Palomar Medical Center Poway Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Palomar Medical Center Poway, Poway, CA in 2024, from traditional Medicare claims. Back to the Palomar Medical Center Poway profile, with quality ratings, finances and negotiated rates.
847
Medicare inpatient discharges
In 30 published DRGs
1.49
Case mix index
IPPS FY 2027
2%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
870
Medicare outpatient services
In 20 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases232 discharges in 3 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 | 189 | $160,548 | $15,347 | $23,922 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 27 | $102,816 | $7,021 | $15,320 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 16 | $368,028 | $40,995 | $54,836 | 6.96 |
Respiratory system185 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 60 | $134,013 | $11,333 | $19,968 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 57 | $119,269 | $8,768 | $17,771 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 18 | $88,895 | $5,060 | $13,245 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 14 | $137,029 | $9,833 | $20,417 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 13 | $128,554 | $5,554 | $19,155 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 12 | $87,926 | $5,061 | $13,101 | 0.99 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 11 | $381,630 | $53,935 | $56,863 | 6.91 |
Kidney and urinary tract126 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 34 | $142,897 | $12,367 | $21,292 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 32 | $72,902 | $4,672 | $10,862 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 25 | $92,580 | $9,180 | $13,794 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 22 | $73,376 | $6,373 | $10,933 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 13 | $160,585 | $13,667 | $23,927 | 1.50 |
Digestive system89 discharges in 5 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 | 25 | $74,237 | $4,316 | $11,061 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 24 | $101,727 | $7,179 | $15,157 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 16 | $82,296 | $5,371 | $12,262 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 12 | $142,166 | $14,328 | $21,183 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 12 | $102,068 | $9,938 | $15,208 | 1.28 |
Circulatory system87 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 76 | $90,702 | $7,797 | $13,515 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 11 | $64,265 | $4,373 | $9,575 | 0.74 |
Nervous system35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 18 | $122,778 | $7,016 | $18,294 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 17 | $133,375 | $15,279 | $19,873 | 2.00 |
Endocrine, nutritional and metabolic34 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 18 | $81,180 | $4,708 | $12,096 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 16 | $117,809 | $8,986 | $17,554 | 1.32 |
Musculoskeletal system and connective tissue32 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 16 | $104,859 | $9,701 | $15,624 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 16 | $84,014 | $7,316 | $12,518 | 0.97 |
Mental diseases and disorders14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 14 | $91,167 | $10,914 | $13,584 | 1.37 |
Factors influencing health status13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 13 | $44,375 | $5,302 | $6,612 | 0.59 |
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 | 249 | 239 | $45,957 | $2,202 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 133 | 127 | $68,451 | $9,710 | $10,772 |
| Level 1 Intraocular ProceduresAPC 5491 | 73 | 53 | $22,660 | $1,814 | $1,752 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 57 | 56 | $51,605 | $3,963 | $4,358 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 42 | 42 | $87,516 | $14,146 | $15,763 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 40 | 38 | $13,744 | $831 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 40 | 39 | $38,854 | $2,904 | $3,918 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 34 | 28 | $34,089 | $2,390 | $2,636 |
| Level 4 Urology and Related ServicesAPC 5374 | 31 | 28 | $31,798 | $1,873 | $2,629 |
| Level 3 Urology and Related ServicesAPC 5373 | 28 | 21 | $14,565 | $1,419 | $1,516 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 20 | 20 | $52,493 | $5,370 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 19 | 19 | $30,499 | $2,503 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 17 | $5,375 | $1,663 | $1,264 | |
| Level 4 Vascular ProceduresAPC 5184 | 15 | 15 | $68,530 | $5,024 | $3,946 |
| Level 3 Vascular ProceduresAPC 5183 | 14 | 14 | $38,265 | $2,318 | $2,405 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 13 | 13 | $90,815 | $9,312 | $8,164 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 12 | 12 | $85,838 | $4,259 | $4,982 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 11 | 11 | $29,141 | $1,271 | $1,196 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 11 | 11 | $58,050 | $7,502 | $8,569 |
| Level 2 Upper GI ProceduresAPC 5302 | 11 | 11 | $14,142 | $1,529 | $1,445 |
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.