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Scripps Memorial Hospital La Jolla: what a joint replacement costs

La Jolla, CA 92037 · CMS Certification Number 050324. 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.

Surgery center nearby
$10,395
Outpatient Surgery Center of La Jolla, same ZIP
Outpatient here
$16,028
Medicare allowed amount, 121 cases, APC 5115
Inpatient here
$18,571
Avg total payment (incl. patient share), 63 Medicare stays, MS-DRG 470

Medicare prices at Scripps Memorial Hospital La Jolla

OperationInpatient avg total payment
Medicare + patient share
List priceList ÷ totalOutpatient Medicare allowed
Hip or knee replacement$18,571$160,3848.6×$16,028
Shoulder replacement———$22,851
Hip replacement after a fracture (DRG 522)$22,533$163,8907.3×—

Commercial negotiated rates (beta)

MS-DRG 470Median across insurers× Medicare total paymentLowest–highest insurerInsurers
Hip or knee replacement$27,0051.5×$18,726–$44,26215
InsurerMedian negotiated, MS-DRG 470× Medicare total paymentPlans
Ucsd$44,2622.4×1
Prospect Med Group$32,7701.8×1
Prime Healthcare$31,8341.7×1
UnitedHealthcare$30,5871.6×1
Cigna$27,9561.5×1
Elevance/Anthem/Empire$27,6011.5×1
HealthPartners$27,6011.5×1
Centivo$27,0051.5×1
Aetna$22,4301.2×1
Mpmg$22,2021.2×1
Blue Shield of California$18,7261.0×1
Health Net$18,7261.0×1
Mc Alignment$18,7261.0×1
Mc Health Net$18,7261.0×1
Mc Scan$18,7261.0×1

From the hospital's price-transparency file (2026-03-30); commercial plans, dollar-amount contracts only.

From the hospital's price-transparency file (2026-03-30); commercial plans, dollar-amount contracts only.

Quality

Complications after hip or knee replacement: 3.3% (no different from the national rate). Readmissions: 5.2%. Overall Care Compare rating: 5 of 5 stars. Physician-owned · Acute · 332 beds

California has no certificate-of-need law.

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Questions

How much does Medicare pay Scripps Memorial Hospital La Jolla for a knee or hip replacement?

In 2024 the average total payment to Scripps Memorial Hospital La Jolla for an inpatient hip or knee replacement stay was $18,571 (MS-DRG 470, 63 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $16,028 per outpatient case (APC 5115, 121 cases).

What is Scripps Memorial Hospital La Jolla's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $160,384, 8.6× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

Is a knee replacement cheaper at a surgery center near Scripps Memorial Hospital La Jolla?

Yes for Medicare facility payments. Outpatient Surgery Center of La Jolla, an orthopedic surgery center same ZIP away, is paid about $10,395 by Medicare for a knee replacement (CPT 27447), $8,176 less than an inpatient stay at Scripps Memorial Hospital La Jolla. Not every patient is a surgery-center candidate.

How does Scripps Memorial Hospital La Jolla compare with other California hospitals?

Scripps Memorial Hospital La Jolla's average total payment per Medicare stay is lower than 78% of the 119 California hospitals that report inpatient hip or knee replacement.

What do commercial insurers pay Scripps Memorial Hospital La Jolla for a hip or knee replacement?

From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $27,005 across 15 insurers, ranging from $18,726 to $44,262.