California / Kaiser Foundation Hospital - Orange County - Anahe
CMS certification 050609 · Anaheim, CA
Kaiser Foundation Hospital - Orange County - Anahe: charges and Medicare payments
Kaiser Foundation Hospital - Orange County - Anahe reported 231 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 2.83 times what it was paid — among the lower ratios in California, number 228 of 247 hospitals with at least 100 stays (state median 5.18×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 100 stays at an average charge of $75,787, 16% below the national average. It also billed 108 outpatient services, charging 9.99 times what Medicare paid.
- 1Medicare inpatient stays 231
- 2Charge ÷ paid, inpatient 2.83×
- 3Rank in CA (highest ratio = 1) 228 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 9 DRGs that can be compared with the national average, Kaiser Foundation Hospital - Orange County - Anahe charged more than the national average in 5 (56%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 100 | $75,787 | -16% | $26,792 |
| 291 Heart Failure and Shock with MCC | 27 | $63,595 | +13% | $18,230 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 24 | $37,191 | -24% | $19,174 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $56,020 | -21% | $19,148 |
| 193 Simple Pneumonia and Pleurisy with MCC | 15 | $66,794 | +12% | $20,657 |
| 690 Kidney and Urinary Tract Infections without MCC | 13 | $40,644 | +7% | $9,963 |
| 189 Pulmonary Edema and Respiratory Failure | 12 | $74,379 | +29% | $15,547 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $102,731 | +2% | $26,265 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 11 | $169,464 | -26% | $89,334 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 81 | $36,632 | $3,203 |
| Level 5 Musculoskeletal Procedures | 15 | $66,845 | $14,889 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 12 | $13,740 | $1,315 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Kaiser Foundation Hospital - Orange County - Anahe charged $75,787 on average, 47% less than the California average of $143,063, and was paid $26,792 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Kaiser Foundation Hospital - Orange County - Anahe charged $63,595 on average, 37% less than the California average of $100,739, and was paid $18,230 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Kaiser Foundation Hospital - Orange County - Anahe charged $37,191 on average, 51% less than the California average of $76,120, and was paid $19,174 against a state average of $12,552. For Respiratory Infections and Inflammations with MCC (DRG 177), Kaiser Foundation Hospital - Orange County - Anahe charged $56,020 on average, 55% less than the California average of $124,302, and was paid $19,148 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $36,632 was 12% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $66,845 was 39% below the state average of $109,149. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $13,740 was 7% below the state average of $14,749.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.