San Diego, CA 92103 · CMS Certification Number 050077. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $21,958 | $165,226 | 7.5× | $15,979 |
| Shoulder replacement | — | — | — | — |
| Hip replacement after a fracture (DRG 522) | $27,194 | $191,427 | 7.0× | — |
Complications after hip or knee replacement: 3.4% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 700 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Scripps Mercy Hospital an average of $21,958 per inpatient hip or knee replacement stay (MS-DRG 470, 85 stays) and $15,979 per outpatient case (APC 5115, 86 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $165,226, 7.5× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Scripps Mercy Surgery Pavilion, an orthopedic surgery center same ZIP away, is paid about $10,395 by Medicare for a knee replacement (CPT 27447), $11,563 less than an inpatient stay at Scripps Mercy Hospital. Not every patient is a surgery-center candidate.
Medicare paid Scripps Mercy Hospital more than 75% of the 119 California hospitals that report inpatient hip or knee replacement.