La Jolla, CA 92037 · CMS Certification Number 050424. 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 | $21,624 | $125,805 | 5.8× | $16,052 |
| Shoulder replacement | $29,182 | $181,357 | 6.2× | $22,673 |
Complications after hip or knee replacement: 2.8% (no different from the national rate). Readmissions: 4.4%. Overall Care Compare rating: 5 of 5 stars. Nonprofit · Acute · 173 beds
California has no certificate-of-need law.
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In 2024 Medicare paid Scripps Green Hospital an average of $21,624 per inpatient hip or knee replacement stay (MS-DRG 470, 475 stays) and $16,052 per outpatient case (APC 5115, 603 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $125,805, 5.8× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
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), $11,229 less than an inpatient stay at Scripps Green Hospital. Not every patient is a surgery-center candidate.
Medicare paid Scripps Green Hospital more than 73% of the 119 California hospitals that report inpatient hip or knee replacement.