California / Loma Linda University Medical Center

CMS certification 050327 · Loma Linda, CA · 3 entries in CMS's price-transparency list

Loma Linda University Medical Center: charges and Medicare payments

Loma Linda University Medical Center reported 3,171 Medicare inpatient stays across 95 DRGs in 2024. Across them it charged 5.11 times what it was paid — mid-range in California, number 125 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: 317 stays at an average charge of $146,667, 62% above the national average. It also billed 4,046 outpatient services, charging 9.08 times what Medicare paid.

1Medicare inpatient stays 3,171
2Charge ÷ paid, inpatient 5.11×
3Rank in CA (highest ratio = 1) 125 of 247
4CMS price-transparency actions 3

Average charge per stay at Loma Linda University Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 95 DRGs that can be compared with the national average, Loma Linda University Medical Center charged more than the national average in 92 (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	317	$146,667	+62%	$31,039
291 Heart Failure and Shock with MCC	189	$84,343	+50%	$20,965
189 Pulmonary Edema and Respiratory Failure	114	$148,637	+158%	$24,541
274 Percutaneous and Other Intracardiac Procedures without MCC	102	$153,544	-2%	$45,182
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	85	$77,550	+58%	$18,051
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	70	$100,307	+66%	$22,068
698 Other Kidney and Urinary Tract Diagnoses with MCC	68	$122,776	+67%	$26,715
683 Renal Failure with CC	67	$64,302	+58%	$15,338
853 Infectious and Parasitic Diseases with O.R. Procedures with...	66	$500,275	+119%	$92,467
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	60	$213,207	+113%	$34,141
267 Endovascular Cardiac Valve Replacement and Supplement...	57	$170,886	-23%	$66,929
177 Respiratory Infections and Inflammations with MCC	52	$125,720	+78%	$27,362
682 Renal Failure with MCC	49	$86,608	+31%	$23,626
812 Red Blood Cell Disorders without MCC	49	$49,893	+12%	$16,314
870 Septicemia or Severe Sepsis with MV >96 Hours	47	$659,953	+104%	$114,883
699 Other Kidney and Urinary Tract Diagnoses with CC	45	$68,255	+44%	$17,488
309 Cardiac Arrhythmia and Conduction Disorders with CC	44	$42,854	+19%	$12,112
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	41	$102,028	+83%	$18,086
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	41	$72,661	+96%	$14,374
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	40	$1,697,576	+61%	$313,708
208 Respiratory System Diagnosis with Ventilator Support <=96...	40	$282,035	+108%	$46,168
377 Gastrointestinal Hemorrhage with MCC	40	$173,148	+103%	$32,323
314 Other Circulatory System Diagnoses with MCC	39	$164,895	+74%	$34,958
652 Kidney Transplant	39	$540,437	+61%	$50,498
378 Gastrointestinal Hemorrhage with CC	38	$72,820	+50%	$16,435
603 Cellulitis without MCC	37	$70,272	+88%	$15,905
389 Gastrointestinal Obstruction with CC	35	$77,795	+100%	$15,356
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	35	$63,336	+58%	$13,646
025 Craniotomy and Endovascular Intracranial Procedures with MCC	34	$467,568	+102%	$75,059
690 Kidney and Urinary Tract Infections without MCC	34	$48,095	+27%	$13,214
308 Cardiac Arrhythmia and Conduction Disorders with MCC	31	$76,049	+34%	$18,886
070 Other Cerebrovascular Disorders with MCC	30	$181,878	+139%	$35,840
229 Other Cardiothoracic Procedures without MCC	30	$200,086	+21%	$45,830
312 Syncope and Collapse	30	$92,419	+103%	$16,117
330 Major Small and Large Bowel Procedures with CC	28	$309,183	+160%	$39,126
101 Seizures without MCC	27	$38,023	-22%	$15,700
322 Percutaneous Cardiovascular Procedures with Intraluminal...	27	$139,219	+22%	$27,812
071 Other Cerebrovascular Disorders with CC	26	$99,102	+96%	$18,855
280 Acute Myocardial Infarction, Discharged Alive with MCC	26	$115,737	+53%	$25,811
481 Hip and Femur Procedures except Major Joint with CC	26	$154,690	+54%	$31,422
163 Major Chest Procedures with MCC	25	$387,143	+84%	$74,491
287 Circulatory Disorders except AMI, with Cardiac...	25	$75,927	+19%	$16,976
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	25	$85,678	+40%	$22,160
811 Red Blood Cell Disorders with MCC	25	$133,210	+95%	$28,058
193 Simple Pneumonia and Pleurisy with MCC	24	$82,094	+37%	$21,594
207 Respiratory System Diagnosis with Ventilator Support >96...	24	$427,196	+46%	$91,528
286 Circulatory Disorders except AMI, with Cardiac...	24	$165,481	+47%	$33,990
394 Other Digestive System Diagnoses with CC	23	$72,512	+54%	$16,656
470 Major Hip and Knee Joint Replacement or Reattachment of...	23	$164,082	+76%	$29,131
023 Craniotomy with Major Device Implant or Acute Complex Cns...	22	$456,590	+63%	$97,714
273 Percutaneous and Other Intracardiac Procedures with MCC	22	$229,202	+7%	$56,713
321 Percutaneous Cardiovascular Procedures with Intraluminal...	22	$189,360	+16%	$41,920
252 Other Vascular Procedures with MCC	21	$287,170	+68%	$56,511
432 Cirrhosis and Alcoholic Hepatitis with MCC	21	$141,094	+47%	$33,719
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	21	$421,718	+95%	$78,744
004 Tracheostomy with MV >96 Hours or Principal Diagnosis except...	20	$1,209,822	+97%	$199,663
480 Hip and Femur Procedures except Major Joint with MCC	20	$248,102	+79%	$44,019
689 Kidney and Urinary Tract Infections with MCC	20	$81,601	+59%	$20,985
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	19	$632,865	+59%	$112,937
393 Other Digestive System Diagnoses with MCC	19	$132,720	+73%	$27,396

Showing the 60 most frequent of 95 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	827	$37,634	$3,355
Level 2 Excision/ Biopsy/ Incision and Drainage	280	$12,745	$1,986
Level 1 Endovascular Procedures	189	$25,131	$4,013
Level 3 Electrophysiologic Procedures	179	$124,768	$29,114
Level 2 Upper GI Procedures	142	$19,935	$2,339
Level 3 Vascular Procedures	123	$34,424	$3,919
Level 2 Intraocular Procedures	119	$45,766	$4,999
Level 1 Intraocular Procedures	112	$34,920	$2,846
Level 5 Urology and Related Services	110	$64,410	$6,333
Level 5 ENT Procedures	102	$67,011	$7,200
Level 1 Laparoscopy and Related Services	95	$113,539	$7,094
Level 4 Urology and Related Services	90	$47,644	$4,286
Level 4 Musculoskeletal Procedures	84	$84,443	$8,792
Level 5 Musculoskeletal Procedures	82	$95,335	$16,148
Level 5 Airway Endoscopy	82	$78,998	$8,352
Level 3 Urology and Related Services	82	$24,652	$2,504
Level 2 Laparoscopy and Related Services	74	$163,433	$12,420
Level 2 Musculoskeletal Procedures	73	$27,537	$1,976
Level 3 Musculoskeletal Procedures	73	$44,985	$3,936
Level 3 Endovascular Procedures	73	$94,204	$13,375
Level 3 Excision/ Biopsy/ Incision and Drainage	71	$40,823	$3,493
Level 4 Vascular Procedures	67	$41,825	$6,252
Level 3 Airway Endoscopy	61	$22,348	$2,059
Level 4 Airway Endoscopy	61	$58,294	$4,604
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	60	$41,450	$4,218

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Loma Linda University Medical Center charged $146,667 on average, 3% more than the California average of $143,063, and was paid $31,039 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Loma Linda University Medical Center charged $84,343 on average, 16% less than the California average of $100,739, and was paid $20,965 against a state average of $15,556. For Pulmonary Edema and Respiratory Failure (DRG 189), Loma Linda University Medical Center charged $148,637 on average, 43% more than the California average of $104,292, and was paid $24,541 against a state average of $15,897. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Loma Linda University Medical Center charged $153,544 on average, 24% less than the California average of $200,964, and was paid $45,182 against a state average of $35,770. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $37,634 was 10% below the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,745 was 14% below the state average of $14,749. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $25,131 was 38% below the state average of $40,544. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $124,768 was 39% below the state average of $205,167.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Loma Linda University Medical Center in Loma Linda, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2024-11-19 (CMS case 2938)
Closure Notice — 2025-02-21 (CMS case 2938)
Met Requirements — 2025-03-18 (CMS case 3310)

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.