California / Uci Health-Fountain Valley
CMS certification 050570 · Fountain Valley, CA
Uci Health-Fountain Valley: charges and Medicare payments
Uci Health-Fountain Valley reported 2,203 Medicare inpatient stays across 70 DRGs in 2024. Across them it charged 12.28 times what it was paid — among the higher ratios in California, number 13 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: 272 stays at an average charge of $278,596, 209% above the national average. It also billed 272 outpatient services, charging 16.74 times what Medicare paid.
- 1Medicare inpatient stays 2,203
- 2Charge ÷ paid, inpatient 12.28×
- 3Rank in CA (highest ratio = 1) 13 of 247
- 4CMS price-transparency actions 0
Inpatient stays
For the 70 DRGs that can be compared with the national average, Uci Health-Fountain Valley charged more than the national average in 70 (100%). 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 | 272 | $278,596 | +209% | $20,813 |
| 291 Heart Failure and Shock with MCC | 145 | $175,363 | +211% | $13,966 |
| 177 Respiratory Infections and Inflammations with MCC | 94 | $220,346 | +212% | $17,815 |
| 193 Simple Pneumonia and Pleurisy with MCC | 84 | $189,155 | +217% | $13,738 |
| 690 Kidney and Urinary Tract Infections without MCC | 68 | $112,311 | +197% | $8,424 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 64 | $102,826 | +156% | $8,292 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 55 | $173,933 | +188% | $14,397 |
| 689 Kidney and Urinary Tract Infections with MCC | 50 | $132,356 | +158% | $12,152 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 50 | $127,810 | +161% | $10,806 |
| 313 Chest Pain | 47 | $83,511 | +109% | $7,747 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 45 | $340,271 | +241% | $24,011 |
| 312 Syncope and Collapse | 44 | $112,129 | +146% | $9,222 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 43 | $733,018 | +220% | $58,913 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 41 | $105,187 | +184% | $8,375 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 40 | $198,566 | +162% | $16,267 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 37 | $692,355 | +114% | $65,104 |
| 683 Renal Failure with CC | 36 | $135,046 | +232% | $9,570 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 36 | $200,275 | +173% | $18,903 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 35 | $138,012 | +148% | $10,735 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 35 | $246,397 | +164% | $19,593 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 34 | $136,022 | +140% | $13,189 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 32 | $94,728 | +162% | $7,955 |
| 682 Renal Failure with MCC | 31 | $169,762 | +157% | $15,029 |
| 552 Medical Back Problems without MCC | 30 | $117,732 | +141% | $9,836 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 29 | $141,792 | +122% | $11,467 |
| 378 Gastrointestinal Hemorrhage with CC | 27 | $155,613 | +221% | $10,533 |
| 069 Transient Ischemia without Thrombolytic | 25 | $152,854 | +203% | $8,529 |
| 194 Simple Pneumonia and Pleurisy with CC | 25 | $121,566 | +217% | $8,355 |
| 305 Hypertension without MCC | 25 | $91,688 | +129% | $8,068 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 23 | $165,684 | +227% | $11,921 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 23 | $123,440 | +102% | $13,477 |
| 637 Diabetes with MCC | 23 | $191,991 | +189% | $14,944 |
| 377 Gastrointestinal Hemorrhage with MCC | 22 | $289,742 | +239% | $21,935 |
| 189 Pulmonary Edema and Respiratory Failure | 21 | $170,168 | +196% | $14,828 |
| 057 Degenerative Nervous System Disorders without MCC | 20 | $120,970 | +114% | $13,926 |
| 394 Other Digestive System Diagnoses with CC | 20 | $135,138 | +187% | $9,981 |
| 314 Other Circulatory System Diagnoses with MCC | 19 | $304,386 | +221% | $26,902 |
| 638 Diabetes with CC | 19 | $102,816 | +147% | $9,479 |
| 149 Dysequilibrium | 18 | $99,192 | +123% | $8,026 |
| 202 Bronchitis and Asthma with CC/MCC | 18 | $95,847 | +108% | $10,206 |
| 389 Gastrointestinal Obstruction with CC | 18 | $93,461 | +140% | $8,543 |
| 603 Cellulitis without MCC | 18 | $148,068 | +297% | $9,445 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 18 | $727,893 | +237% | $66,778 |
| 178 Respiratory Infections and Inflammations with CC | 17 | $117,787 | +160% | $10,273 |
| 270 Other Major Cardiovascular Procedures with MCC | 17 | $537,418 | +107% | $52,147 |
| 393 Other Digestive System Diagnoses with MCC | 17 | $152,110 | +98% | $17,016 |
| 207 Respiratory System Diagnosis with Ventilator Support >96... | 16 | $588,004 | +101% | $64,597 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 15 | $495,983 | +203% | $28,183 |
| 551 Medical Back Problems with MCC | 14 | $290,002 | +268% | $26,101 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 13 | $660,808 | +135% | $55,805 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 13 | $439,172 | +224% | $29,477 |
| 242 Permanent Cardiac Pacemaker Implant with MCC | 13 | $604,269 | +276% | $38,918 |
| 315 Other Circulatory System Diagnoses with CC | 13 | $155,480 | +224% | $10,303 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 13 | $295,808 | +113% | $29,528 |
| 948 Signs and Symptoms without MCC | 13 | $123,400 | +224% | $8,637 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 12 | $641,161 | +177% | $45,251 |
| 101 Seizures without MCC | 12 | $96,721 | +98% | $9,646 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 12 | $108,910 | +175% | $9,312 |
| 304 Hypertension with MCC | 12 | $104,407 | +83% | $12,179 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 12 | $295,764 | +158% | $18,982 |
Showing the 60 most frequent of 70 DRGs.
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 65 | $59,311 | $3,324 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 56 | $15,500 | $1,993 |
| Level 1 Endovascular Procedures | 34 | $74,318 | $4,013 |
| Level 3 Pacemaker and Similar Procedures | 23 | $159,639 | $12,619 |
| Level 3 Vascular Procedures | 21 | $34,073 | $3,919 |
| Level 1 Laparoscopy and Related Services | 20 | $87,595 | $7,094 |
| Level 3 Urology and Related Services | 15 | $20,995 | $2,505 |
| Level 4 Musculoskeletal Procedures | 14 | $118,575 | $8,792 |
| Level 3 Endovascular Procedures | 13 | $176,057 | $13,503 |
| Level 2 Vascular Procedures | 11 | $51,925 | $1,969 |
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Uci Health-Fountain Valley charged $278,596 on average, 95% more than the California average of $143,063, and was paid $20,813 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Uci Health-Fountain Valley charged $175,363 on average, 74% more than the California average of $100,739, and was paid $13,966 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Uci Health-Fountain Valley charged $220,346 on average, 77% more than the California average of $124,302, and was paid $17,815 against a state average of $18,986. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Uci Health-Fountain Valley charged $189,155 on average, 82% more than the California average of $103,761, and was paid $13,738 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $59,311 was 42% above the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,500 was 5% above the state average of $14,749. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $74,318 was 83% above the state average of $40,544. For Level 3 Pacemaker and Similar Procedures (outpatient APC 5223), its average charge of $159,639 was 103% above the state average of $78,537.
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.