California / Hoag Memorial Hospital Presbyterian
CMS certification 050224 · Newport Beach, CA · 6 entries in CMS's price-transparency list
Hoag Memorial Hospital Presbyterian: charges and Medicare payments
Hoag Memorial Hospital Presbyterian reported 8,303 Medicare inpatient stays across 175 DRGs in 2024. Across them it charged 4.7 times what it was paid — mid-range in California, number 151 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: 1082 stays at an average charge of $82,100, 9% below the national average. It also billed 7,670 outpatient services, charging 5.99 times what Medicare paid.
- 1Medicare inpatient stays 8,303
- 2Charge ÷ paid, inpatient 4.7×
- 3Rank in CA (highest ratio = 1) 151 of 247
- 4CMS price-transparency actions 6
Inpatient stays
For the 175 DRGs that can be compared with the national average, Hoag Memorial Hospital Presbyterian charged more than the national average in 53 (30%). 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 | 1082 | $82,100 | -9% | $17,894 |
| 291 Heart Failure and Shock with MCC | 341 | $55,678 | -1% | $12,198 |
| 177 Respiratory Infections and Inflammations with MCC | 269 | $80,340 | +14% | $15,388 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 235 | $45,733 | -7% | $10,240 |
| 378 Gastrointestinal Hemorrhage with CC | 162 | $43,762 | -10% | $9,646 |
| 690 Kidney and Urinary Tract Infections without MCC | 157 | $35,136 | -7% | $8,009 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 156 | $39,767 | -1% | $8,628 |
| 683 Renal Failure with CC | 153 | $39,992 | -2% | $9,138 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 136 | $61,407 | -16% | $14,752 |
| 193 Simple Pneumonia and Pleurisy with MCC | 135 | $70,271 | +18% | $13,219 |
| 481 Hip and Femur Procedures except Major Joint with CC | 111 | $82,186 | -18% | $19,152 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 106 | $224,053 | -2% | $48,789 |
| 330 Major Small and Large Bowel Procedures with CC | 103 | $157,299 | +32% | $23,993 |
| 603 Cellulitis without MCC | 103 | $32,975 | -12% | $8,560 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 99 | $33,435 | -10% | $8,134 |
| 682 Renal Failure with MCC | 99 | $66,591 | +1% | $14,197 |
| 194 Simple Pneumonia and Pleurisy with CC | 94 | $45,357 | +18% | $8,370 |
| 689 Kidney and Urinary Tract Infections with MCC | 88 | $44,884 | -13% | $10,574 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 87 | $49,548 | -11% | $10,292 |
| 178 Respiratory Infections and Inflammations with CC | 87 | $44,347 | -2% | $9,662 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 87 | $53,672 | -11% | $12,331 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 84 | $82,246 | -18% | $17,938 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 83 | $33,262 | -30% | $9,294 |
| 377 Gastrointestinal Hemorrhage with MCC | 82 | $81,167 | -5% | $16,922 |
| 189 Pulmonary Edema and Respiratory Failure | 79 | $56,095 | -3% | $11,893 |
| 389 Gastrointestinal Obstruction with CC | 77 | $36,742 | -6% | $8,013 |
| 394 Other Digestive System Diagnoses with CC | 73 | $44,480 | -5% | $9,652 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 71 | $157,196 | -29% | $45,458 |
| 552 Medical Back Problems without MCC | 65 | $36,952 | -24% | $9,371 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 62 | $84,137 | -27% | $18,929 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 61 | $94,405 | -8% | $19,528 |
| 895 Alcohol, Drug Abuse or Dependence with Rehabilitation... | 61 | $26,809 | -22% | $15,014 |
| 314 Other Circulatory System Diagnoses with MCC | 59 | $82,236 | -13% | $18,950 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 58 | $186,785 | -19% | $37,741 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 56 | $39,340 | +9% | $7,374 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 55 | $134,966 | -18% | $29,260 |
| 644 Endocrine Disorders with CC | 54 | $40,885 | -15% | $9,894 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 52 | $67,394 | -11% | $14,842 |
| 312 Syncope and Collapse | 52 | $39,233 | -14% | $8,486 |
| 418 Laparoscopic Cholecystectomy without C.D.E. with CC | 52 | $101,848 | +9% | $16,379 |
| 329 Major Small and Large Bowel Procedures with MCC | 51 | $262,718 | +22% | $46,871 |
| 372 Major Gastrointestinal Disorders and Peritoneal Infections... | 51 | $51,605 | +9% | $10,344 |
| 164 Major Chest Procedures with CC | 50 | $132,544 | +4% | $23,195 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 49 | $57,984 | -5% | $12,340 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 48 | $102,596 | -35% | $30,501 |
| 027 Craniotomy and Endovascular Intracranial Procedures without... | 45 | $117,637 | -16% | $23,542 |
| 300 Peripheral Vascular Disorders with CC | 43 | $49,847 | +1% | $11,234 |
| 643 Endocrine Disorders with MCC | 42 | $46,639 | -37% | $15,255 |
| 536 Fractures of Hip and Pelvis without MCC | 41 | $33,640 | -11% | $7,631 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 40 | $142,851 | +5% | $27,759 |
| 393 Other Digestive System Diagnoses with MCC | 40 | $69,630 | -9% | $15,753 |
| 482 Hip and Femur Procedures except Major Joint without CC/MCC | 38 | $70,516 | -9% | $15,132 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 37 | $139,215 | +62% | $16,126 |
| 390 Gastrointestinal Obstruction without CC/MCC | 37 | $27,928 | 0% | $6,555 |
| 445 Disorders of The Biliary Tract with CC | 37 | $57,310 | -2% | $10,580 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 36 | $229,541 | +9% | $36,873 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 34 | $44,337 | +5% | $8,055 |
| 069 Transient Ischemia without Thrombolytic | 34 | $44,388 | -12% | $7,897 |
| 101 Seizures without MCC | 34 | $32,885 | -33% | $9,216 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 34 | $65,178 | -3% | $13,013 |
Showing the 60 most frequent of 175 DRGs.
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Hoag Memorial Hospital Presbyterian charged $82,100 on average, 43% less than the California average of $143,063, and was paid $17,894 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Hoag Memorial Hospital Presbyterian charged $55,678 on average, 45% less than the California average of $100,739, and was paid $12,198 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Hoag Memorial Hospital Presbyterian charged $80,340 on average, 35% less than the California average of $124,302, and was paid $15,388 against a state average of $18,986. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Hoag Memorial Hospital Presbyterian charged $45,733 on average, 40% less than the California average of $76,120, and was paid $10,240 against a state average of $12,552. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,574 was 41% below the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,486 was 22% below the state average of $14,749. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $9,801 was 49% below the state average of $19,034. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $24,025 was 41% below the state average of $40,544.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Hoag Memorial Hospital Presbyterian in Newport Beach, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-04-11 (CMS case 1518)
- CAP Request — 2023-08-16 (CMS case 1518)
- Closure Notice — 2024-03-28 (CMS case 1518)
- Warning Notice — 2025-04-23 (CMS case 3968)
- CAP Request — 2025-07-28 (CMS case 3968)
- Closure Notice — 2025-08-18 (CMS case 3968)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
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.