California / Scripps Mercy Hospital
CMS certification 050077 · San Diego, CA · 5 entries in CMS's price-transparency list
Scripps Mercy Hospital: charges and Medicare payments
Scripps Mercy Hospital reported 3,387 Medicare inpatient stays across 107 DRGs in 2024. Across them it charged 6 times what it was paid — mid-range in California, number 88 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: 516 stays at an average charge of $124,784, 38% above the national average. It also billed 1,596 outpatient services, charging 12.19 times what Medicare paid.
- 1Medicare inpatient stays 3,387
- 2Charge ÷ paid, inpatient 6×
- 3Rank in CA (highest ratio = 1) 88 of 247
- 4CMS price-transparency actions 5
Inpatient stays
For the 107 DRGs that can be compared with the national average, Scripps Mercy Hospital charged more than the national average in 103 (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 | 516 | $124,784 | +38% | $22,741 |
| 291 Heart Failure and Shock with MCC | 197 | $79,073 | +40% | $15,218 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 106 | $69,090 | +41% | $12,328 |
| 189 Pulmonary Edema and Respiratory Failure | 86 | $90,705 | +58% | $14,192 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 85 | $165,226 | +77% | $21,958 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 83 | $328,226 | +43% | $57,001 |
| 177 Respiratory Infections and Inflammations with MCC | 72 | $87,602 | +24% | $19,373 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 65 | $87,872 | +16% | $18,477 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 51 | $54,333 | +35% | $10,555 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 50 | $83,042 | +49% | $12,765 |
| 378 Gastrointestinal Hemorrhage with CC | 49 | $67,178 | +38% | $12,050 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 47 | $154,458 | +55% | $22,623 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 47 | $356,458 | +61% | $57,384 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 47 | $82,452 | +12% | $18,557 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 46 | $78,554 | +30% | $15,210 |
| 603 Cellulitis without MCC | 44 | $43,864 | +18% | $10,935 |
| 683 Renal Failure with CC | 44 | $62,584 | +54% | $10,551 |
| 377 Gastrointestinal Hemorrhage with MCC | 41 | $94,253 | +10% | $17,995 |
| 481 Hip and Femur Procedures except Major Joint with CC | 41 | $194,664 | +93% | $23,301 |
| 682 Renal Failure with MCC | 41 | $74,453 | +13% | $16,196 |
| 057 Degenerative Nervous System Disorders without MCC | 39 | $68,582 | +21% | $15,002 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 38 | $234,270 | +49% | $38,229 |
| 312 Syncope and Collapse | 37 | $56,808 | +25% | $10,406 |
| 070 Other Cerebrovascular Disorders with MCC | 36 | $94,733 | +25% | $18,814 |
| 193 Simple Pneumonia and Pleurisy with MCC | 35 | $72,648 | +22% | $14,636 |
| 690 Kidney and Urinary Tract Infections without MCC | 35 | $51,686 | +37% | $9,633 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 34 | $54,631 | +51% | $9,907 |
| 552 Medical Back Problems without MCC | 33 | $67,926 | +39% | $11,492 |
| 389 Gastrointestinal Obstruction with CC | 32 | $54,334 | +40% | $9,688 |
| 884 Organic Disturbances and Intellectual Disability | 31 | $109,647 | +76% | $17,726 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 30 | $49,801 | +34% | $10,150 |
| 056 Degenerative Nervous System Disorders with MCC | 29 | $122,049 | +27% | $24,637 |
| 300 Peripheral Vascular Disorders with CC | 29 | $72,508 | +47% | $12,281 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 29 | $228,078 | +64% | $32,318 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 29 | $57,114 | +20% | $11,967 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 26 | $177,571 | +31% | $30,526 |
| 643 Endocrine Disorders with MCC | 25 | $106,928 | +44% | $17,960 |
| 393 Other Digestive System Diagnoses with MCC | 24 | $123,822 | +61% | $19,106 |
| 252 Other Vascular Procedures with MCC | 23 | $203,737 | +19% | $34,892 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 23 | $52,449 | -14% | $15,011 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 22 | $111,992 | +72% | $15,407 |
| 194 Simple Pneumonia and Pleurisy with CC | 22 | $52,786 | +38% | $9,341 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 22 | $64,604 | +28% | $11,533 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 22 | $191,427 | +87% | $27,194 |
| 638 Diabetes with CC | 22 | $66,693 | +60% | $10,827 |
| 394 Other Digestive System Diagnoses with CC | 21 | $54,655 | +16% | $11,177 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $60,530 | +18% | $13,215 |
| 220 Cardiac Valve and Other Major Cardiothoracic Procedures... | 20 | $584,458 | +112% | $59,986 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 20 | $71,596 | +26% | $15,425 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 19 | $490,953 | +112% | $61,051 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 19 | $125,247 | +9% | $23,847 |
| 329 Major Small and Large Bowel Procedures with MCC | 19 | $336,294 | +56% | $47,907 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 19 | $60,004 | +41% | $10,621 |
| 092 Other Disorders of Nervous System with CC | 18 | $70,927 | +38% | $12,356 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 18 | $85,349 | +69% | $12,109 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 18 | $663,214 | +66% | $93,336 |
| 644 Endocrine Disorders with CC | 18 | $62,247 | +30% | $12,255 |
| 071 Other Cerebrovascular Disorders with CC | 17 | $74,029 | +47% | $12,531 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 17 | $49,373 | +25% | $10,198 |
| 388 Gastrointestinal Obstruction with MCC | 17 | $84,594 | +24% | $16,805 |
Showing the 60 most frequent of 107 DRGs.
Outpatient services
Against the California average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Scripps Mercy Hospital charged $124,784 on average, 13% less than the California average of $143,063, and was paid $22,741 against a state average of $23,020. For Heart Failure and Shock with MCC (DRG 291), Scripps Mercy Hospital charged $79,073 on average, 22% less than the California average of $100,739, and was paid $15,218 against a state average of $15,556. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Scripps Mercy Hospital charged $69,090 on average, 9% less than the California average of $76,120, and was paid $12,328 against a state average of $12,552. For Pulmonary Edema and Respiratory Failure (DRG 189), Scripps Mercy Hospital charged $90,705 on average, 13% less than the California average of $104,292, and was paid $14,192 against a state average of $15,897. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $38,858 was 7% below the state average of $41,628. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $34,159 was 132% above the state average of $14,749. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $48,107 was 19% above the state average of $40,544. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $159,638 was 46% above the state average of $109,149.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Scripps Mercy Hospital in San Diego, CA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-05-18 (CMS case 145)
- CAP Request — 2021-10-27 (CMS case 145)
- Closure Notice — 2022-01-28 (CMS case 145)
- Warning Notice — 2025-04-24 (CMS case 4053)
- Closure Notice — 2025-05-09 (CMS case 4053)
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.