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Short Term Acute Care HospitalGovernment - Hospital District Or Authority

Tri-City Medical Center

Oceanside, CA

4002 Vista Way, Oceanside, CA 92056(760) 724-8411

1 of 5

CMS star rating

262

Beds

8,635

Inpatient discharges a year

$290.7M

Net patient revenue a year

36

In-network payers

Photo 1: Alan Islas, CC BY-SA 4.0, via Wikimedia Commons · Photo 2: Public domain (USGS NAIP, CONUS), via USGS National Map / USDA NAIP

About this hospital

Tri-City Medical Center is a 262-bed government - hospital district or authority hospital in Oceanside, CA. Below you'll find publicly disclosed negotiated rates and facility details, including 36 in-network payers and 319 disclosed rate categories.

  • Disproportionate share hospital
  • 340B participant
  • Helipad
CCN
050128
NPI
1801861190
Website
tricitymed.org
Teaching
Teaching hospital
County
San Diego County
Metro area
San Diego-Chula Vista-Carlsbad, CA MSA
Medicare contractor
Jurisdiction E, Noridian Healthcare Solutions (01011)
In Medicare since
1966
Last CMS survey
2018

Prices for common services

The 24 services Tri-City Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.

Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.

Childbirth · Inpatient

Vaginal delivery, hospital stay

MS-DRG 807

$6,318

negotiated rate

UnitedHealthcare$6,318

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 obstetrics / child birth services to CMS

Childbirth · Inpatient

Cesarean delivery, hospital stay

MS-DRG 788

$11,762

negotiated rate

UnitedHealthcare$11,762

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 obstetrics / child birth services to CMS

CT imaging

CT abdomen and pelvis with contrast

CPT 74177

$98 - $2,158

from 2 insurers · median $1,128

Anthem / Blue Shield$98
Insurer A*$2,158
Medicare $454Nearby hospitals $2,93662% below nearby hospitals

Common here, based on CMS Medicare volume

Digestive procedures

Colonoscopy with biopsy

CPT 45380

$820 - $6,136

from 2 insurers · median $3,478

UnitedHealthcare$820
Insurer A*$6,136
Medicare $1,557Nearby hospitals $1,406147% above nearby hospitals

Common here, based on CMS Medicare volume

How the insurers pay at Tri-City Medical Center

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.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*21
460%
813
Insurer B*16
78%
01
Insurer C*6
43%
05
Insurer D*1
-
01

How we chose these services: 3 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 9 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 Tri-City Medical Center, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
AmbetterAmeri HealthAspirus Health PlanAvera Health PlansBanner HealthCentene

More about this hospital

  • Quality

    1 of 5 stars

    • 248 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.29%)
    See quality ratings

  • Doctors and services

    Accredited by The Joint Commission

    • Teaching hospital
    • 42 services
    • 317 affiliated clinicians
    See doctors and services

  • Finances

    $290.7M net patient revenue

    • Operating margin on patient care -16.6%
    • $31M unreimbursed and uncompensated care
    • $12M net income
    See finances

  • Ownership and leadership

    Owned by Tri-City Hospital

    • Hospital district or authority
    • Gene Ma, chief executive
    • 340B drug pricing program participant
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Tri-City Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
95-2126937(multi-state) Tri-City Medical Center61Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 56 more1801861190 Tri-City Hospital1770558710 Tri-City Hospital1831164797 Tri-City Hospitaland 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.

Location

4002 Vista Way, Oceanside, CA 92056

(760) 724-8411

Get directions

Frequently asked questions

About Tri-City Medical Center's rates and hospital price transparency.

How much does an MRI cost at Tri-City Medical Center?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Tri-City Medical Center range from $98 to $792 across 3 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $98. The median at nearby comparable hospitals is $992. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Tri-City Medical Center?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Tri-City Medical Center range from $98 to $2,158 across 2 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $98. The median at nearby comparable hospitals is $2,936. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Tri-City Medical Center?

For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Tri-City Medical Center range from $820 to $6,136 across 2 insurers. UnitedHealthcare's rate is $820. The median at nearby comparable hospitals is $1,406. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does giving birth cost at Tri-City Medical Center?

For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Tri-City Medical Center range from $6,318 to $6,318 across 1 insurers. UnitedHealthcare's rate is $6,318. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Tri-City Medical Center?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Tri-City Medical Center range from $228 to $228 across 1 insurers. Aetna's rate is $228. The median at nearby comparable hospitals is $328. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Tri-City Medical Center's CMS star rating?

Tri-City Medical Center has a CMS overall hospital star rating of 1 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is the lowest rating, shared by 6% of US hospitals.

Is Tri-City Medical Center a teaching hospital?

Yes. CMS counts 0.01 Medicare-funded residents per bed at Tri-City Medical Center for fiscal year 2027, so it is a teaching hospital.

Does Medicare penalize Tri-City Medical Center for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Tri-City Medical Center's base inpatient payments by an estimated 0.29% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Tri-City Medical Center?

In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (228 discharges), pulmonary edema and respiratory failure (82 discharges), septicemia or severe sepsis without mv >96 hours without mcc (63 discharges).

What is Tri-City Medical Center's case mix index?

Tri-City Medical Center's Medicare case mix index is 1.93 for fiscal year 2027, higher than 73% of hospitals paid under the inpatient prospective payment system.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

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.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "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
      }
    ]
  }]
}
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  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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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.

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CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
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  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
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