Northbay Medical Center
NorthBay Medical Center in Fairfield, CA charges 12.1x the Medicare reimbursement rate across 71 analyzed procedures, with all procedures showing significant price variations above the Medicare benchmark.
Fairfield, CA 94533 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
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Pricing grade
F
Very high
Avg markup vs Medicare
12.11x
Charge / Medicare rate
Max markup
20.98x
Worst procedure
Procedures analyzed
71
With pricing data
Outlier procedures
100%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $440,416 | $220,208 | — | 21x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $340,784 | $170,392 | — | 18.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $152,827 | $76,413 | — | 17.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $87,067 | $43,534 | — | 16.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $376,358 | $188,179 | — | 16.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $433,838 | $216,919 | — | 15.5x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $539,472 | $269,736 | — | 15.4x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $180,387 | $90,193 | — | 15.3x |
| DIABETES WITH CC | 638 | $171,648 | $85,824 | — | 15.2x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $144,794 | $72,397 | — | 15.1x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $190,766 | $95,383 | — | 15x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $344,234 | $172,117 | — | 14.6x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $153,658 | $76,829 | — | 14.2x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $445,013 | $222,507 | — | 14.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $114,054 | $57,027 | — | 14.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $144,497 | $72,249 | — | 13.7x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $142,870 | $71,435 | — | 13.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $433,417 | $216,709 | — | 13.4x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $320,327 | $160,163 | — | 13.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $97,617 | $48,808 | — | 13.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $111,252 | $55,626 | — | 13.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $133,764 | $66,882 | — | 13.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $107,121 | $53,560 | — | 13.2x |
| SEIZURES WITHOUT MCC | 101 | $119,665 | $59,833 | — | 13.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $100,433 | $50,216 | — | 13x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $130,080 | $65,040 | — | 12.8x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $184,335 | $92,168 | — | 12.6x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $117,691 | $58,846 | — | 12.4x |
| RENAL FAILURE WITH CC | 683 | $115,069 | $57,535 | — | 12.3x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | 442 | $129,171 | $64,586 | — | 12.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $129,313 | $64,657 | — | 12.3x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $250,273 | $125,137 | — | 12.3x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $239,693 | $119,846 | — | 12.2x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $693,130 | $346,565 | — | 12.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $130,841 | $65,421 | — | 12x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $677,168 | $338,584 | — | 12x |
| SYNCOPE AND COLLAPSE | 312 | $111,344 | $55,672 | — | 12x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $105,299 | $52,650 | — | 11.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $1,149,569 | $574,785 | — | 11.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $165,582 | $82,791 | — | 11.7x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $95,932 | $47,966 | — | 11.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $249,845 | $124,922 | — | 11.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $126,338 | $63,169 | — | 11.3x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $264,234 | $132,117 | — | 11x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $92,412 | $46,206 | — | 11x |
| ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WIT | 062 | $229,586 | $114,793 | — | 10.8x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $211,592 | $105,796 | — | 10.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $128,670 | $64,335 | — | 10.8x |
| SEIZURES WITH MCC | 100 | $299,515 | $149,757 | — | 10.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $151,654 | $75,827 | — | 10.7x |
Showing 50 of 71 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use