California / Scripps Memorial Hospital - Encinitas
CMS certification 050503 · Encinitas, CA · 2 entries in CMS's price-transparency list
Scripps Memorial Hospital - Encinitas: charges and Medicare payments
Scripps Memorial Hospital - Encinitas reported 3,849 Medicare inpatient stays across 110 DRGs in 2024. Across them it charged 5.79 times what it was paid — mid-range in California, number 96 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: 575 stays at an average charge of $94,929, 5% above the national average. It also billed 2,810 outpatient services, charging 12.95 times what Medicare paid.
- 1Medicare inpatient stays 3,849
- 2Charge ÷ paid, inpatient 5.79×
- 3Rank in CA (highest ratio = 1) 96 of 247
- 4CMS price-transparency actions 2
Inpatient stays
For the 110 DRGs that can be compared with the national average, Scripps Memorial Hospital - Encinitas charged more than the national average in 80 (73%). 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 | 575 | $94,929 | +5% | $18,603 |
| 291 Heart Failure and Shock with MCC | 207 | $66,617 | +18% | $12,379 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 167 | $53,210 | +8% | $10,685 |
| 177 Respiratory Infections and Inflammations with MCC | 131 | $81,429 | +15% | $15,700 |
| 378 Gastrointestinal Hemorrhage with CC | 100 | $55,846 | +15% | $10,141 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 88 | $44,422 | +11% | $7,852 |
| 189 Pulmonary Edema and Respiratory Failure | 76 | $65,704 | +14% | $12,794 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 65 | $162,843 | +75% | $18,476 |
| 552 Medical Back Problems without MCC | 65 | $54,695 | +12% | $9,487 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 64 | $67,115 | -9% | $15,956 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 63 | $255,944 | +12% | $48,666 |
| 193 Simple Pneumonia and Pleurisy with MCC | 61 | $58,290 | -2% | $12,331 |
| 481 Hip and Femur Procedures except Major Joint with CC | 55 | $130,284 | +29% | $19,572 |
| 690 Kidney and Urinary Tract Infections without MCC | 55 | $39,426 | +4% | $7,481 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 51 | $48,798 | 0% | $10,031 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 49 | $70,058 | -8% | $14,850 |
| 603 Cellulitis without MCC | 49 | $33,173 | -11% | $7,990 |
| 683 Renal Failure with CC | 48 | $51,131 | +26% | $8,789 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 47 | $103,427 | +4% | $17,677 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 46 | $143,947 | +26% | $17,650 |
| 057 Degenerative Nervous System Disorders without MCC | 45 | $58,674 | +4% | $12,810 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 44 | $69,260 | +24% | $9,090 |
| 377 Gastrointestinal Hemorrhage with MCC | 42 | $95,808 | +12% | $15,861 |
| 389 Gastrointestinal Obstruction with CC | 39 | $48,543 | +25% | $8,246 |
| 071 Other Cerebrovascular Disorders with CC | 38 | $58,881 | +17% | $9,966 |
| 070 Other Cerebrovascular Disorders with MCC | 37 | $75,658 | 0% | $16,073 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 36 | $43,783 | +21% | $7,328 |
| 092 Other Disorders of Nervous System with CC | 34 | $60,838 | +18% | $10,363 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 33 | $65,994 | +8% | $12,493 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 30 | $182,586 | +78% | $20,744 |
| 178 Respiratory Infections and Inflammations with CC | 29 | $59,151 | +31% | $9,501 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 29 | $190,177 | +37% | $26,160 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 28 | $210,366 | +29% | $36,671 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 28 | $53,015 | +12% | $9,562 |
| 884 Organic Disturbances and Intellectual Disability | 28 | $71,822 | +15% | $14,199 |
| 056 Degenerative Nervous System Disorders with MCC | 26 | $93,993 | -2% | $18,554 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 26 | $67,239 | +33% | $9,403 |
| 312 Syncope and Collapse | 26 | $51,065 | +12% | $8,533 |
| 643 Endocrine Disorders with MCC | 26 | $76,363 | +3% | $15,144 |
| 644 Endocrine Disorders with CC | 26 | $56,599 | +18% | $10,239 |
| 689 Kidney and Urinary Tract Infections with MCC | 26 | $55,946 | +9% | $11,575 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 24 | $56,187 | -1% | $11,292 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 24 | $84,242 | +40% | $13,621 |
| 682 Renal Failure with MCC | 24 | $61,358 | -7% | $14,210 |
| 330 Major Small and Large Bowel Procedures with CC | 22 | $286,710 | +141% | $29,119 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 22 | $41,963 | -2% | $8,592 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 22 | $47,450 | +28% | $8,126 |
| 074 Cranial and Peripheral Nerve Disorders without MCC | 21 | $50,236 | -6% | $10,115 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 21 | $97,145 | +49% | $13,572 |
| 516 Other Musculoskeletal System and Connective Tissue O.R.... | 21 | $148,479 | +46% | $19,751 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 21 | $137,167 | +40% | $22,240 |
| 194 Simple Pneumonia and Pleurisy with CC | 20 | $40,676 | +6% | $8,963 |
| 196 Interstitial Lung Disease with MCC | 20 | $97,031 | +13% | $17,814 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 20 | $108,821 | +70% | $11,925 |
| 329 Major Small and Large Bowel Procedures with MCC | 20 | $259,613 | +21% | $41,105 |
| 394 Other Digestive System Diagnoses with CC | 20 | $57,705 | +23% | $9,260 |
| 605 Trauma To The Skin, Subcutaneous Tissue and Breast without... | 20 | $40,970 | -12% | $8,885 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 20 | $60,169 | +62% | $8,017 |
| 314 Other Circulatory System Diagnoses with MCC | 19 | $132,228 | +39% | $19,439 |
| 315 Other Circulatory System Diagnoses with CC | 19 | $49,454 | +3% | $9,252 |
Showing the 60 most frequent of 110 DRGs.
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Scripps Memorial Hospital - Encinitas charged $94,929 on average, 34% less than the California average of $143,063, and was paid $18,603 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Scripps Memorial Hospital - Encinitas charged $66,617 on average, 34% less than the California average of $100,739, and was paid $12,379 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Scripps Memorial Hospital - Encinitas charged $53,210 on average, 30% less than the California average of $76,120, and was paid $10,685 against a state average of $12,552. For Respiratory Infections and Inflammations with MCC (DRG 177), Scripps Memorial Hospital - Encinitas charged $81,429 on average, 34% less than the California average of $124,302, and was paid $15,700 against a state average of $18,986. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $35,729 was 14% below the state average of $41,628. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $53,678 was 5% above the state average of $51,167. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $46,374 was 27% above the state average of $36,378. For Level 4 Airway Endoscopy (outpatient APC 5154), its average charge of $59,984 was 35% above the state average of $44,289.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Scripps Memorial Hospital - Encinitas in Encinitas, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-11-14 (CMS case 2907)
- Closure Notice — 2025-02-19 (CMS case 2907)
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.