California / Paradise Valley Hospital
CMS certification 050024 · National City, CA · 1 entry in CMS's price-transparency list
Paradise Valley Hospital: charges and Medicare payments
Paradise Valley Hospital reported 708 Medicare inpatient stays across 22 DRGs in 2024. Across them it charged 3.22 times what it was paid — among the lower ratios in California, number 211 of 247 hospitals with at least 100 stays (state median 5.18×, national 4.15×). Its most frequent stay was DRG 885, Psychoses: 147 stays at an average charge of $56,909, 29% above the national average. It also billed 104 outpatient services, charging 10.82 times what Medicare paid.
- 1Medicare inpatient stays 708
- 2Charge ÷ paid, inpatient 3.22×
- 3Rank in CA (highest ratio = 1) 211 of 247
- 4CMS price-transparency actions 1
Inpatient stays
For the 22 DRGs that can be compared with the national average, Paradise Valley Hospital charged more than the national average in 4 (18%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 885 Psychoses | 147 | $56,909 | +29% | $16,506 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 135 | $66,336 | -27% | $21,576 |
| 291 Heart Failure and Shock with MCC | 69 | $39,725 | -30% | $14,482 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 40 | $41,786 | -31% | $14,778 |
| 189 Pulmonary Edema and Respiratory Failure | 38 | $42,315 | -26% | $13,916 |
| 689 Kidney and Urinary Tract Infections with MCC | 38 | $31,019 | -40% | $13,100 |
| 177 Respiratory Infections and Inflammations with MCC | 32 | $54,462 | -23% | $18,396 |
| 682 Renal Failure with MCC | 19 | $30,564 | -54% | $15,983 |
| 073 Cranial and Peripheral Nerve Disorders with MCC | 18 | $34,571 | -56% | $16,937 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 18 | $27,136 | -27% | $9,367 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 17 | $82,844 | +9% | $18,507 |
| 193 Simple Pneumonia and Pleurisy with MCC | 16 | $54,039 | -10% | $14,309 |
| 074 Cranial and Peripheral Nerve Disorders without MCC | 15 | $24,553 | -54% | $11,776 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $23,136 | -42% | $9,207 |
| 305 Hypertension without MCC | 12 | $32,090 | -20% | $8,910 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $58,453 | -32% | $19,396 |
| 603 Cellulitis without MCC | 12 | $28,369 | -24% | $10,311 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $23,878 | -37% | $9,216 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 12 | $212,138 | -7% | $55,018 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $32,005 | -48% | $14,492 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 11 | $339,415 | +5% | $74,801 |
| 917 Poisoning and Toxic Effects of Drugs with MCC | 11 | $130,383 | +74% | $23,316 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 3 Airway Endoscopy | 63 | $16,972 | $2,087 |
| Level 1 Intraocular Procedures | 16 | $32,234 | $2,865 |
| Level 2 Vascular Procedures | 14 | $25,898 | $1,969 |
| Comprehensive Observation Services | 11 | $12,442 | $3,365 |
Against the California average
For Psychoses (DRG 885), Paradise Valley Hospital charged $56,909 on average, 11% more than the California average of $51,465, and was paid $16,506 against a state average of $15,642. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Paradise Valley Hospital charged $66,336 on average, 54% less than the California average of $143,063, and was paid $21,576 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Paradise Valley Hospital charged $39,725 on average, 61% less than the California average of $100,739, and was paid $14,482 against a state average of $15,556. For Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC (DRG 640), Paradise Valley Hospital charged $41,786 on average, 53% less than the California average of $88,573, and was paid $14,778 against a state average of $15,580. For Level 3 Airway Endoscopy (outpatient APC 5153), its average charge of $16,972 was 0% below the state average of $17,053. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $32,234 was 54% above the state average of $20,986. For Level 2 Vascular Procedures (outpatient APC 5182), its average charge of $25,898 was 68% above the state average of $15,422. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,442 was 70% below the state average of $41,628.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Paradise Valley Hospital in National City, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-03 (CMS case 3534)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
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.