Providence St Johns Health Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Providence St Johns Health Center, Santa Monica, CA in 2024, from traditional Medicare claims. Back to the Providence St Johns Health Center profile, with quality ratings, finances and negotiated rates.
3,841
Medicare inpatient discharges
In 100 published DRGs
2.19
Case mix index
IPPS FY 2027
37%
Surgical stays
61%
Stays with complications
In DRGs with a CC or MCC
3,924
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Musculoskeletal system and connective tissue1,006 discharges in 22 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 | 505 | $77,201 | $16,177 | $20,381 | 1.88 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 47 | $122,452 | $31,693 | $32,327 | 3.66 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 43 | $94,868 | $18,078 | $25,045 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 37 | $108,839 | $17,946 | $28,733 | 2.11 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 34 | $74,641 | $16,542 | $19,705 | 1.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 33 | $89,748 | $22,096 | $23,694 | 2.48 |
| Medical back problems without MCCMS-DRG 552, medical | 32 | $46,332 | $7,571 | $12,232 | 0.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 29 | $124,214 | $27,732 | $32,793 | 3.49 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 23 | $58,913 | $12,524 | $15,553 | 1.49 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 23 | $43,324 | $5,727 | $11,438 | 0.79 |
| Back and neck procedures except spinal fusion with MCC or disc device or neurostimulatorMS-DRG 518, surgical | 21 | $108,070 | $29,428 | $28,531 | 3.65 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 20 | $247,934 | $56,269 | $65,454 | 6.12 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 20 | $114,372 | $26,743 | $30,194 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 20 | $69,715 | $15,622 | $18,405 | 2.04 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 19 | $149,838 | $41,915 | $39,557 | 4.61 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 18 | $41,217 | $6,887 | $10,881 | 0.90 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 16 | $98,189 | $23,751 | $25,922 | 2.67 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 15 | $107,874 | $18,593 | $28,479 | 2.46 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 15 | $59,712 | $11,986 | $15,764 | 1.43 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 14 | $123,378 | $24,240 | $32,572 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 11 | $102,782 | $27,431 | $27,134 | 3.33 |
| Medical back problems with MCCMS-DRG 551, medical | 11 | $69,509 | $13,316 | $18,350 | 1.70 |
Infectious and parasitic diseases819 discharges in 7 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 | 598 | $100,141 | $17,515 | $26,437 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 88 | $52,573 | $8,103 | $13,879 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 68 | $226,643 | $46,817 | $59,834 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 30 | $324,590 | $67,436 | $85,692 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 13 | $102,298 | $14,914 | $27,007 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 11 | $119,736 | $20,749 | $31,610 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $44,380 | $8,347 | $11,716 | 1.01 |
Circulatory system624 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 152 | $59,471 | $10,743 | $15,700 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 121 | $109,469 | $27,997 | $28,900 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 52 | $76,613 | $13,657 | $20,226 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 35 | $198,192 | $44,202 | $52,323 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 35 | $38,280 | $6,009 | $10,106 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 32 | $47,108 | $7,226 | $12,437 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 29 | $48,899 | $7,376 | $12,909 | 0.91 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 27 | $57,478 | $10,196 | $15,174 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 21 | $85,220 | $15,022 | $22,498 | 1.82 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 18 | $95,485 | $16,876 | $25,208 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 15 | $49,393 | $9,049 | $13,040 | 1.08 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 15 | $30,779 | $3,734 | $8,126 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 13 | $182,582 | $22,198 | $48,202 | 2.87 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 12 | $100,979 | $27,918 | $26,659 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 12 | $71,273 | $20,227 | $18,816 | 2.28 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $149,993 | $32,535 | $39,598 | 3.90 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $33,763 | $8,175 | $8,913 | 0.97 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 11 | $43,234 | $5,607 | $11,414 | 0.72 |
Respiratory system339 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 107 | $88,689 | $15,135 | $23,414 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 87 | $68,053 | $10,967 | $17,966 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 41 | $57,206 | $10,706 | $15,102 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 21 | $76,190 | $9,238 | $20,114 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 19 | $45,611 | $6,534 | $12,041 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 16 | $63,587 | $8,129 | $16,787 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 13 | $68,856 | $11,345 | $18,178 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $78,032 | $14,389 | $20,600 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $87,698 | $12,855 | $23,152 | 1.55 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 11 | $49,704 | $7,861 | $13,122 | 0.96 |
Digestive system308 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 49 | $54,940 | $7,581 | $14,504 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 49 | $41,515 | $6,263 | $10,960 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 37 | $111,067 | $20,249 | $29,322 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 31 | $268,502 | $48,280 | $70,885 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 27 | $42,611 | $5,779 | $11,249 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 25 | $79,678 | $15,163 | $21,035 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 15 | $79,862 | $14,192 | $21,084 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 14 | $66,943 | $10,469 | $17,673 | 1.28 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 13 | $41,883 | $8,008 | $11,057 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 13 | $56,049 | $12,376 | $14,797 | 1.45 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 12 | $89,419 | $13,896 | $23,607 | 1.67 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 12 | $43,180 | $7,895 | $11,399 | 0.94 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 11 | $106,047 | $20,628 | $27,996 | 2.50 |
Kidney and urinary tract272 discharges in 6 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 | 81 | $68,296 | $14,314 | $18,030 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 51 | $63,663 | $9,934 | $16,807 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 50 | $40,041 | $6,576 | $10,571 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 38 | $72,185 | $13,268 | $19,057 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 38 | $47,927 | $6,846 | $12,653 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 14 | $39,318 | $7,274 | $10,380 | 1.02 |
Nervous system237 discharges in 11 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 | 57 | $54,837 | $7,906 | $14,477 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 49 | $106,886 | $17,140 | $28,218 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 24 | $207,090 | $39,367 | $54,672 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 15 | $40,313 | $7,272 | $10,643 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 14 | $256,415 | $46,621 | $67,694 | 5.67 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $76,943 | $11,283 | $20,313 | 1.47 |
| Seizures with MCCMS-DRG 100, medical | 14 | $99,903 | $18,923 | $26,374 | 1.98 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 13 | $123,946 | $18,170 | $32,722 | 2.43 |
| Seizures without MCCMS-DRG 101, medical | 13 | $56,945 | $7,325 | $15,033 | 0.91 |
| Spinal procedures with CC or spinal neurostimulatorsMS-DRG 029, surgical | 12 | $119,206 | $27,887 | $31,470 | 3.43 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 12 | $41,355 | $5,032 | $10,918 | 0.69 |
Endocrine, nutritional and metabolic89 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 | 34 | $70,497 | $10,595 | $18,611 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 29 | $43,572 | $5,874 | $11,503 | 0.78 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 14 | $102,320 | $18,597 | $27,013 | 2.25 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $88,325 | $11,274 | $23,318 | 1.65 |
Skin, subcutaneous tissue and breast37 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 37 | $41,670 | $6,549 | $11,001 | 0.88 |
Blood and immune system31 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 17 | $53,843 | $7,034 | $14,215 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 14 | $80,178 | $13,598 | $21,167 | 1.56 |
Male reproductive system27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major male pelvic procedures without cc/mccMS-DRG 708, surgical | 14 | $117,772 | $10,545 | $31,092 | 1.46 |
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 13 | $133,559 | $17,149 | $35,260 | 1.96 |
Injuries, poisonings and toxic effects of drugs26 discharges in 2 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 | 13 | $51,175 | $14,209 | $13,510 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $93,375 | $15,609 | $24,651 | 1.82 |
Other14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 14 | $120,024 | $25,268 | $31,686 |
Transplants, ECMO and tracheostomy (pre-MDC)12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 12 | $728,997 | $158,145 | $192,455 | 14.70 |
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 | 504 | 485 | $24,241 | $2,676 | $2,090 |
| Level 3 Urology and Related ServicesAPC 5373 | 336 | 268 | $11,509 | $1,988 | $1,516 |
| Level 2 Urology and Related ServicesAPC 5372 | 306 | 192 | $3,273 | $664 | $502 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 265 | 256 | $68,176 | $14,374 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 258 | 247 | $8,802 | $1,562 | $1,220 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 200 | 192 | $87,169 | $27,352 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 150 | 149 | $18,373 | $2,860 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 138 | 138 | $35,151 | $5,649 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 136 | 123 | $18,329 | $3,364 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 129 | 124 | $26,849 | $5,069 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 127 | 117 | $11,450 | $1,827 | $1,445 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 107 | 104 | $21,705 | $3,734 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 101 | 100 | $34,768 | $6,388 | $4,982 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 97 | 95 | $14,073 | $2,783 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 84 | 76 | $17,718 | $2,936 | $2,405 |
| Level 6 Urology and Related ServicesAPC 5376 | 73 | 72 | $50,677 | $9,548 | $7,291 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 69 | 69 | $41,319 | $7,160 | $5,339 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 66 | 66 | $30,651 | $11,475 | $8,569 |
| Level 3 Endovascular ProceduresAPC 5193 | 64 | 61 | $57,314 | $11,702 | $8,874 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 61 | 61 | $94,978 | $11,005 | $8,164 |
| Level 7 Radiation TherapyAPC 5627 | 57 | 57 | $93,460 | $7,936 | $6,121 |
| Level 5 ENT ProceduresAPC 5165 | 54 | 52 | $29,002 | $5,630 | $4,436 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 48 | 48 | $20,971 | $8,801 | $6,514 |
| Level 2 Vascular ProceduresAPC 5182 | 47 | 46 | $6,791 | $1,564 | $1,204 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 42 | 42 | $82,951 | $20,255 | $15,763 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 39 | 37 | $14,757 | $3,389 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 39 | 39 | $11,630 | $2,984 | $2,389 |
| Level 2 Intraocular ProceduresAPC 5492 | 38 | 37 | $28,863 | $3,980 | $3,116 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 33 | 32 | $11,282 | $1,569 | $1,196 |
| Level 5 Airway EndoscopyAPC 5155 | 33 | 32 | $25,288 | $6,781 | $5,183 |
| Level 4 Endovascular ProceduresAPC 5194 | 28 | 28 | $74,411 | $19,182 | $14,606 |
| Level 4 Airway EndoscopyAPC 5154 | 26 | 24 | $17,487 | $3,668 | $2,833 |
| Level 3 Lower GI ProceduresAPC 5313 | 20 | 20 | $12,010 | $2,793 | $2,176 |
| Level 5 Gynecologic ProceduresAPC 5415 | 20 | 20 | $15,527 | $4,872 | $3,792 |
| Level 2 Endovascular ProceduresAPC 5192 | 15 | 15 | $33,536 | $5,599 | $4,338 |
| Level 4 Vascular ProceduresAPC 5184 | 14 | 14 | $39,139 | $5,375 | $3,946 |
| Level 1 Intraocular ProceduresAPC 5491 | 14 | $5,698 | $2,283 | $1,752 | |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 13 | 12 | $49,651 | $9,943 | $7,546 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 13 | 13 | $19,155 | $3,171 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 13 | 13 | $8,555 | $1,663 | $1,264 |
| Level 4 ENT ProceduresAPC 5164 | 12 | 12 | $16,008 | $3,154 | $2,217 |
| Cochlear Implant ProcedureAPC 5166 | 12 | 12 | $149,369 | $39,462 | $29,489 |
| Level 3 Intraocular ProceduresAPC 5493 | 12 | 11 | $36,235 | $5,120 | $4,004 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 11 | 11 | $90,969 | $38,684 | $29,375 |
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.