Palomar Medical Center Escondido Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Palomar Medical Center Escondido, Escondido, CA in 2024, from traditional Medicare claims. Back to the Palomar Medical Center Escondido profile, with quality ratings, finances and negotiated rates.
2,878
Medicare inpatient discharges
In 80 published DRGs
1.75
Case mix index
IPPS FY 2027
18%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,431
Medicare outpatient services
In 24 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases508 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 342 | $176,671 | $15,766 | $25,617 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 90 | $100,072 | $7,316 | $14,510 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 45 | $397,444 | $44,756 | $57,629 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 19 | $474,543 | $59,140 | $68,809 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 12 | $177,119 | $14,400 | $25,682 | 2.04 |
Circulatory system476 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 153 | $105,283 | $8,960 | $15,266 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 51 | $133,097 | $11,754 | $19,299 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 40 | $86,102 | $5,340 | $12,485 | 0.74 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 38 | $171,492 | $16,876 | $24,866 | 3.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 32 | $109,833 | $8,930 | $15,926 | 1.20 |
| Syncope and collapseMS-DRG 312, medical | 32 | $89,093 | $6,560 | $12,918 | 0.86 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 20 | $162,011 | $10,698 | $23,492 | 1.59 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $99,998 | $6,757 | $14,500 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 17 | $240,940 | $22,989 | $34,936 | 2.87 |
| Chest painMS-DRG 313, medical | 16 | $74,764 | $4,936 | $10,841 | 0.72 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 12 | $219,362 | $29,330 | $31,807 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $68,443 | $5,145 | $9,924 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 12 | $161,154 | $16,278 | $23,367 | 2.09 |
| Other vascular procedures with CCMS-DRG 253, surgical | 11 | $223,266 | $19,859 | $32,374 | 2.55 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 11 | $62,764 | $2,315 | $9,101 | 0.55 |
Respiratory system425 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 122 | $126,156 | $9,783 | $18,293 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 121 | $145,166 | $11,572 | $21,049 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 35 | $94,195 | $6,744 | $13,658 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 31 | $137,774 | $8,218 | $19,977 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 31 | $83,706 | $5,900 | $12,137 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $285,097 | $24,640 | $41,339 | 2.70 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 27 | $100,169 | $6,997 | $14,525 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 18 | $146,487 | $12,142 | $21,241 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $118,144 | $6,467 | $17,131 | 0.96 |
Kidney and urinary tract353 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 80 | $98,168 | $7,465 | $14,234 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 78 | $128,082 | $11,749 | $18,572 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 75 | $76,721 | $5,211 | $11,125 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 60 | $77,559 | $6,845 | $11,246 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 38 | $114,320 | $10,103 | $16,576 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 22 | $108,764 | $6,992 | $15,771 | 1.02 |
Musculoskeletal system and connective tissue333 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 63 | $158,564 | $15,117 | $22,992 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 43 | $134,214 | $7,113 | $19,461 | 0.97 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 37 | $186,199 | $23,612 | $26,999 | 4.61 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 36 | $138,521 | $14,924 | $20,086 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 30 | $185,184 | $16,157 | $26,852 | 2.40 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 23 | $117,198 | $13,303 | $16,994 | 1.59 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 21 | $112,914 | $6,754 | $16,372 | 0.90 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 18 | $205,147 | $19,727 | $29,746 | 2.95 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $75,609 | $5,473 | $10,963 | 0.79 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $232,769 | $27,179 | $33,751 | 2.99 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 12 | $108,981 | $11,987 | $15,802 | 1.88 |
| Medical back problems with MCCMS-DRG 551, medical | 12 | $216,521 | $15,536 | $31,396 | 1.70 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $144,728 | $15,650 | $20,986 | 1.87 |
Digestive system267 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 66 | $76,066 | $5,328 | $11,030 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 52 | $88,334 | $6,302 | $12,808 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 29 | $145,941 | $10,907 | $21,161 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 29 | $67,154 | $5,445 | $9,737 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 26 | $87,448 | $9,904 | $12,680 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 24 | $102,915 | $6,942 | $14,923 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 16 | $248,756 | $18,417 | $36,070 | 2.37 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 13 | $122,754 | $11,546 | $17,799 | 1.45 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 12 | $312,755 | $36,577 | $45,350 | 4.52 |
Nervous system224 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 48 | $194,262 | $16,317 | $28,168 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 37 | $115,635 | $7,036 | $16,767 | 1.02 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 25 | $395,457 | $48,786 | $57,341 | 5.67 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 20 | $163,698 | $9,827 | $23,736 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 18 | $352,248 | $26,594 | $51,076 | 4.42 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 17 | $216,593 | $9,853 | $31,406 | 1.32 |
| Seizures with MCCMS-DRG 100, medical | 17 | $203,142 | $16,131 | $29,456 | 1.98 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 16 | $123,877 | $8,260 | $17,962 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 14 | $91,229 | $9,217 | $13,228 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 12 | $115,980 | $14,204 | $16,817 | 1.79 |
Endocrine, nutritional and metabolic133 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 55 | $115,411 | $10,670 | $16,735 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 39 | $73,554 | $5,305 | $10,665 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $105,611 | $10,923 | $15,314 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 18 | $80,370 | $7,343 | $11,654 | 0.90 |
Skin, subcutaneous tissue and breast56 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 39 | $67,263 | $6,929 | $9,753 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 17 | $93,560 | $9,763 | $13,566 | 1.49 |
Alcohol and drug use35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 20 | $113,234 | $7,482 | $16,419 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 15 | $119,768 | $15,645 | $17,366 | 1.78 |
Blood and immune system27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 15 | $121,781 | $7,575 | $17,658 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 12 | $67,161 | $5,267 | $9,738 | 0.90 |
Injuries, poisonings and toxic effects of drugs17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 17 | $140,039 | $11,701 | $20,306 | 1.60 |
Other13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 13 | $408,127 | $44,907 | $59,178 | 4.74 |
Mental diseases and disorders11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 11 | $83,408 | $13,871 | $12,094 | 1.76 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 527 | 505 | $51,028 | $2,017 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 222 | 208 | $88,607 | $8,135 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 59 | 58 | $38,936 | $1,750 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 55 | 54 | $14,123 | $891 | $1,220 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 50 | 47 | $221,938 | $15,390 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 49 | 49 | $33,160 | $2,294 | $2,405 |
| Level 3 Urology and Related ServicesAPC 5373 | 47 | 34 | $21,269 | $1,570 | $1,516 |
| Level 3 Endovascular ProceduresAPC 5193 | 44 | 43 | $86,381 | $7,282 | $8,874 |
| Level 2 Upper GI ProceduresAPC 5302 | 43 | 30 | $12,136 | $1,432 | $1,445 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 42 | 41 | $57,924 | $7,087 | $8,569 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 32 | 32 | $65,761 | $3,179 | $4,358 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 30 | 30 | $18,875 | $1,478 | $2,141 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 30 | 30 | $112,724 | $7,705 | $8,164 |
| Level 5 Urology and Related ServicesAPC 5375 | 29 | 28 | $45,315 | $3,145 | $3,918 |
| Level 4 Vascular ProceduresAPC 5184 | 25 | 24 | $65,426 | $4,952 | $3,946 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 23 | 23 | $76,361 | $4,670 | $5,339 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 21 | 21 | $21,976 | $1,331 | $1,196 |
| Level 4 Airway EndoscopyAPC 5154 | 20 | 19 | $46,816 | $1,467 | $2,833 |
| Level 4 Endovascular ProceduresAPC 5194 | 17 | 16 | $125,491 | $11,681 | $14,606 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 16 | 15 | $40,074 | $1,982 | $2,373 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 14 | 14 | $46,308 | $1,197 | $2,636 |
| Level 3 Airway EndoscopyAPC 5153 | 12 | 11 | $15,293 | $693 | $1,264 |
| Level 2 Vascular ProceduresAPC 5182 | 12 | 12 | $13,084 | $1,438 | $1,204 |
| Level 4 Urology and Related ServicesAPC 5374 | 12 | 11 | $47,968 | $3,130 | $2,629 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.