19/100
#2,180 nationally
Adventist Health Simi Valley
2975 N Sycamore Dr, Simi Valley, CA 93065 · (805) 955-6000
Among the highest charge markups in the country
For every $1 of care Medicare actually paid for here, Adventist Health Simi Valley billed $7.80 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 7.8x
- volume-weighted across all its priced work
- Procedures priced
- 73
- inpatient and outpatient combined
- Rank in CA
- #166
- lower markup ranks higher
- CMS quality stars
- 2/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 10% of U.S. hospitals.
Better than 40% of U.S. hospitals.
Better than 13% of U.S. hospitals.
Better than 17% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
469 | $29,963 | $3,325 | +54% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
270 | $139,998 | $18,497 | +115% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
112 | $105,743 | $12,341 | +144% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
95 | $102,617 | $15,997 | +64% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
73 | $47,855 | $7,016 | +36% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
69 | $30,087 | $3,972 | +19% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
65 | $132,137 | $16,024 | +140% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
63 | $92,389 | $12,172 | +98% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
61 | $5,426 | $1,961 | -46% |
|
Heart Attack (severe)
MS-DRG 280 · Inpatient stay |
52 | $125,206 | $14,845 | +104% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 2 Vascular Procedures
APC 5182 · Hospital outpatient visit |
$29,103 | $1,799 | +239% |
|
Pneumonia (with complications)
MS-DRG 194 · Inpatient stay |
$93,096 | $7,859 | +193% |
|
Back Problems (without major complications)
MS-DRG 552 · Inpatient stay |
$98,524 | $10,178 | +152% |
|
COPD (severe)
MS-DRG 190 · Inpatient stay |
$104,267 | $10,388 | +149% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
$105,743 | $12,341 | +144% |
|
Stroke (uncomplicated)
MS-DRG 066 · Inpatient stay |
$86,193 | $6,608 | +141% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
$132,137 | $16,024 | +140% |
|
Transient Ischemia without Thrombolytic
MS-DRG 069 · Inpatient stay |
$97,190 | $7,643 | +135% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
$5,426 | $1,961 | -46% |
|
Level 3 Airway Endoscopy
APC 5153 · Hospital outpatient visit |
$10,373 | $2,012 | -9% |
|
Level 1 Breast/lymphatic Surgery and Related Procedures
APC 5091 · Hospital outpatient visit |
$23,912 | $4,686 | about average |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$12,443 | $2,275 | +6% |
|
Level 3 Electrophysiologic Procedures
APC 5213 · Hospital outpatient visit |
$152,100 | $28,063 | +15% |
|
Level 2 Laparoscopy and Related Services
APC 5362 · Hospital outpatient visit |
$68,736 | $12,637 | +15% |
|
Level 2 Breast/lymphatic Surgery and Related Procedures
APC 5092 · Hospital outpatient visit |
$45,864 | $8,017 | +16% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
$30,087 | $3,972 | +19% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.