California / Palomar Medical Center Poway
CMS certification 050636 · Poway, CA · 3 entries in CMS's price-transparency list
Palomar Medical Center Poway: charges and Medicare payments
Palomar Medical Center Poway reported 847 Medicare inpatient stays across 30 DRGs in 2024. Across them it charged 10.03 times what it was paid — among the higher ratios in California, number 24 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: 189 stays at an average charge of $160,548, 78% above the national average. It also billed 870 outpatient services, charging 10.84 times what Medicare paid.
- 1Medicare inpatient stays 847
- 2Charge ÷ paid, inpatient 10.03×
- 3Rank in CA (highest ratio = 1) 24 of 247
- 4CMS price-transparency actions 3
Inpatient stays
For the 30 DRGs that can be compared with the national average, Palomar Medical Center Poway charged more than the national average in 30 (100%). 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 | 189 | $160,548 | +78% | $16,425 |
| 291 Heart Failure and Shock with MCC | 76 | $90,702 | +61% | $8,848 |
| 177 Respiratory Infections and Inflammations with MCC | 60 | $134,013 | +90% | $12,529 |
| 193 Simple Pneumonia and Pleurisy with MCC | 57 | $119,269 | +100% | $10,483 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 34 | $142,897 | +95% | $13,123 |
| 690 Kidney and Urinary Tract Infections without MCC | 32 | $72,902 | +93% | $6,535 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 27 | $102,816 | +110% | $8,169 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 25 | $74,237 | +85% | $7,123 |
| 689 Kidney and Urinary Tract Infections with MCC | 25 | $92,580 | +80% | $10,290 |
| 378 Gastrointestinal Hemorrhage with CC | 24 | $101,727 | +110% | $8,267 |
| 683 Renal Failure with CC | 22 | $73,376 | +80% | $7,708 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 18 | $122,778 | +120% | $8,467 |
| 194 Simple Pneumonia and Pleurisy with CC | 18 | $88,894 | +132% | $6,330 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 18 | $81,180 | +119% | $5,978 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 17 | $133,375 | +34% | $16,719 |
| 389 Gastrointestinal Obstruction with CC | 16 | $82,296 | +111% | $6,799 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 16 | $104,858 | +13% | $11,129 |
| 552 Medical Back Problems without MCC | 16 | $84,014 | +72% | $8,642 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $117,809 | +95% | $9,802 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 16 | $368,028 | +14% | $48,156 |
| 189 Pulmonary Edema and Respiratory Failure | 14 | $137,029 | +138% | $10,882 |
| 885 Psychoses | 14 | $91,167 | +107% | $14,830 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $128,554 | +154% | $6,810 |
| 682 Renal Failure with MCC | 13 | $160,585 | +144% | $15,173 |
| 951 Other Factors Influencing Health Status | 13 | $44,375 | +74% | $6,118 |
| 178 Respiratory Infections and Inflammations with CC | 12 | $87,926 | +94% | $6,285 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $142,166 | +66% | $15,280 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $102,068 | +67% | $10,822 |
| 207 Respiratory System Diagnosis with Ventilator Support >96... | 11 | $381,630 | +30% | $55,085 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 11 | $64,265 | +78% | $5,857 |
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Palomar Medical Center Poway charged $160,548 on average, 12% more than the California average of $143,063, and was paid $16,425 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Palomar Medical Center Poway charged $90,702 on average, 10% less than the California average of $100,739, and was paid $8,848 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Palomar Medical Center Poway charged $134,013 on average, 8% more than the California average of $124,302, and was paid $12,529 against a state average of $18,986. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Palomar Medical Center Poway charged $119,269 on average, 15% more than the California average of $103,761, and was paid $10,483 against a state average of $15,112. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $45,957 was 10% above the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $68,451 was 37% below the state average of $109,149. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $22,660 was 8% above the state average of $20,986. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $51,605 was 20% below the state average of $64,351.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Palomar Medical Center Poway in Poway, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- CAP Request — 2024-01-31 (CMS case 1879)
- Closure Notice — 2024-09-24 (CMS case 1879)
- Warning Notice — 2026-07-14 (CMS case 8252)
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.