Santa Monica - UCLA Med Ctr & Orthopaedic Hospital: charges and Medicare payments

Santa Monica - UCLA Med Ctr & Orthopaedic Hospital reported 3,245 Medicare inpatient stays across 99 DRGs in 2024. Across them it charged 4.67 times what it was paid — mid-range in California, number 153 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: 473 stays at an average charge of $145,259, 61% above the national average. It also billed 4,863 outpatient services, charging 5.72 times what Medicare paid.

1Medicare inpatient stays 3,245
2Charge ÷ paid, inpatient 4.67×
3Rank in CA (highest ratio = 1) 153 of 247
4CMS price-transparency actions 0

Average charge per stay at Santa Monica - UCLA Med Ctr & Orthopaedic Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 99 DRGs that can be compared with the national average, Santa Monica - UCLA Med Ctr & Orthopaedic Hospital charged more than the national average in 91 (92%). 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	473	$145,259	+61%	$29,008
291 Heart Failure and Shock with MCC	168	$108,691	+93%	$18,633
177 Respiratory Infections and Inflammations with MCC	106	$102,145	+45%	$21,012
467 Revision of Hip or Knee Replacement with CC	82	$201,117	+27%	$42,336
470 Major Hip and Knee Joint Replacement or Reattachment of...	82	$116,741	+25%	$22,698
698 Other Kidney and Urinary Tract Diagnoses with MCC	75	$115,628	+57%	$21,271
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	66	$59,097	+20%	$12,512
057 Degenerative Nervous System Disorders without MCC	61	$62,373	+10%	$16,154
870 Septicemia or Severe Sepsis with MV >96 Hours	61	$360,608	+12%	$89,927
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	60	$69,760	+3%	$15,938
314 Other Circulatory System Diagnoses with MCC	57	$162,422	+71%	$31,089
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	53	$90,362	+50%	$20,385
683 Renal Failure with CC	49	$70,038	+72%	$12,014
853 Infectious and Parasitic Diseases with O.R. Procedures with...	48	$408,079	+78%	$94,440
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	44	$89,532	+47%	$18,475
189 Pulmonary Edema and Respiratory Failure	43	$108,486	+88%	$17,102
193 Simple Pneumonia and Pleurisy with MCC	42	$77,828	+30%	$15,706
377 Gastrointestinal Hemorrhage with MCC	42	$118,186	+38%	$23,232
689 Kidney and Urinary Tract Infections with MCC	42	$61,111	+19%	$13,093
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	40	$55,858	+51%	$12,661
682 Renal Failure with MCC	39	$112,079	+70%	$18,659
393 Other Digestive System Diagnoses with MCC	38	$106,166	+38%	$26,015
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	37	$49,673	+24%	$11,402
481 Hip and Femur Procedures except Major Joint with CC	35	$100,158	-1%	$24,141
846 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	35	$148,497	+10%	$37,936
840 Lymphoma and Non-Acute Leukemia with MCC	34	$250,291	+60%	$56,349
329 Major Small and Large Bowel Procedures with MCC	33	$296,297	+38%	$70,693
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	33	$127,357	+24%	$24,875
180 Respiratory Neoplasms with MCC	31	$140,737	+60%	$27,498
690 Kidney and Urinary Tract Infections without MCC	31	$47,098	+25%	$10,053
389 Gastrointestinal Obstruction with CC	30	$56,517	+45%	$11,061
603 Cellulitis without MCC	30	$50,510	+35%	$11,667
435 Malignancy of Hepatobiliary System or Pancreas with MCC	29	$122,352	+29%	$23,635
480 Hip and Femur Procedures except Major Joint with MCC	27	$167,159	+20%	$39,835
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	26	$162,781	+63%	$27,660
091 Other Disorders of Nervous System with MCC	26	$116,297	+41%	$21,996
378 Gastrointestinal Hemorrhage with CC	26	$62,319	+28%	$11,872
699 Other Kidney and Urinary Tract Diagnoses with CC	26	$80,120	+69%	$13,010
018 Chimeric Antigen Receptor (Car) T-Cell and Other...	25	$2,137,236	-3%	$554,836
280 Acute Myocardial Infarction, Discharged Alive with MCC	25	$146,920	+94%	$24,462
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	25	$149,590	+11%	$35,220
374 Digestive Malignancy with MCC	24	$138,051	+37%	$29,067
312 Syncope and Collapse	23	$57,886	+27%	$10,657
552 Medical Back Problems without MCC	23	$67,518	+38%	$11,780
394 Other Digestive System Diagnoses with CC	22	$100,635	+114%	$18,066
464 Wound Debridement and Skin Graft except Hand for...	22	$200,379	+38%	$39,375
643 Endocrine Disorders with MCC	22	$90,895	+23%	$19,661
330 Major Small and Large Bowel Procedures with CC	21	$127,882	+7%	$27,468
542 Pathological Fractures and Musculoskeletal and Connective...	21	$166,491	+108%	$26,730
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	20	$110,819	+70%	$17,718
543 Pathological Fractures and Musculoskeletal and Connective...	20	$79,448	+62%	$14,640
602 Cellulitis with MCC	20	$75,505	+26%	$17,266
811 Red Blood Cell Disorders with MCC	20	$96,157	+41%	$18,274
056 Degenerative Nervous System Disorders with MCC	19	$231,401	+141%	$49,695
299 Peripheral Vascular Disorders with MCC	19	$96,514	+28%	$18,684
466 Revision of Hip or Knee Replacement with MCC	19	$320,893	+33%	$74,865
472 Cervical Spinal Fusion with CC	19	$173,859	+22%	$34,281
812 Red Blood Cell Disorders without MCC	19	$57,905	+30%	$11,198
196 Interstitial Lung Disease with MCC	17	$206,593	+140%	$40,333
308 Cardiac Arrhythmia and Conduction Disorders with MCC	17	$79,177	+40%	$16,043

Showing the 60 most frequent of 99 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	702	$27,676	$3,346
Level 5 Musculoskeletal Procedures	346	$72,584	$15,737
Level 1 Nerve Procedures	296	$8,203	$2,367
Level 2 Excision/ Biopsy/ Incision and Drainage	266	$10,915	$1,978
Level 5 Urology and Related Services	238	$35,995	$6,308
Level 1 Laparoscopy and Related Services	185	$34,567	$6,972
Level 4 Musculoskeletal Procedures	183	$36,905	$8,676
Level 3 Vascular Procedures	162	$24,154	$3,919
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	159	$24,496	$4,197
Level 5 ENT Procedures	154	$36,737	$7,200
Level 2 Upper GI Procedures	153	$9,923	$2,315
Level 3 Endovascular Procedures	151	$58,992	$13,270
Level 4 Airway Endoscopy	141	$25,198	$4,511
Level 1 Endovascular Procedures	133	$23,269	$3,889
Level 5 Airway Endoscopy	132	$34,164	$8,310
Level 4 ENT Procedures	129	$13,576	$3,958
Level 4 Urology and Related Services	105	$22,100	$4,286
Level 2 Laparoscopy and Related Services	100	$48,372	$12,535
Level 3 Excision/ Biopsy/ Incision and Drainage	96	$18,885	$3,494
Level 6 Musculoskeletal Procedures	82	$83,926	$22,334
Level 3 Urology and Related Services	75	$19,865	$2,504
Level 2 Musculoskeletal Procedures	73	$10,200	$1,954
Level 3 Lower GI Procedures	69	$10,519	$3,411
Level 1 Breast/Lymphatic Surgery and Related Procedures	54	$20,082	$4,686
Level 3 Musculoskeletal Procedures	54	$21,796	$3,980

Against the California average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Santa Monica - UCLA Med Ctr & Orthopaedic Hospital charged $145,259 on average, 2% more than the California average of $143,063, and was paid $29,008 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Santa Monica - UCLA Med Ctr & Orthopaedic Hospital charged $108,691 on average, 8% more than the California average of $100,739, and was paid $18,633 against a state average of $15,556. For Respiratory Infections and Inflammations with MCC (DRG 177), Santa Monica - UCLA Med Ctr & Orthopaedic Hospital charged $102,145 on average, 18% less than the California average of $124,302, and was paid $21,012 against a state average of $18,986. For Revision of Hip or Knee Replacement with CC (DRG 467), Santa Monica - UCLA Med Ctr & Orthopaedic Hospital charged $201,117 on average, 16% less than the California average of $239,470, and was paid $42,336 against a state average of $39,790. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $27,676 was 34% below the state average of $41,628. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $72,584 was 34% below the state average of $109,149. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $8,203 was 58% below the state average of $19,391. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,915 was 26% below the state average of $14,749.

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.