Pih Health Downey Hospital
PIH Health Downey Hospital in Downey, CA charges 7.2x the Medicare reimbursement rate on average across 28 analyzed procedures at this nonprofit facility.
Downey, CA 90241 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
D
High
Avg markup vs Medicare
7.24x
Charge / Medicare rate
Max markup
11.91x
Worst procedure
Procedures analyzed
28
With pricing data
Outlier procedures
3.6%
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 |
|---|---|---|---|---|---|
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $67,453 | $33,726 | — | 11.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $78,929 | $39,465 | — | 9.7x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $73,243 | $36,622 | — | 9.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $54,776 | $27,388 | — | 8.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $54,866 | $27,433 | — | 8.7x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $68,378 | $34,189 | — | 8.7x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $106,862 | $53,431 | — | 8.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $46,690 | $23,345 | — | 7.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $62,398 | $31,199 | — | 7.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $77,188 | $38,594 | — | 7.8x |
| DIABETES WITH CC | 638 | $54,604 | $27,302 | — | 7.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $73,406 | $36,703 | — | 7.4x |
| CELLULITIS WITHOUT MCC | 603 | $54,423 | $27,212 | — | 7.4x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $69,157 | $34,578 | — | 7.3x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $66,450 | $33,225 | — | 7.3x |
| SYNCOPE AND COLLAPSE | 312 | $49,954 | $24,977 | — | 7.1x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $310,278 | $155,139 | — | 6.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $108,299 | $54,150 | — | 6.6x |
| DIABETES WITH MCC | 637 | $78,539 | $39,269 | — | 6.6x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $67,560 | $33,780 | — | 6.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $86,261 | $43,130 | — | 6.1x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $88,543 | $44,271 | — | 6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $57,134 | $28,567 | — | 5.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $91,970 | $45,985 | — | 5.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $72,777 | $36,388 | — | 5.4x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $92,341 | $46,171 | — | 5.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $86,545 | $43,273 | — | 5x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $76,377 | $38,189 | — | 4.9x |
How PIH HEALTH DOWNEY HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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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