaid 12%
6,490
Inpatient days
38% of available bed days used
219
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 841639). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Ponca City Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,915 | 870 | 3,705 | 6,490 |
| Discharges | 509 | 228 | 1,110 | 1,847 |
| Average length of stay | 3.8 days | 3.8 days | 3.3 days | 3.5 days |
| Average daily census | 5.2 | 2.4 | 10.2 | 17.8 |
370
Medicare Advantage days
94 discharges
632
Medicaid managed care days
440
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 37 | 5,013 | 1,577 | 37% |
| Intensive care unit | 10 | 983 | 338 | 27% |
| Nursery | 494 |
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Ponca City Hospital treats Medicare patients for most often, in 2024. 241 Medicare discharges in 13 published DRGs; 12% surgical; 68% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 35 | $80,100 | $9,203 | $13,777 | 1.28 |
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 33 | $89,456 | $14,435 | $15,386 | 1.98 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 24 | $99,695 | $12,069 | $17,147 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 22 | $75,934 | $9,235 | $13,061 | 1.33 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 19 | $55,006 | $5,554 | $9,461 | 0.78 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 16 | $45,857 | $5,522 | $7,887 | 0.81 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 15 | $109,114 | $15,381 | $18,768 | 2.11 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 14 | $53,346 | $7,911 | $9,176 | 1.10 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 14 | $111,402 | $13,582 | $19,161 | 1.88 |
| Renal failure with CCMS-DRG 683, medical | 14 | $43,424 | $6,326 | $7,469 | 0.90 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 12 | $93,184 | $9,665 | $16,028 | 1.23 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 12 | $43,430 | $7,825 | $7,470 | 1.17 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 11 | $78,397 | $7,346 | $13,484 | 0.98 |
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) Ponca City Hospital billed Medicare for most in 2024: 424 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 210 | 122 | $15,115 | $1,647 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 73 | 71 | $46,708 | $1,956 | $2,090 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 35 | 35 | $65,818 | $4,062 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 23 | 23 | $40,430 | $4,959 | $5,339 |
| Level 3 Vascular ProceduresAPC 5183 | 20 | 20 | $31,663 | $2,310 | $2,405 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 18 | 18 | $31,858 | $2,211 | $2,373 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 16 | 16 | $15,731 | $1,163 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 15 | 13 | $20,295 | $1,379 | $1,445 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 14 | 14 | $17,624 | $1,165 | $1,196 |
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 Ponca City 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 897 in 2020 to 892 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 74601 | 415 | 47% | 1,587 | $34.8M | 44% | 52% |
| 74604 | 284 | 32% | 1,018 | $22.2M | 41% | 50% |
| 74631 | 57 | 6% | 218 | $4.7M | 20% | 11% |
| 74647 | 50 | 6% | 153 | $3.5M | 50% | 60% |
| 74653 | 31 | 3% | 99 | $2.2M | 39% | 24% |
| 74641 | 27 | 3% | 69 | $1.7M | 100% | 100% |
| 74602 | 16 | 2% | 75 | $1.2M | 100% | 100% |
| 74644 | 12 | 1% | 46 | $915,261 | 100% |
Source: CMS Hospital Service Area file. Shares are of the 892 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 Ponca City Hospital reported at its latest Medicare certification survey (2023). Counts are people, not full-time equivalents.
6
Operating rooms
1
Endoscopy rooms
12
Psychiatric unit beds
1
Off-site locations
68
Registered nurses
13
Licensed practical nurses
8
Physicians
4
Nurse practitioners
3
Pharmacists
2
Respiratory therapists
4
Physical therapists
13
Radiology technicians
1
Nuclear medicine technicians
3
Laboratory technicians
3
Medical technologists
1
Dietitians
Source: CMS Provider of Services file.
145 clinicians who bill Medicare list Ponca City 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.
Chad Schroeder, PA-C
Medical Physician Assistant
NPI 1861761199
See commercial rates for Chad Schroeder, PA-CSean Anderson, AGACNP-BC
Acute Care Nurse Practitioner
NPI 1164829057
See commercial rates for Sean Anderson, AGACNP-BCJohn Holden, M.D.
Internal Medicine Physician
NPI 1427034792
See commercial rates for John Holden, M.D.Jeremy Theisen, MD
Diagnostic Radiology Physician
NPI 1881954501
See commercial rates for Jeremy Theisen, MDRodger Spillars, M.D.
Internal Medicine Physician
NPI 1679508568
See commercial rates for Rodger Spillars, M.D.Varun Chauhan, MD
Neurology Physician
NPI 1669890612
See commercial rates for Varun Chauhan, MDAndrea Fraley, MD
Sports Medicine (Physical Medicine & Rehabilitation) Physician
NPI 1487660585
See commercial rates for Andrea Fraley, MDShyam Poludasu, M.D
Interventional Cardiology Physician
NPI 1811171705
See commercial rates for Shyam Poludasu, M.DMichael Owens, DO
Pain Medicine (Anesthesiology) Physician
NPI 1114133907
See commercial rates for Michael Owens, DOAamir Mohammad, MD
Hospitalist Physician
NPI 1558356923
See commercial rates for Aamir Mohammad, MDSteven Cummings, M.D.
Internal Medicine Physician
NPI 1750365292
See commercial rates for Steven Cummings, M.D.Julia Knarreborg, M.D.
Diagnostic Radiology Physician
NPI 1952662363
See commercial rates for Julia Knarreborg, M.D.Nicholas Armstrong, M.D.
Diagnostic Radiology Physician
NPI 1134418759
See commercial rates for Nicholas Armstrong, M.D.Eugenio Erquiaga, M.D.
Diagnostic Radiology Physician
NPI 1528005048
See commercial rates for Eugenio Erquiaga, M.D.Michael Scherlag, M.D.
Interventional Cardiology Physician
NPI 1578550505
See commercial rates for Michael Scherlag, M.D.Paul Briggs, M.D.
Family Medicine Physician
NPI 1528064805
See commercial rates for Paul Briggs, M.D.Rafel Alvarez, D.O.
Diagnostic Radiology Physician
NPI 1215383005
See commercial rates for Rafel Alvarez, D.O.James Harris, D.O.
Cardiovascular Disease Physician
NPI 1417139924
See commercial rates for James Harris, D.O.Mark Paden, M.D.
Orthopaedic Surgery Physician
NPI 1336288133
See commercial rates for Mark Paden, M.D.Surya Artham, MD, MPH
Interventional Cardiology Physician
NPI 1215127493
See commercial rates for Surya Artham, MD, MPHJamal Siddiqui, M.D.
Ophthalmology Physician
NPI 1578883336
See commercial rates for Jamal Siddiqui, M.D.Brad Liston, D.O.
Adult Medicine Physician
NPI 1487817375
See commercial rates for Brad Liston, D.O.Jawad Trad, D.O
Internal Medicine Physician
NPI 1669770145
See commercial rates for Jawad Trad, D.OSarah Matousek-Fraser, MD
Pulmonary Disease Physician
NPI 1083874267
See commercial rates for Sarah Matousek-Fraser, 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 Ponca City Hospital reported to Medicare for Jul 1, 2024 to Jun 30, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $428.6M | 790.7% |
| Inpatient | $136M | 251.0% |
| Outpatient | $292.6M | 539.8% |
| Contractual allowances and discounts | -$374.4M | -690.7% |
| Net patient revenue | $54.2M | 100.0% |
| Operating expenses | -$59.6M | -109.9% |
| Operating income from patient care | -$5.4M | -9.9% |
| Other income | $1.8M | 3.2% |
| Net income | -$3.6M | -6.7% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $93.3M | 21.8% |
| Medicaid (including managed care) | $91.9M | 21.4% |
| Other payers and self-pay | $243.4M | 56.8% |
| Total charges | $428.6M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, 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 Ponca City Hospital's latest cost report.
-9.9%
Operating margin
Operating income from patient care / net patient revenue
-6.5%
Total margin
Net income / net patient revenue plus other income
-0.3%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
40% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$38.59
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-12.8%
Return on assets
Net income for a year / total assets
-119.4%
Return on equity
Net income for a year / fund balance
0.44
Current ratio
Current assets / current liabilities
0.33
Quick ratio
Cash, temporary investments and net receivables / current liabilities
5 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
49 days
Days in patient receivables
Net patient receivables / daily net patient revenue
155 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.96
Asset turnover
Total revenue for a year / total assets
0.7 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Ponca City Hospital owned and owed at the end of its reporting period (Jun 2025), across all fund types: $28.5M in total assets and a $3M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $714,414 | 2.5% |
| Patient receivables, net | $7.2M | 25.4% |
| Inventory | $1.7M | 6.0% |
| Total current assets | $10.4M | 36.5% |
| Property and equipment, net of depreciation | $17.4M | 61.2% |
| Investments and other assets | $661,276 | 2.3% |
| Total assets | $28.5M | 100.0% |
| Current liabilities | $23.8M | 83.7% |
| Total liabilities | $25.4M | 89.3% |
| Fund balance (net assets) | $3M | 10.7% |
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Ponca City Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$1.7M
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$1.8M
Bad debt
Patient bills written off as uncollectible, at charges
$7M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$2M
Total unreimbursed and uncompensated care
3.4% 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 841639, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Ponca City Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | May 2020 | May 2021 | May 2022 | May 2023 | Jun 2025 |
|---|---|---|---|---|---|
| Net patient revenue | $52.2M | $54.6M | $60.4M | $52.9M | $54.2M |
| Operating expenses | $50.1M | $49.4M | $53.1M | $50.9M | $59.6M |
| Operating margin | 4.0% | 9.5% | 12.1% | 3.7% | -9.9% |
| Net income | $2.4M | $11.3M | $8.8M | $3.8M | -$3.6M |
| Total assets | $36.6M | $42.8M | $42M | $38.6M | $28.5M |
| Discharges | 2,170 | 2,024 | 1,883 | 1,938 | 1,847 |
| Inpatient days | 8,670 | 9,067 | 8,999 | 8,106 | 6,490 |
| Medicare Advantage days | 814 | 1,387 | 1,919 | 1,829 | 370 |
| Beds | 48 | 48 | 47 | 47 | 47 |
| Employees (FTE) | 293 | 264 | 255 | 233 | 219 |
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Ponca City 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 |
|---|---|---|---|---|---|
| Emergency | $1.9M | $8.4M | $45.9M | 0.18 | 52,890 |
| Operating room | $2.2M | $8.3M | $86.1M | 0.10 | 22,413 |
| Laboratory | $5.6M | $65M | 0.09 | 4,762 | |
| Rural health clinic | $656,383 | $4.2M | $1.9M | 2.18 | 4,800 |
| Radiology-diagnostic | $1.3M | $4.2M | $34M | 0.12 | 12,831 |
| Drugs charged to patients | $2.8M | $23.9M | 0.12 | ||
| Delivery room & labor room | $2.8M | $8.9M | 0.31 | 8,110 | |
| Impl. dev. charged to patients | $2.6M | $16.2M | 0.16 | ||
| Physical therapy | $523,693 | $1.6M | $6M | 0.26 | 9,817 |
| Respiratory therapy | $651,848 | $1.6M | $12.1M | 0.13 | 2,212 |
| Ct scan | $432,310 | $1.2M | $67M | 0.02 | |
| Observation beds (non-distinct part | $610,544 | $8.7M | 0.07 | ||
| Radioisotope | $153,935 | $594,350 | $2.5M | 0.24 | |
| Mri | $179,849 | $420,471 | $11.5M | 0.04 | |
| Electrocardiology | $240,168 | $1.7M | 0.14 | 721 | |
| Medical supplies charged to patient | $223,742 | $1.4M | 0.16 | ||
| Cardiac rehabilitation | $68,764 | $179,594 | $1.3M | 0.13 | |
| Clinic | $62,266 | $150,919 | $869,429 | 0.17 | |
| Anesthesiology | $113,530 | $6M | 0.02 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $2.9M | $7.6M | $19.6M | 0.39 | 28,263 |
| Intensive care unit | $1.3M | $3.6M | $6.8M | 0.53 | 6,092 |
| Nursery | $551,677 | $1.3M | 0.42 | 413 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $2.2M | $15.6M | 23,495 | $64.59 | 30,452 |
| Operation of plant | $445,296 | $2.9M | 14,798 | $30.09 | 86,386 |
| Nursing administration | $1.3M | $2M | 28,579 | $45.17 | 2,004 |
| Cap rel costs-mvble equip | $1.9M | ||||
| Cap rel costs-bldg & fixt | $1.6M | 305,420 | |||
| Pharmacy | $643,476 | $1.2M | 13,553 | $47.48 | 3,264 |
| Housekeeping | $410,169 | $1M | 24,066 | $17.04 | 3,426 |
| Cafeteria | $991,203 | 23,625 | $18.42 | 4,516 | |
| Medical records & library | $1,056 | $973,087 | 30 | $35.28 | 4,039 |
| Employee benefits department | $937,005 | 3,217 | $45.49 | 1,962 | |
| Dietary | $622,784 | $485,631 | 10,194 | $18.41 | 5,886 |
| Central services & supply | $168,138 | $385,520 | 8,439 | $19.92 | 4,741 |
| Laundry & linen service | $156,997 | 4,126 |
Source: CMS cost report (HCRIS, Form 2552-10), report 841639, 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 Ponca City Hospital for an inpatient stay.
1.35
Case mix index
Higher than 13% 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).
28.3%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
503
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
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 | 1.56 | 1.56 | 1.79 | 1.76 | 1.53 | 1.47 | 1.35 |
| Wage index | 0.842 | 0.846 | 0.848 | 0.843 | 0.919 | 0.902 | 0.890 |
| Readmissions adjustment | -0.68% | -1.08% | -0.78% | -1.04% | -0.02% | 0.00% | -0.01% |
| Value-based purchasing adjustment | -0.05% | +0.15% | +0.15% | +1.75% | +1.33% | -0.48% | -0.39% |
| Medicare inpatient stays | 1,017 | 1,017 | 726 | 618 | 566 | 583 | 503 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Ponca City Hospital reports to Medicare as owners or with operational control. 4 individuals also hold ownership interests; they are not listed here.
INTEGRIS Health Inc
Operational/managerial control, since 2023
Sources: CMS Hospital All Owners, CMS Hospital Change of Ownership.
The officers and board members on Ponca City 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 14 are shown.
340B drug pricing program
Participating since 2025
340B ID DSH370006, registered as a disproportionate share hospital. Authorizing official: Alexis Elizabeth Ngo, Director, Pharmacy Business Services.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Integris health ponca city hospital
CCN 37U006, certified 2005, Medicare prospective payment
Integris health medical group
CCN 378510, certified 2018, Medicare cost reimbursed
Source: Worksheet S-2 Part I of Ponca City Hospital's latest Medicare cost report (HCRIS).
About Ponca City Hospital's rates and hospital price transparency.
For MRI lumbar spine without contrast (CPT 72148), published negotiated rates at Ponca City Hospital range from $400 to $4,508 across 4 insurers. Aetna's rate is $4,508. The median at nearby comparable hospitals is $1,084. 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 Ponca City Hospital range from $689 to $7,653 across 4 insurers. Aetna's rate is $7,653. The median at nearby comparable hospitals is $2,815. 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 Ponca City Hospital range from $9,264 to $11,777 across 2 insurers. UnitedHealthcare's rate is $11,777. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Ponca City Hospital range from $183 to $777 across 4 insurers. UnitedHealthcare's rate is $183. The median at nearby comparable hospitals is $286. 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 Ponca City Hospital range from $30,958 to $44,824 across 2 insurers. Blue Cross Blue Shield's rate is $30,958. The median at nearby comparable hospitals is $28,648. What a patient pays depends on their plan's deductible, coinsurance and network status.
Ponca City Hospital 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 Ponca City Hospital for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Ponca City Hospital's base inpatient payments by an estimated 0.01% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were heart failure and shock with mcc (35 discharges), septicemia or severe sepsis without mv >96 hours with mcc (33 discharges), respiratory infections and inflammations with mcc (24 discharges).
Ponca City Hospital's Medicare case mix index is 1.35 for fiscal year 2027, higher than 13% of hospitals paid under the inpatient prospective payment system.
Ponca City Hospital reported 1,847 inpatient discharges and 6,490 inpatient days from Jul 1, 2024 to Jun 30, 2025.
Ponca City Hospital reported 219 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.
Ponca City Hospital reported $54.2M in net patient revenue on $428.6M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of -9.9%, and net income of -$3.6M.
Ponca City Hospital reported $2M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $1.7M of charity care at cost.
Ponca City Hospital's Medicare enrollment lists Brent Hubbard as Senior Vice President & COO since 2023.
Insurers' price transparency files list Ponca City Hospital under employer identification number 20-4052936 (Kay County Oklahoma Hospital Company LLC), and 1 other tax ID. 28 health plans and networks list 20-4052936 for it.
Yes. HRSA's 340B database lists Ponca City Hospital (340B ID DSH370006) as a participating disproportionate share hospital since 2025.
145 clinicians who bill Medicare list Ponca City Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (18), internal medicine physician (13), diagnostic radiology physician (10).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Ponca City Hospital, effective 2023.
In its Medicare enrollment, Ponca City Hospital reports INTEGRIS Health Inc as Operational/managerial control.
CMS lists 27 services at Ponca City Hospital, including Anesthesia, Cardiac Catheterization Lab, Clinical Laboratory, CT Scan, Diagnostic Radiology, Dietary Care.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Ponca City Hospital came from ZIP codes 74601 (415), 74604 (284), 74631 (57).
Ponca City Hospital has 47 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 140 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Ponca City Hospital is located at 1900 North 14th Street, Ponca City, OK 74601. Its main phone number is (580) 765-3301.
Ponca City Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 370006.
The National Provider Identifier (NPI) on file for Ponca City Hospital is 1225077035.
Ponca City Hospital is affiliated with INTEGRIS Health.
Ponca City Hospital lists 30 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.
167 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