California Regulations 9789.35

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§ 9789.35 Table B

History:



MedicareNameHospital-Specific Wage-Adjusted Provider Wage Index Conversion Number Factor

050002 ST ROSE HOSPITAL 1.6174 $91.76 050006 ST JOSEPH HOSP.-EUREKA 1.3551 $81.23 050007 MILLS PENINSULA MED.CTR 1.5582 $89.38 050008 CPMC-R.K. DAVIES MED.CTR1.5352 $88.46 050009 QUEEN OF THE VALLEY MEDICAL CENTER 1.5477 $88.96 050013 ST. HELENA HOSPITAL 1.5477 $88.96 050014 SUTTER AMADOR HOSPITAL 1.3602 $81.43 050016 ARROYO GRANDE COMMUNITY HOSPITAL 1.2371 $76.48 050017 MERCY GENERAL HOSPITAL 1.3602 $81.43 050018 PACIFIC ALLIANCE MEDICAL CENTER 1.2014 $75.05 050022 RIVERSIDE COMMUNITY 1.187 $74.47 050024 PARADISE VALLEY HOSP.1.187 $74.47 050025 UCSD MEDICAL CENTER 1.187 $74.47 050026 GROSSMONT HOSPITAL 1.187 $74.47 050028 MAD RIVER COMM. HOSP.1.187 $74.47 050030 OROVILLE HOSPITAL 1.187 $74.47 050036 MEMORIAL HOSPITAL 1.187 $74.47 050038 SANTA CLARA VALLEY MEDICAL CENTER 1.6379 $92.59 050039 ENLOE MEDICAL CENTER 1.187 $74.47 050040 LAC OLIVE VIEW/UCLA MEDICAL CENTER 1.2014 $75.05 050042 ST ELIZABETH COMM.HOSP. 1.3551 $86.99 050043 SUMMIT MEDICAL CENTER 1.6174 $91.76 050045 EL CENTRO REG. MED. CTR.1.187 $74.47 050046 OJAI VALLEY COMM.HOSP. 1.2318 $76.27 050047 CALIFORNIA PACIFIC MEDICAL CENTER 1.5352 $88.46 050054 SAN GORGONIO MEMORIAL 1.187 $74.47 050055 ST. LUKES HOSPITAL 1.5352 $88.46 050056 ANTELOPE VALLEY HOSP.1.2014 $75.05 050057 KAWEAH DELTA HEALTH CARE DISTRICT 1.187 $74.47 050058 GLENDALE MEMORIAL HOSPITAL & HLTH CT 1.2014 $75.05 050060 COMMUNITY REGIONAL MEDICAL CENTER 1.187 $74.47 050063 HOLLYWOOD PRESBYTERIAN MED CTR 1.2014 $75.05 050067 OAK VALLEY DIST. HOSP. 1.2145 $75.58 050069 ST. JOSEPH HOSP. OF ORANGE 1.2014 $75.05 050070 KFH - SOUTH SAN FRAN. 1.5582 $89.38 050071 KFH - SANTA CLARA 1.6379 $92.59 050072 KFH - WALNUT CREEK 1.5852 $90.47 050073 KFH - VALLEJO 1.5739 $90.02 050075 KFH - OAKLAND 1.6174 $91.76 050076 KFH - SAN FRANCISCO 1.5352 $88.46 050077 SCRIPPS MERCY HOSPITAL 1.187 $74.47 050078 PROVIDENCE LTTL CO MARY MC SAN PEDRO 1.2014 $75.05 050079 DOCTORS MEDICAL CENTER SAN PABLO 1.5852 $90.47 050082 ST. JOHNS REGIONAL MEDICAL CENTER 1.2318 $76.27 050084 ST. JOSEPH S MEDICAL CENTER 1.3602 $81.43 050089 COMMUNITY HOSPITAL OF SAN BERNARDINO 1.2014 $75.05 050090 SONOMA VALLEY HEALTH CARE DISTRICT 1.5765 $90.12 050091 COMMUNITY AND MISSION HOSPITAL OF H 1.2014 $75.05 050093 SAINT AGNES MED. CTR 1.187 $74.47 050096 DR S HOSPITAL OF WEST COVINA 1.2014 $75.05 050099 SAN ANTONIO COMM. HOSP. 1.2014 $75.05 050100 SHARP MEMORIAL HOSPITAL 1.187 $74.47 050101 SUTTER SOLANO MEDICAL CENTER 1.5739 $90.02 050102 PARKVIEW COMM. HOSP. 1.187 $74.47 050103 WHITE MEMORIAL MED. CTR 1.2014 $75.05 050104 ST. FRANCIS MED. CTR 1.2014 $75.05 050107 MARIAN MEDICAL CENTER 1.187 $74.47 050108 SUTTER MEDICAL CENTER - SACRAMENTO 1.3602 $81.43 050110 LOMPOC VALLEY MED. CTR 1.187 $74.47 050111 TEMPLE COMM. HOSP. 1.2014 $75.05 050112 SANTA MONICA UCLA MEDICAL CENTER AND 1.2014 $75.05 050113 SAN MATEO MED. CTR 1.5582 $89.38 050115 PALOMAR MEDICAL CENTER 1.187 $74.47 050116 NORTHRIDGE MED. CTR - ROSCOE 1.2014 $75.05 050118 DOCTORS HOSP.OF MANTECA 1.2584 $77.34 050121 HANFORD COMM. MED. CTR 1.187 $74.47 050122 DAMERON HOSPITAL 1.2584 $77.34 050124 VERDUGO HILLS HOSPITAL 1.2014 $75.05 050125 REGIONAL MEDICAL CENTER OF SAN JOSE 1.6379 $92.59 050126 VALLEY PRESB. HOSPITAL 1.2014 $75.05 050127 WOODLAND HEALTHCARE 1.3602 $81.43 050128 TRI-CITY MEDICAL CENTER 1.187 $74.47 050129 ST. BERNARDINE MED. CTR 1.2014 $75.05 050131 NOVATO COMMUNITY HOSP. 1.5739 $90.02 050132 SAN GABRIEL VALLEY MEDICAL CENTER 1.2014 $75.05 050133 RIDEOUT MEMORIAL HOSP. 1.2101 $75.40 050135 HOLLYWOOD COMM. HOSP. 1.2014 $75.05 050136 PETALUMA VALLEY HOSP. 1.5765 $90.12 050137 KFH - PANORAMA CITY 1.2014 $75.05 050138 KFH - SUNSET 1.2014 $75.05 050139 KFH - DOWNEY 1.2014 $75.05 050140 KFH - FONTANA 1.2014 $75.05 050145 COMMUNITY HOSP. MONTEREY PENINSULA 1.5821 $90.35 050149 CALIFORNIA HOSPITAL MEDICAL CENTER 1.2014 $75.05 050150 SIERRA NEVADA MEMORIAL HOSPITAL 1.3602 $81.43 050152 SAINT FRANCIS MEMORIAL HOSPITAL 1.5739 $90.02 050153 O CONNOR HOSPITAL 1.6379 $92.59 050158 ENCINO HOSP. MED CENTER 1.2014 $75.05 050159 VENTURA COUNTY MED. CTR 1.2318 $76.27 050167 SAN JOAQUIN GEN. HOSP. 1.2584 $77.34 050168 ST JUDE MEDICAL CENTER FULLERTON 1.2014 $75.05 050169 PRESBYTERIAN INTERCOMMUNITY HOSP. 1.2014 $75.05 050173 ANAHEIM GENERAL HOSP. 1.2014 $75.05 050174 SANTA ROSA MEM. HOSP. 1.5765 $90.12 050179 EMANUEL MEDICAL CENTER 1.2145 $75.58 050180 JOHN MUIR MEDICAL CENTER-WALNUT CREE 1.5852 $90.47 050188 COMM HOSP.& REHAB- LOS GATOS 1.6379 $92.59 050189 MEE MEMORIAL HOSPITAL 1.5821 $90.35 050191 ST. MARY MEDICAL CENTER 1.2014 $75.05 050192 SIERRA KINGS DIST. HOSP.1.187 $74.47 050193 SOUTH COAST MED. CTR 1.2014 $75.05 050194 WATSONVILLE COMMUNITY 1.6379 $92.59 050195 WASHINGTON HOSP. DIST. 1.6174 $91.76 050196 CENTRAL VALLEY GEN.HOSP.1.187 $74.47 050197 SEQUOIA HEALTH SERVICES 1.6174 $91.76 050204 LANCASTER COMM. HOSP. 1.2014 $75.05 050205 EAST VALLEY HOSP. MED. CENTER 1.2014 $75.05 050211 ALAMEDA HOSPITAL 1.6174 $91.76 050219 COAST PLAZA DRS. HOSP. 1.2014 $75.05 050222 SHARP CHULA VISTA MED. CTR 1.187 $74.47 050224 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1.2014 $75.05 050225 FEATHER RIVER HOSPITAL 1.187 $74.47 050226 ANAHEIM MEM. MED. CTR 1.2014 $75.05 050228 SAN FRAN. GEN. HOSP. 1.5352 $88.46 050230 GARDEN GROVE MED. CTR 1.2014 $75.05 050231 POMONA VAL. HOSP. MED C 1.2014 $75.05 050232 FRENCH HOSPITAL MED. CT 1.2371 $76.48 050234 SHARP CORONADO HOSPITAL 1.187 $74.47 050235 PROVIDENCE ST JOSEPH MEDICAL CENTER 1.2014 $75.05 050236 SIMI VALLEY HOSPITAL 1.2318 $76.27 050238 METHODIST HOSPITAL OF SO. CALIF. 1.2014 $75.05 050239 GLENDALE ADVENTIST MEDICAL CENTER 1.2014 $75.05 050242 DOMINICAN HOSPITAL 1.6379 $92.59 050243 DESERT HOSPITAL 1.187 $74.47 050245 ARROWHEAD REG. MED.CTR 1.2014 $75.05 050248 NATIVIDAD MED. CTR 1.5821 $90.35 050254 MARSHALL HOSPITAL 1.3602 $81.43 050257 GOOD SAMARITAN HOSPITAL 1.187 $74.47 050261 SIERRA VIEW DIST. HOSP. 1.187 $74.47 050262 RONALD REAGAN UCLA MEDICAL CENTER 1.2014 $75.05 050264 SAN LEANDRO HOSPITAL 1.6174 $91.76 050272 REDLANDS COMM. HOSPITAL 1.2014 $75.05 050276 CONTRA COSTA REG.MED.CTR1.5852 $90.47 050277 PACIFIC HOSPITAL OF LONG BEACH 1.2014 $75.05 050278 PROVIDENCE HOLY CROSS MED. CENTER 1.2014 $75.05 050279 HI - DESERT MED. CTR 1.2014 $75.05 050280 MERCY MED. CTR REDDING 1.3551 $81.23 050281 ALHAMBRA HOSPITAL 1.2014 $75.05 050283 VALLEY MEMORIAL HOSP. 1.6174 $91.76 050289 SETON MEDICAL CENTER 1.5582 $89.38 050290 SAINT JOHN S HOSPITAL 1.2014 $75.05 050291 SUTTER MEDICAL CENTER OF SANTA ROSA 1.5765 $90.12 050292 RIVERSIDE COUNTY REG. MED CENTER 1.187 $74.47 050295 MERCY HOSPITAL 1.187 $74.47 050296 HAZEL HAWKINS MEM.HOSP. 1.6363 $92.52 050298 BARSTOW COMMUNITY HOSP. 1.1881 $74.52 050300 ST MARY MEDICAL CENTER 1.2014 $75.05 050301 UKIAH VALLEY MED. CTR 1.187 $74.47 050305 ALTA BATES MED. CTR 1.6174 $91.76 050308 EL CAMINO HOSPITAL 1.6379 $92.59 050309 SUTTER ROSEVILLE MED.CTR1.3602 $81.43 050313 SUTTER TRACY COMM. HOSP.1.2584 $77.34 050315 KERN MEDICAL CENTER 1.187 $74.47 050320 ALAMEDA COUNTY MED.CTR 1.6174 $91.76 050324 SCRIPPS MEM HOSPITAL -LA JOLLA 1.187 $74.47 050325 TUOLUMNE GENERAL HOSP. 1.1917 $74.66 050327 LOMA LINDA U. MED. CTR. 1.2014 $75.05 050329 CORONA REGIONAL MED. CTR1.187 $74.47 050334 SALINAS VALLEY MEM.HOSP.1.6174 $91.76 050335 SONORA REGIONAL MED. CTR1.2145 $80.94 050336 LODI MEMORIAL HOSPITAL 1.2584 $77.34 050342 PIONEERS MEM. HOSPITAL 1.187 $74.47 050348 UCI MEDICAL CENTER 1.2014 $75.05 050349 CORCORAN DISTRICT HOSP. 1.187 $74.47 050350 BEVERLY COMMUNITY HOSP. 1.2014 $75.05 050351 TORRANCE MEMORIAL MED. C1.2014 $75.05 050352 BARTON MEMORIAL HOSPITAL1.3602 $81.43 050353 PROVIDENCE LTTL CO MARY MC TORRANCE 1.2014 $75.05 050357 GOLETA VAL. COTTAGE HOSP.1.187 $74.47 050359 TULARE DISTRICT HOSP. 1.187 $74.47 050360 MARIN GENERAL HOSPITAL 1.5739 $90.02 050366 MARK TWAIN ST. JOSEPH'S 1.3602 $87.21 050367 NORTHBAY MEDICAL CENTER 1.5739 $90.02 050373 LAC+USC MEDICAL CENTER 1.2014 $75.05 050376 HARBOR-UCLA MED. CTR 1.2014 $75.05 050378 PACIFICA HOSP. OF THE VALLEY 1.2014 $75.05 050380 GOOD SAMARITAN HOSPITAL 1.6379 $92.59 050382 CITRUS VALLEY MED. CTR 1.2014 $75.05 050385 PALM DRIVE HOSPITAL 1.5765 $90.12 050390 HEMET VALLEY MED. CTR 1.187 $74.47 050393 DOWNEY REGIONAL MED.CTR 1.2014 $75.05 050394 COMM. MEMORIAL HOSP. OF SAN BUENA 1.2318 $76.27 050396 SANTA BARBARA COT. HOSP.1.187 $74.47 050397 COALINGA REG. MED. CTR 1.187 $74.47 050407 CHINESE HOSPITAL 1.5352 $88.46 050411 KFH - HARBOR CITY 1.2014 $75.05 050414 MERCY HOSP. OF FOLSOM 1.3602 $81.43 050417 SUTTER COAST HOSPITAL 1.187 $79.76 050423 PALO VERDE HOSPITAL 1.187 $74.47 050424 SCRIPPS GREEN HOSPITAL 1.187 $74.47 050425 KFH - SACRAMENTO 1.3602 $81.43 050426 WEST ANAHEIM MED. CTR 1.2014 $75.05 050434 COLUSA REG. MED. CTR 1.187 $79.76 050435 FALLBROOK DISTRICT HOSP.1.187 $74.47 050438 HUNTINGTON HOSPITAL 1.2014 $75.05 050441 STANFORD HOSP. & CLINICS1.6379 $92.59 050444 MERCY MEDICAL CTR MERCED1.2398 $76.59 050448 RIDGECREST REGIONAL HOSP.1.187 $74.47 050454 UCSF MEDICAL CENTER 1.5352 $88.46 050455 SAN JOAQUIN COMM. HOSP. 1.187 $74.47 050457 ST. MARY S MED. CTR 1.5352 $88.46 050464 DOCTORS MED. CTR OF MODESTO 1.2145 $75.58 050468 MEMORIAL HOSP. OF GARDENA 1.2014 $75.05 050471 GOOD SAMARITAN HOSPITAL 1.2014 $75.05 050481 WEST HILLS REG MED. CTR 1.2014 $75.05 050485 LONG BEACH MEM. MED. CTR1.2014 $75.05 050488 EDEN MEDICAL CENTER 1.6174 $91.76 050492 CLOVIS COMMUNITY HOSP. 1.187 $74.47 050496 JOHN MUIR-CONCORD CAMPUS1.5852 $90.47 050498 SUTTER AUBURN FAITH HOSP.1.3602 $81.43 050502 ST. VINCENT MEDICAL CTR 1.2014 $75.05 050503 SCRIPPS MEM HOSPITAL- ENCINITAS 1.187 $74.47 050506 SIERRA VISTA REG. MED CTR1.2371 $76.48 050510 KFH - SAN RAFAEL 1.5739 $90.02 050512 KFH - HAYWARD 1.6174 $91.76 050515 KFH - SAN DIEGO 1.187 $74.47 050516 MERCY SAN JUAN MED. CTR 1.3602 $81.43 050517 VICTOR VAL. COMM. HOSP. 1.2014 $75.05 050523 SUTTER DELTA MED. CTR 1.5852 $90.47 050526 HUNTINGTON BEACH HOSP. 1.2014 $75.05 050528 MEMORIAL HOSPITAL - LOS BANOS 1.187 $79.76 050531 BELLFLOWER MED. CTR 1.2014 $75.05 050534 JOHN.F. KENNEDY MEM. HOSP.1.187 $74.47 050537 SUTTER DAVIS HOSPITAL 1.3602 $81.43 050541 KFH - REDWOOD CITY 1.6174 $91.76 050543 COLLEGE HOSP. COSTA MESA1.2014 $75.05 050545 LANTERMAN DEV. CTR 1.2014 $75.05 050547 SONOMA DEV. CTR 1.5765 $90.12 050548 FAIRVIEW DEV. CTR 1.2014 $75.05 050549 LOS ROBLES HOSP.&MED.CTR1.2318 $76.27 050551 LOS ALAMITOS MED. CTR. 1.2014 $75.05 050552 MOTION PICTURE & TV FUND1.2014 $75.05 050557 MEMORIAL HOSP. MODESTO 1.2145 $75.58 050561 KFH - WEST LOS ANGELES 1.2014 $75.05 050567 MISSION HOSP. REG. MED 1.2014 $75.05 050568 MADERA COMM. HOSP. 1.187 $74.47 050570 FOUNTAIN VAL. REG MED. CENTER 1.2014 $75.05 050573 EISENHOWER MED. CTR 1.187 $74.47 050575 TRI-CITY REG. MED. CTR 1.2014 $75.05 050580 LA PALMA INTERCOMMUNITY HOSPITAL 1.2014 $75.05 050581 LAKEWOOD REG. MED. CTR. 1.2014 $75.05 050586 CHINO VALLEY MED. CTR 1.2014 $75.05 050588 SAN DIMAS COMM. HOSP. 1.2014 $75.05 050589 PLACENTIA LINDA COMM.HOSP.1.2014 $75.05 050590 METHODIST HOSP. OF SAC. 1.3602 $81.43 050597 FOOTHILL PRESBYTERIAN1.2014 $75.05 050599 UC DAVIS MEDICAL CENTER 1.3602 $81.43 050603 SADDLEBACK MEM. MED. CTR1.2014 $75.05 050604 KFH - SAN JOSE 1.6379 $92.59 050608 DELANO REGIONAL MED. CTR.1.187 $74.47 050609 KFH - ANAHEIM 1.2014 $75.05 050616 ST. JOHN S PLEASANT VALLEY HOSPITAL 1.2318 $76.27 050618 BEAR VALLEY COMM. HOSP. 1.187 $79.76 050624 HENRY MAYO NEWHALL MEMORIAL HOSPITAL 1.2014 $75.05 050625 CEDARS-SINAI MED. CTR 1.2014 $75.05 050633 TWIN CITIES COMM. HOSP. 1.2371 $76.48 050636 POMERADO HOSPITAL 1.187 $74.47 050641 EAST LA DOCTORS HOSP. 1.2014 $75.05 050644 LOS ANGELES METROPOLITAN MEDICAL CTR 1.2014 $75.05 050663 LOS ANGELES COMMUNITY 1.2014 $75.05 050667 NELSON M. HOLDERMAN 1.4304 $84.25 050668 LAGUNA HONDA HOSPITAL 1.5739 $90.02 050674 KFH - SOUTH SACRAMENTO 1.3602 $81.43 050677 KFH - WOODLAND HILLS 1.2014 $75.05 050678 ORANGE COAST MEMORIAL MEDICAL CENTER 1.2014 $75.05 050680 VACAVALLEY HOSPITAL 1.5739 $90.02 050682 KINGSBURG DISTRICT HOSP.1.187 $74.47 050684 MENIFEE VALLEY MED. CTR 1.187 $74.47 050686 KFH - RIVERSIDE 1.187 $74.47 050688 ST LOUISE REGIONAL HOSP.1.6379 $92.59 050689 SAN RAMON REG. MED. CTR 1.5852 $90.47 050690 KFH - SANTA ROSA 1.5765 $90.12 050693 IRVINE MEDICAL CENTER 1.2014 $75.05 050696 USC UNIVERSITY HOSPITAL 1.2014 $75.05 050697 PATIENTS HOSP. OF REDDING1.3551 $81.23 050701 SOUTHWEST HEALTHCARE SYS.1.187 $74.47 050704 MISSION COMMUNITY HOSP. 1.2014 $75.05 050708 FRESNO SURGICAL HOSP. 1.187 $74.47 050709 DESERT VALLEY HOSP. INC.1.2014 $75.05 050710 KFH - FRESNO 1.187 $74.47 050714 SUTTER MATERNITY & SURGERY CENTER 1.6379 $92.59 050717 RANCHO LOS AMIGOS NATL.REHAB.CTR. 1.2014 $75.05 050722 SHARP MARY BIRCH HOSPITAL FOR WOMEN 1.187 $74.47 050723 KFH - BALDWIN PARK 1.2014 $75.05 050724 HEART HOSP. OF BAKERSFIELD1.187 $74.47 050726 STANISLAUS SURGICAL HOS 1.2145 $75.58 050727 COMM. HOSP. OF LONG BEACH1.2014 $75.05 050732 FRESNO HEART & SURGICAL HOS1.187$74.47 050735 WHITTIER HOSP. MED. CTR 1.2014 $75.05 050736 MONTEREY PARK HOSPITAL 1.2014 $75.05 050737 GARFIELD MEDICAL CTR. 1.2014 $75.05 050738 GREATER EL MONTE COMM HOS1.2014 $75.05 050739 CENTINELA HOSP MED CTR 1.2014 $75.05 050740 MARINA DEL REY HOSPITAL 1.2014 $75.05 050742 OLYMPIA MEDICAL CENTER 1.2014 $75.05 050744 WESTERN MED CTR ANAHEIM 1.2014 $75.05 050745 CHAPMAN MEDICAL CENTER 1.2014 $75.05 050746 WESTERN MED CTR SANTA ANA1.2014 $75.05 050747 COASTAL COMMUNITIES HOSP1.2014 $75.05 050748 KFH - MANTECA 1.2145 $75.58 050749 THOUSAND OAKS SURGICAL 1.2318 $76.27 050751 MIRACLE MILE MED CTR 1.2014 $75.05 050752 BROTMAN MEDICAL CTR INC 1.2014 $75.05 050754 MENLO PARK SURGICAL H 1.5582 $89.38 050755 SHERMAN OAKS HOSPITAL AND HEALTH CTR 1.2014 $75.05 050757 ALVARADO HOSPITAL LLC 1.187 $74.47 050758 MONTCLAIR HOSP MED CTR 1.2014 $75.05 050760 KFH - ANTIOCH 1.5852 $90.47 050761 PROVIDENCE TARZANA MED CTR1.2014$75.05 050762 MONROVIA MEM HOSP 1.2014 $75.05 050763 SILVER LAKE MED CENTER 1.2014 $75.05 050764 SHASTA REGIONAL MED CTR 1.3551 $81.23 050765 KFH - MORENO VALLEY 1.187 $74.47 050766 SUTTER-TWIN CITIES SURGICAL HOSPITAL 1.187 $74.47


Effective September 15, 2011