Scripps Mercy Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Scripps Mercy Hospital, San Diego, CA in 2024, from traditional Medicare claims. Back to the Scripps Mercy Hospital profile, with quality ratings, finances and negotiated rates.
3,387
Medicare inpatient discharges
In 107 published DRGs
1.93
Case mix index
IPPS FY 2027
20%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,596
Medicare outpatient services
In 29 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases739 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 | 516 | $124,784 | $20,133 | $22,960 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 106 | $69,090 | $10,266 | $12,713 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 83 | $328,226 | $50,254 | $60,394 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 17 | $178,952 | $20,204 | $32,927 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $540,943 | $72,798 | $99,534 | 6.96 |
Circulatory system687 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 197 | $79,073 | $13,059 | $14,549 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 65 | $87,872 | $16,553 | $16,169 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 47 | $356,458 | $52,379 | $65,588 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 38 | $234,270 | $33,743 | $43,106 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 37 | $56,808 | $8,902 | $10,453 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 34 | $54,631 | $6,929 | $10,052 | 0.74 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 29 | $72,508 | $10,933 | $13,342 | 1.07 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $203,737 | $33,782 | $37,488 | 3.35 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 22 | $64,604 | $8,800 | $11,887 | 0.91 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 20 | $584,458 | $58,065 | $107,540 | 5.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 20 | $71,596 | $12,317 | $13,174 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 19 | $125,247 | $16,925 | $23,045 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 18 | $663,215 | $73,994 | $122,031 | 7.71 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 15 | $215,887 | $22,968 | $39,723 | 2.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 15 | $590,779 | $74,004 | $108,703 | 6.25 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 14 | $127,778 | $21,824 | $23,511 | 2.09 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 13 | $172,381 | $35,283 | $31,718 | 3.46 |
| Other vascular procedures with CCMS-DRG 253, surgical | 13 | $248,484 | $25,151 | $45,721 | 2.55 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 13 | $98,260 | $16,698 | $18,080 | 1.58 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 12 | $286,751 | $54,430 | $52,762 | 5.04 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 12 | $183,002 | $27,236 | $33,672 | 2.87 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $148,250 | $36,033 | $27,278 | 3.27 |
Nervous system365 discharges in 16 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 | 50 | $83,042 | $10,159 | $15,280 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 47 | $154,458 | $20,635 | $28,420 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 39 | $68,582 | $13,323 | $12,619 | 1.36 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 36 | $94,733 | $17,001 | $17,431 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 29 | $122,049 | $22,502 | $22,457 | 2.39 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 19 | $490,953 | $50,255 | $90,335 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 18 | $70,927 | $9,396 | $13,051 | 1.03 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 17 | $74,029 | $10,794 | $13,621 | 1.06 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 16 | $204,718 | $25,509 | $37,668 | 2.28 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 15 | $60,963 | $10,695 | $11,217 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 15 | $70,905 | $9,345 | $13,047 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 14 | $121,453 | $17,301 | $22,347 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 14 | $151,958 | $20,153 | $27,960 | 1.98 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 13 | $433,126 | $57,152 | $79,695 | 5.67 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 12 | $86,062 | $12,232 | $15,835 | 1.32 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 11 | $141,804 | $14,281 | $26,092 | 1.36 |
Respiratory system337 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 86 | $90,705 | $12,828 | $16,690 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 72 | $87,602 | $17,153 | $16,119 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 35 | $72,648 | $13,235 | $13,367 | 1.33 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 26 | $177,571 | $29,123 | $32,673 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 22 | $111,992 | $13,985 | $20,606 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 22 | $52,786 | $7,846 | $9,713 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 18 | $85,349 | $10,577 | $15,704 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $49,373 | $8,625 | $9,085 | 0.85 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 15 | $68,735 | $10,121 | $12,647 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $158,133 | $15,985 | $29,096 | 1.74 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 11 | $66,522 | $10,139 | $12,240 | 0.96 |
Musculoskeletal system and connective tissue318 discharges in 13 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 | 85 | $165,226 | $19,250 | $30,402 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 41 | $194,664 | $21,362 | $35,818 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 33 | $67,926 | $9,059 | $12,498 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 29 | $228,078 | $30,281 | $41,966 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 22 | $191,427 | $20,220 | $35,222 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $60,004 | $8,670 | $11,041 | 0.90 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 14 | $57,526 | $15,450 | $10,585 | 1.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 14 | $49,665 | $9,949 | $9,138 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $75,709 | $15,809 | $13,930 | 1.70 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 13 | $271,547 | $35,368 | $49,965 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 12 | $183,942 | $19,639 | $33,845 | 1.87 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 11 | $195,788 | $24,671 | $36,025 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 11 | $217,906 | $31,073 | $40,095 | 2.99 |
Digestive system299 discharges in 11 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 | 51 | $54,333 | $7,421 | $9,997 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 49 | $67,178 | $9,589 | $12,361 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 41 | $94,253 | $16,997 | $17,343 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $54,334 | $7,471 | $9,997 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 24 | $123,822 | $17,617 | $22,783 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 23 | $52,449 | $12,999 | $9,651 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 21 | $54,655 | $9,685 | $10,057 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 19 | $336,294 | $45,503 | $61,878 | 4.52 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 17 | $84,594 | $15,237 | $15,565 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 11 | $72,321 | $11,344 | $13,307 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 11 | $41,672 | $5,181 | $7,668 | 0.56 |
Kidney and urinary tract217 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 | 47 | $82,452 | $17,248 | $15,171 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 44 | $62,584 | $9,075 | $11,515 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 41 | $74,453 | $14,444 | $13,699 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 35 | $51,686 | $7,988 | $9,510 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 29 | $57,114 | $10,899 | $10,509 | 1.02 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 21 | $60,530 | $11,715 | $11,137 | 1.17 |
Endocrine, nutritional and metabolic180 discharges in 8 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 | 46 | $78,554 | $13,056 | $14,454 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 30 | $49,801 | $7,369 | $9,163 | 0.78 |
| Endocrine disorders with MCCMS-DRG 643, medical | 25 | $106,928 | $16,231 | $19,675 | 1.65 |
| Diabetes with CCMS-DRG 638, medical | 22 | $66,693 | $9,293 | $12,272 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 18 | $62,247 | $10,627 | $11,453 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 16 | $70,551 | $14,037 | $12,981 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $115,097 | $17,915 | $21,178 | 1.98 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 11 | $166,041 | $21,410 | $30,551 | 2.26 |
Liver, gallbladder and pancreas54 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 14 | $174,475 | $17,254 | $32,103 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 14 | $149,195 | $21,247 | $27,452 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $187,301 | $17,801 | $34,463 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 13 | $58,195 | $8,451 | $10,708 | 0.86 |
Skin, subcutaneous tissue and breast44 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 44 | $43,864 | $7,744 | $8,071 | 0.88 |
Mental diseases and disorders44 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 31 | $109,647 | $15,559 | $20,175 | 1.76 |
| PsychosesMS-DRG 885, medical | 13 | $80,573 | $13,504 | $14,825 | 1.37 |
Alcohol and drug use31 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 with MCCMS-DRG 896, medical | 16 | $88,394 | $18,578 | $16,265 | 1.78 |
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 15 | $71,870 | $9,148 | $13,224 | 0.86 |
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 | 14 | $121,788 | $14,924 | $22,409 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 12 | $175,778 | $19,626 | $32,343 | 1.82 |
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 | $269,697 | $48,458 | $49,624 | 4.74 |
Ear, nose, mouth and throat11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 11 | $53,974 | $7,197 | $9,931 | 0.74 |
Male reproductive system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 11 | $123,062 | $15,390 | $22,643 | 1.45 |
Blood and immune system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 11 | $107,187 | $15,144 | $19,722 | 1.56 |
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 | 266 | 264 | $38,858 | $2,671 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 122 | 120 | $34,159 | $1,574 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 117 | 117 | $48,107 | $2,877 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 86 | 85 | $159,638 | $14,347 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 83 | 82 | $47,275 | $3,122 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 82 | 82 | $108,895 | $5,583 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 61 | 55 | $15,859 | $1,845 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 59 | 59 | $286,345 | $27,482 | $21,117 |
| Level 1 Intraocular ProceduresAPC 5491 | 55 | 43 | $45,347 | $2,275 | $1,752 |
| Level 4 Vascular ProceduresAPC 5184 | 54 | 51 | $75,555 | $5,333 | $3,946 |
| Level 4 Urology and Related ServicesAPC 5374 | 52 | 50 | $44,345 | $3,348 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 51 | 48 | $64,064 | $4,964 | $3,918 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 50 | 49 | $88,697 | $11,471 | $8,569 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 48 | 48 | $179,645 | $11,005 | $8,164 |
| Level 3 Endovascular ProceduresAPC 5193 | 46 | 43 | $96,705 | $11,859 | $8,874 |
| Level 3 Urology and Related ServicesAPC 5373 | 46 | 40 | $40,995 | $1,994 | $1,516 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 42 | 42 | $106,966 | $7,149 | $5,339 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 38 | 37 | $45,803 | $2,710 | $2,141 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 34 | 34 | $57,186 | $6,388 | $4,982 |
| Level 6 Urology and Related ServicesAPC 5376 | 34 | 34 | $110,549 | $9,681 | $7,291 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 29 | 29 | $60,305 | $3,170 | $2,373 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 26 | 22 | $41,442 | $3,389 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 24 | 23 | $32,153 | $1,574 | $1,196 |
| Level 2 Vascular ProceduresAPC 5182 | 20 | 20 | $26,178 | $1,567 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 20 | 20 | $211,216 | $38,676 | $29,375 |
| Level 4 Gynecologic ProceduresAPC 5414 | 14 | 14 | $36,216 | $3,041 | $2,389 |
| Level 3 Upper GI ProceduresAPC 5303 | 13 | 13 | $29,836 | $3,749 | $2,888 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 12 | 11 | $42,900 | $3,734 | $2,930 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 12 | 12 | $219,519 | $22,259 | $17,052 |
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.