Santa Monica Hospital - Ucla Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Santa Monica Hospital - Ucla, Santa Monica, CA in 2024, from traditional Medicare claims. Back to the Santa Monica Hospital - Ucla profile, with quality ratings, finances and negotiated rates.
3,245
Medicare inpatient discharges
In 99 published DRGs
2.33
Case mix index
IPPS FY 2027
18%
Surgical stays
77%
Stays with complications
In DRGs with a CC or MCC
4,863
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases648 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 | 473 | $145,259 | $26,106 | $40,527 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 66 | $59,097 | $10,367 | $16,488 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 61 | $360,608 | $84,869 | $100,610 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 48 | $408,079 | $88,225 | $113,854 | 5.00 |
Musculoskeletal system and connective tissue506 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 82 | $201,117 | $38,761 | $56,112 | 3.49 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 82 | $116,741 | $20,683 | $32,571 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 35 | $100,158 | $20,956 | $27,944 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 33 | $127,357 | $22,764 | $35,533 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 27 | $167,159 | $28,837 | $46,637 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 25 | $149,590 | $32,960 | $41,736 | 2.99 |
| Medical back problems without MCCMS-DRG 552, medical | 23 | $67,518 | $9,934 | $18,838 | 0.97 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 22 | $200,379 | $36,573 | $55,906 | 3.00 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 21 | $166,491 | $23,722 | $46,451 | 1.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 20 | $79,448 | $12,708 | $22,166 | 1.09 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 19 | $320,893 | $63,554 | $89,529 | 5.19 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 19 | $173,859 | $32,148 | $48,507 | 2.96 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 17 | $130,796 | $25,671 | $36,492 | 2.48 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 16 | $165,719 | $33,191 | $46,236 | 3.33 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $193,050 | $41,218 | $53,861 | 3.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 14 | $44,169 | $7,984 | $12,323 | 0.90 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 13 | $309,380 | $62,943 | $86,317 | 6.12 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 13 | $99,821 | $19,407 | $27,850 | 1.97 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 11 | $71,925 | $8,752 | $20,067 | 0.82 |
Digestive system387 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 44 | $89,532 | $14,663 | $24,979 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 42 | $118,186 | $21,678 | $32,974 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 38 | $106,166 | $18,294 | $29,620 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 37 | $49,673 | $7,274 | $13,859 | 0.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 33 | $296,297 | $62,975 | $82,667 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 30 | $56,517 | $7,836 | $15,768 | 0.80 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 26 | $62,319 | $9,947 | $17,387 | 0.98 |
| Digestive malignancy with MCCMS-DRG 374, medical | 24 | $138,051 | $27,017 | $38,516 | 2.10 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 22 | $100,635 | $13,572 | $28,077 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 21 | $127,882 | $25,213 | $35,679 | 2.37 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 16 | $132,999 | $16,836 | $37,107 | 1.45 |
| Digestive malignancy with CCMS-DRG 375, medical | 15 | $95,577 | $15,603 | $26,666 | 1.20 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 13 | $123,113 | $22,955 | $34,348 | 2.11 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 13 | $114,267 | $18,426 | $31,881 | 1.72 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 13 | $68,640 | $10,732 | $19,151 | 1.04 |
Circulatory system338 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 168 | $108,691 | $16,666 | $30,325 | 1.28 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 57 | $162,422 | $28,546 | $45,316 | 2.09 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 25 | $146,920 | $21,508 | $40,991 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 23 | $57,886 | $9,106 | $16,150 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 19 | $96,514 | $16,958 | $26,927 | 1.58 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 17 | $79,177 | $12,067 | $22,090 | 1.20 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 16 | $71,755 | $7,370 | $20,020 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 13 | $114,742 | $21,975 | $32,013 | 2.16 |
Respiratory system334 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 106 | $102,145 | $17,916 | $28,499 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 43 | $108,486 | $15,495 | $30,268 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 42 | $77,828 | $13,940 | $21,714 | 1.33 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 31 | $140,737 | $20,807 | $39,266 | 1.74 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 20 | $110,819 | $15,142 | $30,919 | 1.40 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 17 | $206,593 | $33,910 | $57,639 | 1.90 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 16 | $97,436 | $10,661 | $27,185 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 14 | $95,970 | $11,688 | $26,776 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 12 | $107,713 | $27,662 | $30,052 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 11 | $140,048 | $46,964 | $39,073 | 4.71 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 11 | $62,454 | $7,980 | $17,425 | 0.85 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 11 | $296,772 | $69,950 | $82,799 | 6.91 |
Kidney and urinary tract273 discharges in 7 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 | 75 | $115,628 | $19,354 | $32,260 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 49 | $70,038 | $9,114 | $19,541 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 42 | $61,111 | $11,555 | $17,050 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 39 | $112,079 | $16,416 | $31,270 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 31 | $47,098 | $7,862 | $13,140 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 26 | $80,120 | $11,450 | $22,354 | 1.02 |
| Major bladder procedures with CCMS-DRG 654, surgical | 11 | $189,870 | $25,480 | $52,974 | 2.74 |
Nervous system186 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 61 | $62,373 | $14,004 | $17,402 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 26 | $162,781 | $25,408 | $45,416 | 2.00 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 26 | $116,297 | $19,923 | $32,447 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $231,401 | $47,072 | $64,561 | 2.39 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 16 | $86,837 | $9,434 | $24,227 | 1.02 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 16 | $72,742 | $10,515 | $20,295 | 1.03 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $182,157 | $24,068 | $50,822 | 1.51 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $106,571 | $10,836 | $29,733 | 1.03 |
Blood cancers and poorly differentiated neoplasms153 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 60 | $69,760 | $13,645 | $19,463 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 35 | $148,497 | $35,707 | $41,431 | 2.44 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 34 | $250,291 | $51,843 | $69,831 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 12 | $101,508 | $15,797 | $28,321 | 1.57 |
| Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mcMS-DRG 843, medical | 12 | $182,622 | $27,023 | $50,951 | 1.86 |
Endocrine, nutritional and metabolic131 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 | 53 | $90,362 | $16,622 | $25,211 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 40 | $55,858 | $7,392 | $15,584 | 0.78 |
| Endocrine disorders with MCCMS-DRG 643, medical | 22 | $90,895 | $16,465 | $25,360 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $68,693 | $11,257 | $19,165 | 1.06 |
Liver, gallbladder and pancreas84 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 29 | $122,352 | $21,239 | $34,136 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 15 | $58,520 | $11,586 | $16,327 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 14 | $255,201 | $37,751 | $71,201 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $86,543 | $16,389 | $24,146 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 12 | $91,959 | $18,149 | $25,657 | 1.83 |
Blood and immune system66 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 20 | $96,157 | $16,965 | $26,828 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 19 | $57,905 | $8,981 | $16,155 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 15 | $121,956 | $25,198 | $34,026 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 12 | $103,946 | $25,152 | $29,001 | 2.19 |
Skin, subcutaneous tissue and breast62 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 30 | $50,510 | $8,573 | $14,092 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 20 | $75,505 | $16,065 | $21,066 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 12 | $45,349 | $9,352 | $12,652 | 0.91 |
Injuries, poisonings and toxic effects of drugs30 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $84,520 | $20,009 | $23,581 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $64,387 | $11,123 | $17,964 | 1.03 |
Transplants, ECMO and tracheostomy (pre-MDC)25 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 25 | $2,137,236 | $552,071 | $596,289 | 36.84 |
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 | $63,405 | $18,211 | $17,690 | 1.76 |
Other11 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 | 11 | $278,797 | $69,411 | $77,784 | 4.74 |
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 | 702 | 638 | $27,676 | $2,662 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 346 | 332 | $72,584 | $14,105 | $10,772 |
| Level 1 Nerve ProceduresAPC 5431 | 296 | 256 | $8,203 | $1,885 | $1,407 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 266 | 251 | $10,915 | $1,573 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 238 | 229 | $35,995 | $5,014 | $3,918 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 185 | 178 | $34,567 | $5,529 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 183 | 180 | $36,905 | $7,051 | $5,339 |
| Level 3 Vascular ProceduresAPC 5183 | 162 | 158 | $24,154 | $3,122 | $2,405 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 159 | 155 | $24,496 | $3,336 | $2,636 |
| Level 5 ENT ProceduresAPC 5165 | 154 | 152 | $36,737 | $5,736 | $4,436 |
| Level 2 Upper GI ProceduresAPC 5302 | 153 | 144 | $9,923 | $1,844 | $1,445 |
| Level 3 Endovascular ProceduresAPC 5193 | 151 | 129 | $58,992 | $11,634 | $8,874 |
| Level 4 Airway EndoscopyAPC 5154 | 141 | 124 | $25,198 | $3,579 | $2,833 |
| Level 1 Endovascular ProceduresAPC 5191 | 133 | 132 | $23,269 | $2,760 | $2,208 |
| Level 5 Airway EndoscopyAPC 5155 | 132 | 123 | $34,164 | $6,678 | $5,183 |
| Level 4 ENT ProceduresAPC 5164 | 129 | 127 | $13,576 | $3,153 | $2,217 |
| Level 4 Urology and Related ServicesAPC 5374 | 105 | 81 | $22,100 | $3,415 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 100 | 91 | $48,372 | $10,902 | $8,164 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 96 | 95 | $18,885 | $2,781 | $2,141 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 82 | 82 | $83,926 | $20,702 | $15,763 |
| Level 3 Urology and Related ServicesAPC 5373 | 75 | 49 | $19,865 | $1,993 | $1,516 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 73 | 70 | $10,200 | $1,553 | $1,196 |
| Level 3 Lower GI ProceduresAPC 5313 | 69 | 69 | $10,519 | $2,775 | $2,176 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 54 | 50 | $20,082 | $3,734 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 54 | 52 | $21,796 | $3,166 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 52 | 51 | $10,657 | $1,615 | $1,264 |
| Level 4 Vascular ProceduresAPC 5184 | 50 | 47 | $71,480 | $5,164 | $3,946 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 49 | 49 | $40,536 | $6,388 | $4,982 |
| Level 4 Endovascular ProceduresAPC 5194 | 44 | 42 | $64,701 | $19,871 | $14,606 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 43 | 41 | $30,873 | $6,775 | $4,524 |
| Level 2 Endovascular ProceduresAPC 5192 | 40 | 37 | $35,085 | $5,599 | $4,338 |
| Level 6 Urology and Related ServicesAPC 5376 | 40 | 37 | $57,567 | $9,681 | $7,291 |
| Level 8 Urology and Related ServicesAPC 5378 | 38 | 35 | $75,304 | $22,796 | $17,428 |
| Level 4 Gynecologic ProceduresAPC 5414 | 34 | 33 | $17,106 | $3,062 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 33 | 33 | $17,692 | $1,496 | $1,204 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 33 | 33 | $117,185 | $36,422 | $26,719 |
| Level 3 Upper GI ProceduresAPC 5303 | 32 | 32 | $18,941 | $3,751 | $2,888 |
| Complex GI ProceduresAPC 5331 | 32 | 29 | $28,796 | $5,583 | $4,263 |
| Level 7 Radiation TherapyAPC 5627 | 24 | 21 | $42,698 | $7,936 | $6,121 |
| Level 6 Gynecologic ProceduresAPC 5416 | 22 | 22 | $37,928 | $7,653 | $5,836 |
| Level 5 Gynecologic ProceduresAPC 5415 | 21 | 21 | $25,570 | $4,872 | $3,792 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 14 | 14 | $22,383 | $3,333 | $2,547 |
| Level 1 Intraocular ProceduresAPC 5491 | 13 | $11,353 | $2,283 | $1,752 | |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 11 | 11 | $78,781 | $25,186 | $18,465 |
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.