Saddleback Memorial Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Saddleback Memorial Medical Center, Laguna Hills, CA in 2024, from traditional Medicare claims. Back to the Saddleback Memorial Medical Center profile, with quality ratings, finances and negotiated rates.
1,525
Medicare inpatient discharges
In 51 published DRGs
1.92
Case mix index
IPPS FY 2027
16%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,719
Medicare outpatient services
In 26 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases346 discharges in 4 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 | 238 | $142,850 | $16,313 | $24,713 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 68 | $79,591 | $7,571 | $13,769 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 27 | $296,341 | $40,031 | $51,267 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 13 | $542,517 | $78,283 | $93,856 | 6.96 |
Circulatory system332 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 137 | $95,834 | $10,708 | $16,579 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 29 | $117,726 | $28,687 | $20,367 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 27 | $164,127 | $15,745 | $28,394 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $127,347 | $13,633 | $22,031 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 21 | $199,255 | $44,070 | $34,471 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 21 | $75,724 | $5,849 | $13,100 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 20 | $82,153 | $10,131 | $14,212 | 1.20 |
| Syncope and collapseMS-DRG 312, medical | 16 | $74,748 | $6,998 | $12,931 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 14 | $227,562 | $26,905 | $39,368 | 2.87 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 12 | $141,719 | $30,530 | $24,517 | 3.35 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 11 | $71,348 | $7,463 | $12,343 | 0.91 |
Respiratory system249 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 67 | $119,831 | $13,613 | $20,731 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 43 | $98,340 | $10,301 | $17,013 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 37 | $118,674 | $9,887 | $20,531 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 27 | $121,916 | $9,089 | $21,091 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 18 | $80,358 | $8,050 | $13,902 | 0.99 |
| Major chest procedures with MCCMS-DRG 163, surgical | 17 | $302,103 | $42,176 | $52,264 | 4.71 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $75,052 | $6,778 | $12,984 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 13 | $152,339 | $20,376 | $26,355 | 2.55 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $94,497 | $7,601 | $16,348 | 0.96 |
Kidney and urinary tract181 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 41 | $60,544 | $6,067 | $10,474 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 39 | $81,850 | $12,358 | $14,160 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 30 | $67,497 | $7,136 | $11,677 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 29 | $109,805 | $12,419 | $18,996 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 28 | $61,721 | $8,971 | $10,678 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 14 | $59,862 | $7,794 | $10,356 | 1.02 |
Digestive system181 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 39 | $73,505 | $8,100 | $12,716 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 37 | $127,834 | $14,753 | $22,115 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 37 | $70,566 | $6,131 | $12,208 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 14 | $200,656 | $20,826 | $34,714 | 2.37 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 14 | $59,789 | $6,995 | $10,344 | 1.04 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 14 | $83,851 | $6,644 | $14,506 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 13 | $85,731 | $11,115 | $14,831 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 13 | $83,803 | $14,111 | $14,498 | 1.62 |
Musculoskeletal system and connective tissue105 discharges in 6 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 | 33 | $111,901 | $17,136 | $19,359 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 19 | $75,160 | $7,494 | $13,003 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 15 | $121,087 | $17,920 | $20,948 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 13 | $178,645 | $30,371 | $30,906 | 3.66 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 13 | $86,585 | $13,461 | $14,979 | 1.59 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 12 | $55,902 | $6,452 | $9,671 | 0.79 |
Nervous system79 discharges in 4 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 | 29 | $85,660 | $7,564 | $14,819 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 24 | $145,626 | $16,176 | $25,193 | 2.00 |
| Seizures with MCCMS-DRG 100, medical | 15 | $216,917 | $16,338 | $37,527 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 11 | $68,125 | $4,889 | $11,786 | 0.69 |
Skin, subcutaneous tissue and breast27 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 27 | $52,499 | $7,046 | $9,082 | 0.88 |
Endocrine, nutritional and metabolic25 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 with MCCMS-DRG 640, medical | 14 | $92,017 | $11,575 | $15,919 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 11 | $48,938 | $5,678 | $8,466 | 0.78 |
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 | 438 | 415 | $41,531 | $2,669 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 221 | 196 | $12,841 | $1,513 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 142 | 142 | $30,513 | $2,837 | $2,208 |
| Level 3 Endovascular ProceduresAPC 5193 | 105 | 90 | $65,392 | $11,870 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 82 | 73 | $25,850 | $3,083 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 79 | 74 | $109,777 | $27,129 | $21,117 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 74 | 73 | $44,851 | $11,474 | $8,569 |
| Level 4 Urology and Related ServicesAPC 5374 | 64 | 55 | $34,715 | $3,414 | $2,629 |
| Level 2 Endovascular ProceduresAPC 5192 | 62 | 56 | $32,198 | $5,599 | $4,338 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 55 | 55 | $77,810 | $14,516 | $10,772 |
| Level 5 Urology and Related ServicesAPC 5375 | 44 | 44 | $37,339 | $4,949 | $3,918 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 42 | 41 | $52,283 | $5,652 | $4,358 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 38 | 37 | $49,508 | $6,388 | $4,982 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 36 | 36 | $24,953 | $2,778 | $2,141 |
| Level 2 Vascular ProceduresAPC 5182 | 26 | 26 | $14,326 | $1,569 | $1,204 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 23 | 23 | $58,608 | $7,160 | $5,339 |
| Level 4 Vascular ProceduresAPC 5184 | 23 | 20 | $48,629 | $5,380 | $3,946 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 22 | 22 | $110,235 | $21,219 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 22 | 22 | $35,794 | $1,659 | $1,264 |
| Level 4 Endovascular ProceduresAPC 5194 | 22 | 20 | $75,411 | $19,871 | $14,606 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 21 | 21 | $77,782 | $10,481 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 17 | 17 | $38,621 | $3,734 | $2,930 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 17 | 17 | $13,769 | $1,574 | $1,196 |
| Level 3 Urology and Related ServicesAPC 5373 | 17 | 14 | $25,797 | $1,995 | $1,516 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 16 | 15 | $43,071 | $3,250 | $2,636 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 11 | 11 | $40,002 | $3,171 | $2,373 |
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.