Pontiac, MI
117
Beds
2
Inpatient discharges a year
$39.4M
Net patient revenue a year
18
In-network payers
Pontiac General Hospital is a 117-bed proprietary hospital in Pontiac, MI. Below you'll find publicly disclosed negotiated rates and facility details, including 18 in-network payers and 247 disclosed rate categories.
The 24 services Pontiac General 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.
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Digestive procedures
CPT 43239
$1,700 - $1,774
from 2 insurers · median $1,737
Typical for a hospital with this service line
CT imaging
CPT 74177
$452
negotiated rate
Typical for a hospital with this service line
Gynecology
CPT 58571
$3,300 - $6,433
from 2 insurers · median $4,866
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,700
negotiated rate
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,700
negotiated rate
Typical for a hospital with this service line
Mammography
CPT 77067
$197
negotiated rate
Typical for a hospital with this service line
Digestive procedures
CPT 49650
$3,300 - $4,972
from 2 insurers · median $4,136
Typical for a hospital with this service line
Ear, nose and throat
CPT 69436
$1,700 - $3,158
from 2 insurers · median $2,429
Typical for a hospital with this service line
Gynecology
CPT 58661
$3,300 - $5,225
from 2 insurers · median $4,262
Typical for a hospital with this service line
Gynecology
CPT 58662
$3,300 - $6,807
from 2 insurers · median $5,053
Typical for a hospital with this service line
Ear, nose and throat
CPT 30520
$2,000 - $8,443
from 2 insurers · median $5,222
Typical for a hospital with this service line
Gynecology
CPT 58558
$2,000 - $2,878
from 2 insurers · median $2,439
Typical for a hospital with this service line
Orthopedics and pain
CPT 27446
$3,980 - $45,050
from 2 insurers · median $24,515
Typical for a hospital with this service line
CT imaging
CPT 71275
$540
negotiated rate
Typical for a hospital with this service line
CT imaging
CPT 74176
$353
negotiated rate
Typical for a hospital with this service line
Medicine & Surgery
CPT 55866
$3,980 - $9,740
from 2 insurers · median $6,860
Typical for a hospital with this service line
Orthopedics and pain
CPT 64721
$2,000 - $5,116
from 2 insurers · median $3,558
Typical for a hospital with this service line
Medicine & Surgery
CPT 42820
$2,000 - $2,502
from 2 insurers · median $2,251
Typical for a hospital with this service line
Orthopedics and pain
CPT 29888
$3,300 - $7,278
from 2 insurers · median $5,289
Typical for a hospital with this service line
CT imaging
CPT 70450
$128
negotiated rate
Typical for a hospital with this service line
MRI imaging
CPT 70553
$682
negotiated rate
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$28,864
negotiated rate
Hospital reports orthopedic surgery services to CMS
Medicine & Surgery
CPT 29881
$2,500 - $3,327
from 2 insurers · median $2,913
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$3,300
negotiated rate
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 | 124% | 9 | 10 |
| Insurer B* | 17 | 53% | 0 | 17 |
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 Pontiac General Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
No Medicare readmissions penalty
See quality ratingsDoctors and services
Major teaching hospital
Finances
$39.4M net patient revenue
The employer identification numbers (EINs) health plans and networks list for Pontiac General 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 |
|---|---|---|
| 26-2512084Pontiac General Hospital | 38Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter, Aspirus Health Plan and 33 more | 1619125788 Oakland Physicians Medical Center LLC1497906010 Oakland Physicians Medical Center LLC1760631238 Oakland Physicians Medical Center LLCand 10 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.
461 West Huron Street, Pontiac, MI 48341
(248) 857-7200
How Medicare adjusts Pontiac General Hospital's inpatient payments for its readmissions, quality and cost results.
No penalty
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2026 IPPS final rule.
0.00% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2026 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2026).
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Pontiac General Hospital reported to Medicare in its latest cost report, covering Jan 1, 2024 to Nov 23, 2024.
2
Inpatient discharges
Medicare 100%, Medicaid n/a
38
Inpatient days
0% of available bed days used
73
Employees (full-time equivalent)
14
Interns and residents (full-time equivalent)
Source: CMS cost report (HCRIS) (report 808216). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Pontiac General Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 38 | 0 | 0 | 38 |
| Discharges | 2 | 0 | 0 | 2 |
| Average length of stay | 19.0 days | 19.0 days | ||
| Average daily census | 0.1 | 0.0 | 0.0 | 0.1 |
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 37 | 38 | 38 | 0% |
| Intensive care unit | 10 | |||
| Subprovider - ipf | 70 | 36,503 | 7,720 | 159% |
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
Revenue, expenses and income Pontiac General Hospital reported to Medicare for Jan 1, 2024 to Nov 23, 2024. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $133.4M | 338.9% |
| Inpatient | $116.3M | 295.5% |
| Outpatient | $17.1M | 43.4% |
| Contractual allowances and discounts | -$94M | -238.9% |
| Net patient revenue | $39.4M | 100.0% |
| Operating expenses | -$29.1M | -73.8% |
| Operating income from patient care | $10.3M | 26.2% |
| Other income | $2.9M | 7.4% |
| Net income | $13.2M | 33.6% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $29,670 | 0.0% |
| Medicaid (including managed care) | $76.4M | 57.3% |
| Other payers and self-pay | $57M | 42.7% |
| Total charges | $133.4M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, 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 Pontiac General Hospital's latest cost report, which covers 328 days; income and expense figures are scaled to a year.
26.2%
Operating margin
Operating income from patient care / net patient revenue
31.2%
Total margin
Net income / net patient revenue plus other income
34% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$27.86
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
67.3%
Return on assets
Net income for a year / total assets
73.9%
Return on equity
Net income for a year / fund balance
0.03
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
5.88
Current ratio
Current assets / current liabilities
3.10
Quick ratio
Cash, temporary investments and net receivables / current liabilities
55 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
-4 days
Days in patient receivables
Net patient receivables / daily net patient revenue
16 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
2.15
Asset turnover
Total revenue for a year / total assets
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Pontiac General Hospital owned and owed at the end of its reporting period (Nov 2024), across all fund types: $21.8M in total assets and a $19.9M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $4.9M | 22.4% |
| Patient receivables, net | -$473,641 | -2.2% |
| Inventory | $423,837 | 1.9% |
| Total current assets | $8.4M | 38.3% |
| Property and equipment, net of depreciation | $13.4M | 61.3% |
| Investments and other assets | $88,687 | 0.4% |
| Total assets | $21.8M | 100.0% |
| Current liabilities | $1.4M | 6.5% |
| Long-term debt | $543,221 | 2.5% |
| Total liabilities | $2M | 9.0% |
| Fund balance (net assets) | $19.9M | 91.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Pontiac General Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$116,743
Bad debt
Patient bills written off as uncollectible, at charges
-$1.3M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$39,078
Total unreimbursed and uncompensated care
0.1% 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 808216, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Pontiac General Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Dec 2019 | Dec 2020 | Dec 2021 | Dec 2022 | Dec 2023 | Nov 2024 |
|---|---|---|---|---|---|---|
| Net patient revenue | $29.2M | $20.7M | $28.5M | $23.3M | $34M | $39.4M |
| Operating expenses | $27.2M | $23.8M | $26.3M | $29.1M | $27.7M | $29.1M |
| Operating margin | 6.7% | -14.9% | 7.7% | -25.1% | 18.6% | 26.2% |
| Net income | $6.4M | $5.7M | $7.4M | -$3.3M | $8.7M | $13.2M |
| Total assets | $19.2M | $20.8M | $26.5M | $18.5M | $23.2M | $21.8M |
| Discharges | 302 | 405 | 192 | 99 | 2 | |
| Inpatient days | 798 | 1,127 | 811 | 339 | 38 | |
| Medicare Advantage days | 96 | 160 | 83 | 26 | ||
| Beds | 91 | 106 | 117 | 122 | 117 | 117 |
| Employees (FTE) | 142 | 104 | 104 | 110 | 74 | 73 |
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Pontiac General 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 |
|---|---|---|---|---|---|
| Laboratory | $453,530 | $3.5M | $16.8M | 0.21 | 12,624 |
| Medical supplies charged to patient | $1.3M | ||||
| Drugs charged to patients | $1.2M | $2.4M | 0.49 | ||
| Operating room | $26,065 | $627,533 | $1.7M | 0.37 | 19,559 |
| Radiology-diagnostic | $353,488 | $63,058 | 5.61 | 16,480 | |
| Emergency | $72,167 | ||||
| Physical therapy | $67,315 | ||||
| Electrocardiology | $65,087 | 2,806 | |||
| Anesthesiology | $16,904 | $77,820 | 0.22 | ||
| Respiratory therapy | $9,532 | ||||
| Multi specialty | $139 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Subprovider - ipf | $5.8M | $16.8M | $112.2M | 0.15 | 11,918 |
| Adults & pediatrics | $78,641 | $1.6M | $139,098 | 11.15 | |
| Intensive care unit | $1,620 | $2,627 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $326,728 | $6.8M | 26,425 | $12.36 | 53,103 |
| Operation of plant | $130,039 | $2.1M | 3,103 | $41.91 | 50,245 |
| Dietary | $1.4M | 13,778 | |||
| Nursing administration | $175,373 | $1.2M | 5,436 | $32.26 | 2,655 |
| Social service | $775,273 | $968,983 | 25,468 | $30.44 | |
| I&r services-salary & fringes apprv | $701,838 | $739,690 | |||
| Employee benefits department | $345,994 | $665,056 | 4,439 | $77.95 | 900 |
| Housekeeping | $607,799 | 2,938 | |||
| Pharmacy | $413,773 | $478,882 | 9,501 | $43.55 | 3,422 |
| Central services & supply | $65,810 | $417,693 | 3,235 | $20.34 | 14,430 |
| Cap rel costs-bldg & fixt | $366,152 | 290,554 | |||
| Medical records & library | $223,222 | $341,118 | 6,191 | $36.05 | 4,869 |
| I&r services-other prgm costs apprv | $208,817 | 29,621 |
Source: CMS cost report (HCRIS, Form 2552-10), report 808216, 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 Pontiac General Hospital for an inpatient stay.
1.40
Case mix index
Higher than 16% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2026); higher means more complex, costlier care.
Major teaching hospital
Teaching status
0.41 residents per bed
Medicare-funded interns and residents per bed (FY 2026).
69.5%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2026).
2
Medicare inpatient stays
Medicare claims CMS based FY 2026 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2026).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2026 |
|---|---|---|---|---|---|
| Case mix index | 1.15 | 1.16 | 1.29 | 1.17 | 1.40 |
| Wage index | 0.959 | 0.923 | 0.911 | 0.899 | 0.959 |
| Readmissions adjustment | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Value-based purchasing adjustment | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Medicare inpatient stays | 79 | 79 | 28 | 19 | 2 |
Source: CMS IPPS final rule Impact File (FY 2026).
Psychiatric
CCN 23S013, certified 1984, Medicare prospective payment
Source: Worksheet S-2 Part I of Pontiac General Hospital's latest Medicare cost report (HCRIS).
About Pontiac General Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Pontiac General Hospital range from $682 to $682 across 1 insurers. Blue Cross Blue Shield's rate is $682. The median at nearby comparable hospitals is $432. 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 Pontiac General Hospital range from $452 to $452 across 1 insurers. Blue Cross Blue Shield's rate is $452. The median at nearby comparable hospitals is $367. 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 Pontiac General Hospital range from $1,700 to $1,700 across 1 insurers. UnitedHealthcare's rate is $1,700. The median at nearby comparable hospitals is $2,986. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Pontiac General Hospital range from $197 to $197 across 1 insurers. Blue Cross Blue Shield's rate is $197. The median at nearby comparable hospitals is $188. 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 Pontiac General Hospital range from $28,864 to $28,864 across 1 insurers. Blue Cross Blue Shield's rate is $28,864. The median at nearby comparable hospitals is $36,261. What a patient pays depends on their plan's deductible, coinsurance and network status.
Yes. CMS counts 0.41 Medicare-funded residents per bed at Pontiac General Hospital for fiscal year 2026, so it is a major teaching hospital.
No. Pontiac General Hospital has no Hospital Readmissions Reduction Program penalty in fiscal year 2026.
Pontiac General Hospital's Medicare case mix index is 1.40 for fiscal year 2026, higher than 16% of hospitals paid under the inpatient prospective payment system.
Pontiac General Hospital reported 2 inpatient discharges and 38 inpatient days from Jan 1, 2024 to Nov 23, 2024.
Pontiac General Hospital reported 73 full-time-equivalent employees on payroll from Jan 1, 2024 to Nov 23, 2024.
Pontiac General Hospital reported $39.4M in net patient revenue on $133.4M of gross charges for Jan 1, 2024 to Nov 23, 2024, an operating margin of 26.2%, and net income of $13.2M.
Pontiac General Hospital reported $39,078 of unreimbursed and uncompensated care for Jan 1, 2024 to Nov 23, 2024.
Insurers' price transparency files list Pontiac General Hospital under employer identification number 26-2512084 (Pontiac General Hospital). 38 health plans and networks list 26-2512084 for it.
CMS lists 24 services at Pontiac General Hospital, including Adult Inpatient Psychiatric Care, Anesthesia, Clinical Laboratory, CT Scan, Diagnostic Radiology, Dietary Care.
Pontiac General Hospital has 117 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. Facility type: Short Term Acute Care Hospital.
Pontiac General Hospital is located at 461 West Huron Street, Pontiac, MI 48341. Its main phone number is (248) 857-7200.
Pontiac General Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 230013.
The National Provider Identifier (NPI) on file for Pontiac General Hospital is 1619125788.
Pontiac General Hospital lists 18 in-network payers, including Avera Health Plans, BCBS, Centene, Cigna, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
247 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