California / Scripps Memorial Hospital La Jolla
CMS certification 050324 · La Jolla, CA · 2 entries in CMS's price-transparency list
Scripps Memorial Hospital La Jolla: charges and Medicare payments
Scripps Memorial Hospital La Jolla reported 6,291 Medicare inpatient stays across 164 DRGs in 2024. Across them it charged 7.31 times what it was paid — among the higher ratios in California, number 51 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: 558 stays at an average charge of $118,276, 31% above the national average. It also billed 5,495 outpatient services, charging 9.32 times what Medicare paid.
- 1Medicare inpatient stays 6,291
- 2Charge ÷ paid, inpatient 7.31×
- 3Rank in CA (highest ratio = 1) 51 of 247
- 4CMS price-transparency actions 2
Inpatient stays
For the 164 DRGs that can be compared with the national average, Scripps Memorial Hospital La Jolla charged more than the national average in 158 (96%). 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 | 558 | $118,276 | +31% | $19,071 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 365 | $226,830 | +45% | $31,919 |
| 291 Heart Failure and Shock with MCC | 338 | $82,114 | +46% | $12,695 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 208 | $380,051 | +72% | $47,660 |
| 177 Respiratory Infections and Inflammations with MCC | 139 | $95,961 | +36% | $16,374 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 102 | $554,315 | +95% | $68,220 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 100 | $59,916 | +22% | $10,150 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 91 | $47,875 | +19% | $8,118 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 82 | $133,474 | +17% | $20,286 |
| 193 Simple Pneumonia and Pleurisy with MCC | 81 | $67,854 | +14% | $12,538 |
| 481 Hip and Femur Procedures except Major Joint with CC | 81 | $163,517 | +62% | $19,548 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 78 | $151,777 | +52% | $19,780 |
| 552 Medical Back Problems without MCC | 77 | $73,705 | +51% | $9,353 |
| 378 Gastrointestinal Hemorrhage with CC | 75 | $65,375 | +35% | $10,370 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 73 | $388,801 | +70% | $52,637 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 72 | $89,343 | +60% | $10,043 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 72 | $117,577 | +55% | $15,487 |
| 377 Gastrointestinal Hemorrhage with MCC | 69 | $118,597 | +39% | $18,114 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 67 | $691,069 | +73% | $84,815 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 64 | $210,847 | +88% | $26,140 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 63 | $160,384 | +72% | $18,571 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 62 | $240,816 | +47% | $28,446 |
| 189 Pulmonary Edema and Respiratory Failure | 59 | $80,766 | +40% | $11,935 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 59 | $93,103 | +46% | $10,883 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 59 | $97,304 | +33% | $15,649 |
| 603 Cellulitis without MCC | 57 | $44,871 | +20% | $8,583 |
| 389 Gastrointestinal Obstruction with CC | 56 | $44,322 | +14% | $8,045 |
| 543 Pathological Fractures and Musculoskeletal and Connective... | 56 | $66,209 | +35% | $10,259 |
| 683 Renal Failure with CC | 53 | $58,010 | +43% | $8,703 |
| 690 Kidney and Urinary Tract Infections without MCC | 52 | $44,543 | +18% | $7,655 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 51 | $48,484 | +34% | $7,709 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 50 | $46,845 | +26% | $7,420 |
| 057 Degenerative Nervous System Disorders without MCC | 49 | $62,399 | +10% | $13,266 |
| 314 Other Circulatory System Diagnoses with MCC | 49 | $131,222 | +38% | $20,724 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 48 | $196,269 | +41% | $27,430 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 47 | $179,721 | +62% | $22,793 |
| 682 Renal Failure with MCC | 44 | $78,723 | +19% | $14,222 |
| 178 Respiratory Infections and Inflammations with CC | 39 | $53,983 | +19% | $10,297 |
| 070 Other Cerebrovascular Disorders with MCC | 38 | $93,801 | +23% | $15,785 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 37 | $64,841 | +14% | $12,966 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 36 | $163,890 | +60% | $22,533 |
| 071 Other Cerebrovascular Disorders with CC | 35 | $61,421 | +22% | $10,217 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 35 | $165,930 | +143% | $12,808 |
| 330 Major Small and Large Bowel Procedures with CC | 35 | $235,576 | +98% | $24,309 |
| 394 Other Digestive System Diagnoses with CC | 35 | $61,401 | +30% | $10,293 |
| 056 Degenerative Nervous System Disorders with MCC | 34 | $87,769 | -9% | $20,485 |
| 317 Concomitant Left Atrial Appendage Closure and Cardiac... | 34 | $344,336 | -5% | $58,833 |
| 329 Major Small and Large Bowel Procedures with MCC | 33 | $337,185 | +57% | $44,582 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 33 | $82,851 | +36% | $12,588 |
| 418 Laparoscopic Cholecystectomy without C.D.E. with CC | 33 | $185,268 | +99% | $15,927 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 32 | $70,012 | +16% | $13,146 |
| 184 Major Chest Trauma with CC | 31 | $120,104 | +117% | $12,233 |
| 273 Percutaneous and Other Intracardiac Procedures with MCC | 31 | $284,483 | +33% | $40,134 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 31 | $182,608 | +53% | $22,623 |
| 183 Major Chest Trauma with MCC | 30 | $134,261 | +80% | $15,226 |
| 194 Simple Pneumonia and Pleurisy with CC | 30 | $48,814 | +27% | $9,143 |
| 312 Syncope and Collapse | 30 | $45,350 | 0% | $9,555 |
| 101 Seizures without MCC | 29 | $53,409 | +10% | $9,926 |
| 229 Other Cardiothoracic Procedures without MCC | 29 | $243,262 | +47% | $30,498 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 28 | $76,638 | +52% | $8,952 |
Showing the 60 most frequent of 164 DRGs.
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Scripps Memorial Hospital La Jolla charged $118,276 on average, 17% less than the California average of $143,063, and was paid $19,071 against a state average of $23,020. For Percutaneous and Other Intracardiac Procedures without MCC (DRG 274), Scripps Memorial Hospital La Jolla charged $226,830 on average, 13% more than the California average of $200,964, and was paid $31,919 against a state average of $35,770. For Heart Failure and Shock with MCC (DRG 291), Scripps Memorial Hospital La Jolla charged $82,114 on average, 18% less than the California average of $100,739, and was paid $12,695 against a state average of $15,556. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Scripps Memorial Hospital La Jolla charged $380,051 on average, 26% more than the California average of $302,584, and was paid $47,660 against a state average of $56,011. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $34,779 was 16% below the state average of $41,628. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $48,189 was 19% above the state average of $40,544. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $203,871 was 1% below the state average of $205,167. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $118,665 was 11% above the state average of $107,140.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Scripps Memorial Hospital La Jolla 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 — 2024-10-31 (CMS case 2857)
- Closure Notice — 2025-02-13 (CMS case 2857)
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.