Grossmont Hospital: charges and Medicare payments

Grossmont Hospital reported 5,390 Medicare inpatient stays across 124 DRGs in 2024. Across them it charged 6.55 times what it was paid — among the higher ratios in California, number 71 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: 564 stays at an average charge of $140,503, 56% above the national average. It also billed 3,213 outpatient services, charging 8.28 times what Medicare paid.

1Medicare inpatient stays 5,390
2Charge ÷ paid, inpatient 6.55×
3Rank in CA (highest ratio = 1) 71 of 247
4CMS price-transparency actions 0

Average charge per stay at Grossmont Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 124 DRGs that can be compared with the national average, Grossmont Hospital charged more than the national average in 120 (97%). 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	564	$140,503	+56%	$20,057
291 Heart Failure and Shock with MCC	313	$85,871	+52%	$13,340
177 Respiratory Infections and Inflammations with MCC	163	$112,678	+60%	$16,880
690 Kidney and Urinary Tract Infections without MCC	150	$54,874	+45%	$9,555
689 Kidney and Urinary Tract Infections with MCC	132	$79,742	+55%	$12,575
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	125	$86,563	+44%	$13,798
698 Other Kidney and Urinary Tract Diagnoses with MCC	119	$129,372	+76%	$17,517
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	115	$56,675	+41%	$8,470
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	110	$65,231	+33%	$10,929
603 Cellulitis without MCC	102	$66,136	+77%	$10,587
193 Simple Pneumonia and Pleurisy with MCC	99	$102,393	+71%	$14,081
274 Percutaneous and Other Intracardiac Procedures without MCC	93	$154,641	-1%	$33,233
312 Syncope and Collapse	88	$59,709	+31%	$9,533
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	88	$60,623	+64%	$8,224
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	84	$169,131	+69%	$22,508
853 Infectious and Parasitic Diseases with O.R. Procedures with...	83	$360,261	+57%	$54,324
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	74	$90,934	+63%	$10,785
190 Chronic Obstructive Pulmonary Disease with MCC	73	$85,475	+69%	$11,418
313 Chest Pain	70	$52,381	+31%	$7,866
552 Medical Back Problems without MCC	70	$61,409	+26%	$11,163
870 Septicemia or Severe Sepsis with MV >96 Hours	65	$402,931	+25%	$64,954
189 Pulmonary Edema and Respiratory Failure	61	$113,096	+96%	$13,513
309 Cardiac Arrhythmia and Conduction Disorders with CC	60	$63,499	+76%	$9,406
378 Gastrointestinal Hemorrhage with CC	58	$78,100	+61%	$10,363
948 Signs and Symptoms without MCC	57	$53,753	+41%	$8,373
194 Simple Pneumonia and Pleurisy with CC	54	$65,144	+70%	$8,714
682 Renal Failure with MCC	53	$95,447	+45%	$15,531
178 Respiratory Infections and Inflammations with CC	50	$65,781	+45%	$11,324
638 Diabetes with CC	48	$58,502	+40%	$9,370
683 Renal Failure with CC	48	$55,070	+35%	$9,594
699 Other Kidney and Urinary Tract Diagnoses with CC	48	$59,814	+26%	$10,525
377 Gastrointestinal Hemorrhage with MCC	47	$129,098	+51%	$19,049
149 Dysequilibrium	45	$48,346	+9%	$8,470
069 Transient Ischemia without Thrombolytic	42	$61,205	+21%	$9,004
191 Chronic Obstructive Pulmonary Disease with CC	42	$66,823	+69%	$8,991
389 Gastrointestinal Obstruction with CC	42	$61,713	+59%	$8,608
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	41	$54,161	+46%	$9,254
207 Respiratory System Diagnosis with Ventilator Support >96...	39	$369,463	+26%	$55,950
267 Endovascular Cardiac Valve Replacement and Supplement...	39	$240,554	+9%	$49,341
101 Seizures without MCC	38	$53,898	+11%	$9,976
287 Circulatory Disorders except AMI, with Cardiac...	38	$77,217	+21%	$12,280
057 Degenerative Nervous System Disorders without MCC	36	$72,304	+28%	$14,162
322 Percutaneous Cardiovascular Procedures with Intraluminal...	36	$145,751	+27%	$18,837
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	36	$49,275	+16%	$9,459
305 Hypertension without MCC	33	$47,363	+18%	$8,363
308 Cardiac Arrhythmia and Conduction Disorders with MCC	33	$119,399	+111%	$14,224
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	33	$187,764	+84%	$21,645
100 Seizures with MCC	32	$109,672	+16%	$20,152
208 Respiratory System Diagnosis with Ventilator Support <=96...	32	$252,884	+86%	$31,815
470 Major Hip and Knee Joint Replacement or Reattachment of...	32	$174,611	+87%	$19,448
280 Acute Myocardial Infarction, Discharged Alive with MCC	31	$123,304	+63%	$17,172
286 Circulatory Disorders except AMI, with Cardiac...	30	$122,144	+9%	$25,936
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	30	$78,351	+28%	$14,197
481 Hip and Femur Procedures except Major Joint with CC	30	$139,903	+39%	$20,979
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	29	$43,335	+51%	$6,458
637 Diabetes with MCC	29	$98,755	+49%	$15,096
884 Organic Disturbances and Intellectual Disability	29	$95,344	+53%	$17,614
321 Percutaneous Cardiovascular Procedures with Intraluminal...	28	$221,622	+35%	$29,220
917 Poisoning and Toxic Effects of Drugs with MCC	28	$132,438	+77%	$17,545
202 Bronchitis and Asthma with CC/MCC	27	$63,194	+37%	$10,233

Showing the 60 most frequent of 124 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	1,010	$31,118	$3,357
Level 5 Musculoskeletal Procedures	287	$136,051	$16,148
Level 1 Endovascular Procedures	229	$36,649	$4,001
Level 2 Upper GI Procedures	143	$12,250	$2,339
Level 1 Intraocular Procedures	138	$22,704	$2,865
Level 2 Excision/ Biopsy/ Incision and Drainage	122	$12,439	$1,959
Level 3 Electrophysiologic Procedures	98	$197,660	$29,114
Level 3 Endovascular Procedures	87	$101,195	$13,503
Level 6 Musculoskeletal Procedures	76	$119,855	$22,574
Level 3 Excision/ Biopsy/ Incision and Drainage	75	$19,558	$3,484
Level 3 Vascular Procedures	74	$25,060	$3,919
Level 4 Musculoskeletal Procedures	71	$59,874	$8,792
Level 3 Pacemaker and Similar Procedures	71	$64,996	$13,108
Level 3 Musculoskeletal Procedures	65	$31,596	$3,980
Level 1 Laparoscopy and Related Services	53	$64,265	$6,987
Level 3 Urology and Related Services	48	$15,083	$2,504
Level 5 Urology and Related Services	45	$60,877	$6,362
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	37	$42,383	$4,254
Level 4 Endovascular Procedures	36	$106,961	$19,712
Level 2 ICD and Similar Procedures	34	$142,504	$40,316
Level 3 Airway Endoscopy	29	$8,702	$2,087
Level 4 Pacemaker and Similar Procedures	28	$103,542	$23,891
Level 4 Urology and Related Services	27	$48,703	$4,286
Complex GI Procedures	25	$45,074	$7,007
Level 2 Musculoskeletal Procedures	24	$18,903	$1,976

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Grossmont Hospital charged $140,503 on average, 2% less than the California average of $143,063, and was paid $20,057 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Grossmont Hospital charged $85,871 on average, 15% less than the California average of $100,739, and was paid $13,340 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Grossmont Hospital charged $112,678 on average, 9% less than the California average of $124,302, and was paid $16,880 against a state average of $18,986. For Kidney and Urinary Tract Infections without MCC (DRG 690), Grossmont Hospital charged $54,874 on average, 14% less than the California average of $63,565, and was paid $9,555 against a state average of $9,722. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $31,118 was 25% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $136,051 was 25% above the state average of $109,149. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $36,649 was 10% below the state average of $40,544. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,250 was 36% below the state average of $19,034.

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.