California / Scripps Green Hospital

CMS certification 050424 · La Jolla, CA · 3 entries in CMS's price-transparency list

Scripps Green Hospital: charges and Medicare payments

Scripps Green Hospital reported 2,338 Medicare inpatient stays across 79 DRGs in 2024. Across them it charged 5.72 times what it was paid — mid-range in California, number 101 of 247 hospitals with at least 100 stays (state median 5.18×, national 4.15×). Its most frequent stay was DRG 470, Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC: 475 stays at an average charge of $125,805, 35% above the national average. It also billed 4,219 outpatient services, charging 10.31 times what Medicare paid.

1Medicare inpatient stays 2,338
2Charge ÷ paid, inpatient 5.72×
3Rank in CA (highest ratio = 1) 101 of 247
4CMS price-transparency actions 3

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

Inpatient stays

For the 79 DRGs that can be compared with the national average, Scripps Green Hospital charged more than the national average in 55 (70%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
470 Major Hip and Knee Joint Replacement or Reattachment of...	475	$125,805	+35%	$21,624
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	141	$97,745	+8%	$25,815
454 Combined Anterior and Posterior Spinal Fusion with CC	82	$481,623	+72%	$78,449
462 Bilateral or Multiple Major Joint Procedures of Lower...	71	$191,396	+38%	$32,338
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	69	$372,600	+84%	$59,500
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	66	$39,929	-19%	$13,994
472 Cervical Spinal Fusion with CC	52	$281,457	+97%	$35,293
378 Gastrointestinal Hemorrhage with CC	49	$39,789	-18%	$12,817
291 Heart Failure and Shock with MCC	43	$72,555	+29%	$17,703
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	43	$35,057	-13%	$11,038
460 Spinal Fusion except Cervical without MCC	41	$307,422	+80%	$48,582
330 Major Small and Large Bowel Procedures with CC	39	$275,921	+132%	$29,426
603 Cellulitis without MCC	36	$28,813	-23%	$11,332
177 Respiratory Infections and Inflammations with MCC	34	$64,229	-9%	$22,223
517 Other Musculoskeletal System and Connective Tissue O.R....	31	$136,363	+74%	$17,729
690 Kidney and Urinary Tract Infections without MCC	29	$26,679	-29%	$11,013
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	27	$77,801	+15%	$17,879
473 Cervical Spinal Fusion without CC/MCC	26	$272,553	+137%	$28,884
025 Craniotomy and Endovascular Intracranial Procedures with MCC	25	$550,765	+138%	$71,410
193 Simple Pneumonia and Pleurisy with MCC	25	$48,861	-18%	$17,288
331 Major Small and Large Bowel Procedures without CC/MCC	24	$204,857	+139%	$21,818
402 Single Level Combined Anterior and Posterior Spinal Fusion...	24	$425,160	+126%	$54,220
552 Medical Back Problems without MCC	24	$37,229	-24%	$13,298
468 Revision of Hip or Knee Replacement without CC/MCC	23	$177,596	+43%	$30,283
027 Craniotomy and Endovascular Intracranial Procedures without...	22	$356,870	+155%	$32,917
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	22	$50,461	-17%	$17,283
377 Gastrointestinal Hemorrhage with MCC	21	$141,930	+66%	$27,757
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	21	$27,591	-26%	$10,167
683 Renal Failure with CC	21	$39,788	-2%	$12,008
057 Degenerative Nervous System Disorders without MCC	20	$34,474	-39%	$17,178
435 Malignancy of Hepatobiliary System or Pancreas with MCC	20	$117,922	+25%	$24,978
520 Back and Neck Procedures except Spinal Fusion without CC/MCC	20	$170,802	+117%	$18,792
194 Simple Pneumonia and Pleurisy with CC	19	$34,304	-11%	$10,890
394 Other Digestive System Diagnoses with CC	19	$38,337	-19%	$12,250
432 Cirrhosis and Alcoholic Hepatitis with MCC	19	$153,741	+61%	$25,694
445 Disorders of The Biliary Tract with CC	19	$63,812	+10%	$13,608
467 Revision of Hip or Knee Replacement with CC	19	$308,218	+95%	$42,247
456 Spinal Fusion except Cervical with Spinal Curvature,...	18	$884,539	+108%	$125,394
919 Complications of Treatment with MCC	18	$95,643	+8%	$25,193
374 Digestive Malignancy with MCC	17	$131,572	+31%	$28,594
652 Kidney Transplant	16	$503,605	+50%	$39,326
689 Kidney and Urinary Tract Infections with MCC	16	$34,453	-33%	$14,468
699 Other Kidney and Urinary Tract Diagnoses with CC	16	$75,598	+59%	$13,805
834 Acute Leukemia with MCC	16	$173,721	-39%	$70,390
840 Lymphoma and Non-Acute Leukemia with MCC	16	$159,707	+2%	$41,083
853 Infectious and Parasitic Diseases with O.R. Procedures with...	16	$329,550	+44%	$74,013
857 Postoperative or Post-Traumatic Infections with O.R....	16	$196,559	+96%	$29,281
189 Pulmonary Edema and Respiratory Failure	15	$64,096	+11%	$16,397
329 Major Small and Large Bowel Procedures with MCC	15	$357,068	+66%	$48,083
427 Multiple Level Combined Anterior and Posterior Spinal Fusion...	15	$642,356	+88%	$113,450
453 Combined Anterior and Posterior Spinal Fusion with MCC	15	$645,614	+42%	$114,075
643 Endocrine Disorders with MCC	15	$81,284	+10%	$23,465
682 Renal Failure with MCC	15	$109,892	+67%	$20,594
092 Other Disorders of Nervous System with CC	14	$97,184	+88%	$16,447
393 Other Digestive System Diagnoses with MCC	14	$80,942	+5%	$22,271
483 Major Joint or Limb Reattachment Procedures of Upper...	14	$181,357	+44%	$29,182
543 Pathological Fractures and Musculoskeletal and Connective...	14	$45,084	-8%	$14,886
813 Coagulation Disorders	14	$69,086	-14%	$20,250
920 Complications of Treatment with CC	14	$63,212	+28%	$14,513
026 Craniotomy and Endovascular Intracranial Procedures with CC	13	$513,944	+211%	$71,387

Showing the 60 most frequent of 79 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	603	$128,762	$16,052
Level 2 Excision/ Biopsy/ Incision and Drainage	473	$30,773	$1,987
Level 2 Upper GI Procedures	383	$16,575	$2,334
Level 1 Laparoscopy and Related Services	319	$64,697	$7,024
Level 4 Musculoskeletal Procedures	244	$102,717	$8,691
Level 3 Excision/ Biopsy/ Incision and Drainage	214	$42,884	$3,455
Level 3 Vascular Procedures	184	$39,997	$3,902
Level 5 Urology and Related Services	153	$64,504	$6,295
Level 4 Urology and Related Services	132	$43,435	$4,208
Level 6 Musculoskeletal Procedures	119	$147,109	$22,673
Level 4 Airway Endoscopy	118	$34,031	$4,573
Comprehensive Observation Services	111	$18,959	$3,341
Level 1 Breast/Lymphatic Surgery and Related Procedures	108	$41,706	$4,686
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	95	$47,334	$4,146
Level 5 ENT Procedures	80	$70,584	$7,200
Level 3 Endovascular Procedures	77	$95,201	$13,503
Level 3 Upper GI Procedures	75	$34,734	$4,708
Level 2 Vascular Procedures	74	$29,719	$1,969
Level 2 Breast/Lymphatic Surgery and Related Procedures	72	$77,611	$8,017
Level 3 Urology and Related Services	71	$39,352	$2,476
Level 2 Laparoscopy and Related Services	61	$153,100	$12,637
Complex GI Procedures	56	$44,585	$6,882
Level 3 Airway Endoscopy	55	$12,038	$2,087
Level 3 Lower GI Procedures	54	$24,775	$3,451
Level 4 Vascular Procedures	52	$64,059	$6,756

Against the California average

For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Scripps Green Hospital charged $125,805 on average, 9% less than the California average of $137,972, and was paid $21,624 against a state average of $21,800. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Scripps Green Hospital charged $97,745 on average, 32% less than the California average of $143,063, and was paid $25,815 against a state average of $23,020. For Combined Anterior and Posterior Spinal Fusion with CC (DRG 454), Scripps Green Hospital charged $481,623 on average, 17% more than the California average of $412,133, and was paid $78,449 against a state average of $76,337. For Bilateral or Multiple Major Joint Procedures of Lower Extremity without MCC (DRG 462), Scripps Green Hospital charged $191,396 on average, 9% less than the California average of $210,134, and was paid $32,338 against a state average of $35,263. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $128,762 was 18% above the state average of $109,149. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $30,773 was 109% above the state average of $14,749. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $16,575 was 13% below the state average of $19,034. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $64,697 was 1% above the state average of $64,351.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Scripps Green Hospital in La Jolla, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2024-08-28 (CMS case 2523)
Closure Notice — 2024-12-06 (CMS case 2523)
Met Requirements — 2025-08-20 (CMS case 5630)

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.