PROVIDENCE MISSION HOSPITAL
MISSION VIEJO, CA 92691 · Acute Care Hospitals
114 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
114
With CMS pricing data
Avg Charge-to-Medicare Ratio
6.8x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Private
Above 90th Percentile
0%
Compared to CA hospitals
Understanding Your Costs
When you receive a bill from PROVIDENCE MISSION HOSPITAL, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, PROVIDENCE MISSION HOSPITAL lists chargemaster rates that average 6.8x the corresponding Medicare reimbursement amount across 114 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in CA has a chargemaster-to-Medicare ratio of 6.3x, with ratios across the state ranging from 1.7x to 17.6x. At 6.8x, this facility’s average ratio is above the state median. 273 hospitals in CA report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at PROVIDENCE MISSION HOSPITAL is Cardiac Arrhythmia and Conduction Disorders without Complications (DRG 310). The listed chargemaster rate is $39,190, while Medicare reimburses $3,466 for the same procedure — a ratio of 11.3x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
PROVIDENCE MISSION HOSPITAL is a voluntary non-profit - private acute care hospitals facility with a CMS quality rating of 4/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| Cardiac Arrhythmia and Conduction Disorders without Complications | 310 | $39,190 | $3,466 | 11.3x | 1th | Compare your bill |
| Seizures with Major Complications or Comorbidities | 100 | $160,782 | $15,981 | 10.1x | 1th | Compare your bill |
| Diabetes with Complications | 638 | $54,501 | $5,803 | 9.4x | 1th | Compare your bill |
| Intracranial Hemorrhage or Cerebral Infarction without Complications | 066 | $47,568 | $5,113 | 9.3x | 1th | Compare your bill |
| Traumatic Stupor and Coma <1 Hour with Complications | 086 | $82,083 | $9,140 | 9.0x | 1th | Compare your bill |
| Traumatic Stupor and Coma >1 Hour with Complications | 083 | $83,554 | $9,320 | 9.0x | 1th | Compare your bill |
| Acute Myocardial Infarction, Discharged Alive with Complications | 281 | $61,496 | $7,081 | 8.7x | 1th | Compare your bill |
| Syncope and Collapse | 312 | $54,648 | $6,343 | 8.6x | 1th | Compare your bill |
| Intracranial Hemorrhage or Cerebral Infarction with Complications or Tpa in 24 Hours | 065 | $69,259 | $8,053 | 8.6x | 1th | Compare your bill |
| Major Small and Large Bowel Procedures with Complications | 330 | $140,299 | $16,360 | 8.6x | 1th | Compare your bill |
| Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without Major Complications | 563 | $53,793 | $6,368 | 8.4x | 1th | Compare your bill |
| Peripheral Vascular Disorders with Major Complications or Comorbidities | 299 | $107,963 | $13,099 | 8.2x | 1th | Compare your bill |
| Other Musculoskeletal System and Connective Tissue Operating Room Procedures with Complications | 516 | $116,755 | $14,242 | 8.2x | 1th | Compare your bill |
| Medical Back Problems without Major Complications | 552 | $56,586 | $6,996 | 8.1x | 1th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Complications | 309 | $43,138 | $5,336 | 8.1x | 1th | Compare your bill |
| Traumatic Stupor and Coma >1 Hour with Major Complications or Comorbidities | 082 | $171,411 | $21,287 | 8.1x | 1th | Compare your bill |
| Postoperative and Post-Traumatic Infections with Major Complications or Comorbidities | 862 | $90,216 | $11,232 | 8.0x | 1th | Compare your bill |
| Simple Pneumonia and Pleurisy with Major Complications or Comorbidities | 193 | $86,274 | $10,757 | 8.0x | 1th | Compare your bill |
| Endocrine Disorders with Complications | 644 | $56,647 | $7,187 | 7.9x | 1th | Compare your bill |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit | 062 | $127,563 | $16,219 | 7.9x | 1th | Compare your bill |
| Simple Pneumonia and Pleurisy with Complications | 194 | $44,118 | $5,627 | 7.8x | 1th | Compare your bill |
| Infectious and Parasitic Diseases with Operating Room Procedures with Complications | 854 | $122,629 | $15,845 | 7.7x | 1th | Compare your bill |
| Poisoning and Toxic Effects of Drugs with Major Complications or Comorbidities | 917 | $81,847 | $10,598 | 7.7x | 1th | Compare your bill |
| Gastrointestinal Obstruction with Complications | 389 | $44,684 | $5,836 | 7.7x | 1th | Compare your bill |
| Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without Major Complications | 392 | $43,138 | $5,640 | 7.7x | 1th | Compare your bill |
| Major Small and Large Bowel Procedures without Complications | 331 | $98,909 | $12,955 | 7.6x | 1th | Compare your bill |
| Trauma to the Skin, Subcutaneous Tissue and Breast without Major Complications | 605 | $51,500 | $6,799 | 7.6x | 1th | Compare your bill |
| Other Respiratory System Diagnoses with Major Complications or Comorbidities | 205 | $104,039 | $13,763 | 7.6x | 1th | Compare your bill |
| Acute Myocardial Infarction, Discharged Alive with Major Complications or Comorbidities | 280 | $91,677 | $12,181 | 7.5x | 1th | Compare your bill |
| Revision of Hip or Knee Replacement with Complications | 467 | $173,655 | $23,079 | 7.5x | 1th | Compare your bill |
| Bronchitis and Asthma with Complications or Comorbidities | 202 | $50,107 | $6,706 | 7.5x | 1th | Compare your bill |
| Major Chest Procedures with Complications | 164 | $156,174 | $20,961 | 7.5x | 1th | Compare your bill |
| Percutaneous Cardiovascular Procedures with Drug-Eluting Stent without Major Complications | 247 | $92,708 | $12,526 | 7.4x | 0th | Compare your bill |
| Respiratory System Diagnosis with Ventilator Support over 96 Hours | 207 | $414,108 | $56,572 | 7.3x | 1th | Compare your bill |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Complications | 493 | $140,436 | $19,282 | 7.3x | 1th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Major Complications or Comorbidities | 308 | $69,677 | $9,568 | 7.3x | 1th | Compare your bill |
| Septicemia or Severe Sepsis with Mechanical Ventilation over 96 Hours | 870 | $496,805 | $68,697 | 7.2x | 1th | Compare your bill |
| Circulatory Disorders Except Ami, with Cardiac Catheterization without Major Complications | 287 | $62,581 | $8,674 | 7.2x | 1th | Compare your bill |
| Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without Major Complications | 470 | $100,943 | $14,084 | 7.2x | 1th | Compare your bill |
| Heart Failure and Shock with Major Complications or Comorbidities | 291 | $71,403 | $9,999 | 7.1x | 1th | Compare your bill |
| Laparoscopic Cholecystectomy without C.D.E. with Complications | 418 | $85,265 | $12,035 | 7.1x | 1th | Compare your bill |
| Renal Failure with Complications | 683 | $46,626 | $6,591 | 7.1x | 1th | Compare your bill |
| Traumatic Stupor and Coma <1 Hour with Major Complications or Comorbidities | 085 | $126,161 | $17,883 | 7.0x | 1th | Compare your bill |
| Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without Major Complications | 641 | $40,872 | $5,802 | 7.0x | 1th | Compare your bill |
| Kidney and Urinary Tract Infections without Major Complications | 690 | $39,618 | $5,626 | 7.0x | 1th | Compare your bill |
| Nonspecific Cerebrovascular Disorders with Major Complications or Comorbidities | 070 | $90,959 | $12,925 | 7.0x | 1th | Compare your bill |
| Gastrointestinal Hemorrhage with Complications | 378 | $50,696 | $7,262 | 7.0x | 1th | Compare your bill |
| Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications | 522 | $117,327 | $16,868 | 7.0x | 1th | Compare your bill |
| Craniotomy and Endovascular Intracranial Procedures with Major Complications or Comorbidities | 025 | $273,479 | $39,347 | 7.0x | 1th | Compare your bill |
| Pulmonary Edema and Respiratory Failure | 189 | $74,110 | $10,694 | 6.9x | 1th | Compare your bill |
Showing 50 of 114 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across CA hospitals
273 hospitals in CA report pricing data to CMS. This facility's average ratio of 6.8x places it at the lower-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About PROVIDENCE MISSION HOSPITAL
How much does PROVIDENCE MISSION HOSPITAL charge compared to Medicare?
According to CMS IPPS data, PROVIDENCE MISSION HOSPITAL's listed chargemaster rates average 6.8x the Medicare reimbursement amount across 114 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at PROVIDENCE MISSION HOSPITAL?
The procedure with the highest chargemaster-to-Medicare ratio at PROVIDENCE MISSION HOSPITAL is Cardiac Arrhythmia and Conduction Disorders without Complications (DRG 310), with a listed charge of $39,190 compared to Medicare reimbursement of $3,466 — a ratio of 11.3x. Source: CMS IPPS Provider Summary.
Is PROVIDENCE MISSION HOSPITAL expensive compared to other CA hospitals?
PROVIDENCE MISSION HOSPITAL's average chargemaster-to-Medicare ratio is 6.8x. Ratios vary significantly across CA hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for PROVIDENCE MISSION HOSPITAL come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from PROVIDENCE MISSION HOSPITAL is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does PROVIDENCE MISSION HOSPITAL in MISSION VIEJO, CA accept Medicare?
PROVIDENCE MISSION HOSPITAL is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact PROVIDENCE MISSION HOSPITAL directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.