California / Pih Health Downey Hospital
CMS certification 050393 · Downey, CA · 8 entries in CMS's price-transparency list
Pih Health Downey Hospital: charges and Medicare payments
Pih Health Downey Hospital reported 915 Medicare inpatient stays across 28 DRGs in 2024. Across them it charged 5.37 times what it was paid — mid-range in California, number 117 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: 269 stays at an average charge of $109,056, 21% above the national average. It also billed 548 outpatient services, charging 6.22 times what Medicare paid.
- 1Medicare inpatient stays 915
- 2Charge ÷ paid, inpatient 5.37×
- 3Rank in CA (highest ratio = 1) 117 of 247
- 4CMS price-transparency actions 8
Inpatient stays
For the 28 DRGs that can be compared with the national average, Pih Health Downey Hospital charged more than the national average in 23 (82%). 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 | 269 | $109,056 | +21% | $19,954 |
| 291 Heart Failure and Shock with MCC | 101 | $68,477 | +21% | $13,302 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 56 | $61,816 | +26% | $11,204 |
| 177 Respiratory Infections and Inflammations with MCC | 39 | $79,823 | +13% | $14,871 |
| 193 Simple Pneumonia and Pleurisy with MCC | 37 | $60,213 | +1% | $12,805 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 34 | $83,426 | +10% | $15,703 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 31 | $89,920 | +49% | $13,391 |
| 682 Renal Failure with MCC | 23 | $80,070 | +21% | $15,315 |
| 378 Gastrointestinal Hemorrhage with CC | 21 | $70,989 | +46% | $10,119 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 21 | $53,205 | +44% | $8,525 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $52,837 | +3% | $12,405 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $70,483 | +22% | $13,373 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 20 | $82,501 | +12% | $19,925 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 20 | $307,281 | +34% | $47,767 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 19 | $57,753 | +44% | $8,686 |
| 091 Other Disorders of Nervous System with MCC | 18 | $80,156 | -3% | $17,396 |
| 690 Kidney and Urinary Tract Infections without MCC | 17 | $43,038 | +14% | $8,299 |
| 377 Gastrointestinal Hemorrhage with MCC | 16 | $92,929 | +9% | $18,565 |
| 312 Syncope and Collapse | 15 | $45,958 | +1% | $9,430 |
| 683 Renal Failure with CC | 15 | $42,374 | +4% | $9,541 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 14 | $56,716 | +12% | $9,926 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 14 | $98,303 | 0% | $19,736 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 13 | $69,597 | +25% | $10,004 |
| 100 Seizures with MCC | 13 | $68,119 | -28% | $19,842 |
| 252 Other Vascular Procedures with MCC | 13 | $162,532 | -5% | $35,287 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 12 | $47,602 | +32% | $8,210 |
| 603 Cellulitis without MCC | 12 | $44,249 | +19% | $9,422 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 11 | $90,725 | -9% | $19,476 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 171 | $31,774 | $3,365 |
| Level 5 Musculoskeletal Procedures | 143 | $70,138 | $15,750 |
| Level 1 Endovascular Procedures | 24 | $25,820 | $4,013 |
| Level 3 Vascular Procedures | 22 | $30,430 | $3,919 |
| Level 2 Intraocular Procedures | 22 | $21,220 | $4,999 |
| Level 4 Musculoskeletal Procedures | 21 | $35,159 | $8,792 |
| Level 3 Pacemaker and Similar Procedures | 21 | $41,310 | $13,108 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 19 | $26,319 | $4,076 |
| Level 2 Endovascular Procedures | 18 | $44,120 | $7,027 |
| Level 2 Upper GI Procedures | 17 | $15,572 | $2,339 |
| Level 1 Laparoscopy and Related Services | 16 | $30,756 | $7,094 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 15 | $14,371 | $1,887 |
| Level 2 Vascular Procedures | 14 | $12,479 | $1,969 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 13 | $14,533 | $3,494 |
| Level 1 Intraocular Procedures | 12 | $17,466 | $2,732 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Pih Health Downey Hospital charged $109,056 on average, 24% less than the California average of $143,063, and was paid $19,954 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Pih Health Downey Hospital charged $68,477 on average, 32% less than the California average of $100,739, and was paid $13,302 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Pih Health Downey Hospital charged $61,816 on average, 19% less than the California average of $76,120, and was paid $11,204 against a state average of $12,552. For Respiratory Infections and Inflammations with MCC (DRG 177), Pih Health Downey Hospital charged $79,823 on average, 36% less than the California average of $124,302, and was paid $14,871 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $31,774 was 24% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $70,138 was 36% below the state average of $109,149. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $25,820 was 36% below the state average of $40,544. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $30,430 was 1% above the state average of $30,190.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Pih Health Downey Hospital in Downey, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-02-15 (CMS case 1457)
- CAP Request — 2023-05-23 (CMS case 1457)
- CAP Request — 2024-05-13 (CMS case 1457)
- Closure Notice — 2024-06-05 (CMS case 1457)
- Warning Notice — 2025-09-19 (CMS case 6693)
- CAP Request — 2025-12-22 (CMS case 6693)
- Closure Notice — 2026-03-24 (CMS case 6693)
- Warning Notice — 2026-07-17 (CMS case 8284)
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.