36/100
#1,720 nationally
Providence Mission Hospital
27700 Medical Center Rd, Mission Viejo, CA 92691 · (949) 364-1400
Charges far above the national norm
For every $1 of care Medicare actually paid for here, Providence Mission Hospital billed $5.32 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
- 5.3x
- volume-weighted across all its priced work
- Procedures priced
- 155
- inpatient and outpatient combined
- Rank in CA
- #83
- lower markup ranks higher
- CMS quality stars
- 5/5
- 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 28% of U.S. hospitals.
Better than 59% of U.S. hospitals.
Better than 27% of U.S. hospitals.
Better than 32% 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 |
868 | $28,208 | $3,365 | +45% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
694 | $101,956 | $19,048 | +56% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
431 | $6,815 | $2,328 | -42% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
365 | $95,295 | $16,148 | +53% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
325 | $9,819 | $1,979 | about average |
|
Level 3 Electrophysiologic Procedures
APC 5213 · Hospital outpatient visit |
316 | $130,691 | $29,031 | about average |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
193 | $99,806 | $16,293 | +81% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
150 | $62,688 | $7,094 | +79% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
143 | $74,898 | $12,173 | +73% |
|
Sepsis (without major complications)
MS-DRG 872 · Inpatient stay |
128 | $56,801 | $10,187 | +45% |
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 |
|---|---|---|---|
|
Traumatic Stupor and Coma <1 Hour with Major Complications
MS-DRG 085 · Inpatient stay |
$258,577 | $77,740 | +165% |
|
Level 2 Musculoskeletal Procedures
APC 5112 · Hospital outpatient visit |
$24,749 | $1,976 | +120% |
|
Traumatic Stupor and Coma >1 Hour with Major Complications
MS-DRG 082 · Inpatient stay |
$199,974 | $30,454 | +107% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
$92,762 | $13,576 | +99% |
|
Respiratory System Diagnosis with Ventilator Support >96 Hours
MS-DRG 207 · Inpatient stay |
$503,460 | $81,368 | +97% |
|
Diabetes (with complications)
MS-DRG 638 · Inpatient stay |
$67,236 | $9,193 | +94% |
|
Level 1 Breast/lymphatic Surgery and Related Procedures
APC 5091 · Hospital outpatient visit |
$45,470 | $4,686 | +91% |
|
Coagulation Disorders
MS-DRG 813 · Inpatient stay |
$127,203 | $19,087 | +90% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 3 Lower GI Procedures
APC 5313 · Hospital outpatient visit |
$8,631 | $3,449 | -48% |
|
Level 7 Radiation Therapy
APC 5627 · Hospital outpatient visit |
$32,039 | $9,568 | -46% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$6,815 | $2,328 | -42% |
|
Endovascular Cardiac Valve Replacement and Supplement Procedures with Major Complications
MS-DRG 266 · Inpatient stay |
$158,479 | $58,364 | -34% |
|
Level 2 Icd and Similar Procedures
APC 5232 · Hospital outpatient visit |
$98,920 | $40,316 | -33% |
|
Endovascular Cardiac Valve Replacement and Supplement Procedures without Major
MS-DRG 267 · Inpatient stay |
$147,580 | $46,408 | -22% |
|
Level 3 Pacemaker and Similar Procedures
APC 5223 · Hospital outpatient visit |
$40,603 | $13,108 | -21% |
|
Permanent Cardiac Pacemaker Implant with Complications
MS-DRG 243 · Inpatient stay |
$75,501 | $21,376 | -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.