Grossmont Hospital
Grossmont Hospital in La Mesa, CA charges 7.9x the Medicare reimbursement rate on average, with 17% of procedures showing particularly high markup ratios.
La Mesa, CA 91942 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — government
Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.
Pricing grade
D
High
Avg markup vs Medicare
7.89x
Charge / Medicare rate
Max markup
13.58x
Worst procedure
Procedures analyzed
138
With pricing data
Outlier procedures
16.7%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $173,644 | $86,822 | — | 13.6x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $53,343 | $26,672 | — | 12x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $118,180 | $59,090 | — | 11.4x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $76,364 | $38,182 | — | 10.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $82,107 | $41,054 | — | 10.4x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $228,544 | $114,272 | — | 10.2x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $190,369 | $95,184 | — | 10.2x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | 417 | $204,832 | $102,416 | — | 10.2x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | 093 | $60,987 | $30,494 | — | 10.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $220,066 | $110,033 | — | 10.1x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $161,705 | $80,852 | — | 10.1x |
| ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WIT | 062 | $166,131 | $83,065 | — | 10x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $54,284 | $27,142 | — | 10x |
| DIABETES WITH CC | 638 | $69,323 | $34,662 | — | 10x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $82,326 | $41,163 | — | 9.8x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $378,227 | $189,113 | — | 9.8x |
| SEIZURES WITHOUT MCC | 101 | $69,243 | $34,622 | — | 9.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $36,481 | $18,240 | — | 9.6x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $115,374 | $57,687 | — | 9.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $129,945 | $64,973 | — | 9.5x |
| DIABETES WITH MCC | 637 | $114,907 | $57,454 | — | 9.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $134,971 | $67,485 | — | 9.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $233,134 | $116,567 | — | 9.3x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $124,949 | $62,475 | — | 9.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $64,635 | $32,317 | — | 9.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $173,992 | $86,996 | — | 9.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $120,593 | $60,296 | — | 9.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $74,980 | $37,490 | — | 9x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | 419 | $97,866 | $48,933 | — | 8.9x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $58,518 | $29,259 | — | 8.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $54,106 | $27,053 | — | 8.8x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $56,563 | $28,281 | — | 8.8x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $210,719 | $105,360 | — | 8.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $142,805 | $71,402 | — | 8.8x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | 918 | $58,881 | $29,440 | — | 8.7x |
| DYSEQUILIBRIUM | 149 | $48,908 | $24,454 | — | 8.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $111,558 | $55,779 | — | 8.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $150,698 | $75,349 | — | 8.7x |
| INTERSTITIAL LUNG DISEASE WITH MCC | 196 | $135,679 | $67,839 | — | 8.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $91,398 | $45,699 | — | 8.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | 195 | $45,072 | $22,536 | — | 8.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $160,648 | $80,324 | — | 8.6x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $55,400 | $27,700 | — | 8.6x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $104,225 | $52,113 | — | 8.6x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $54,368 | $27,184 | — | 8.6x |
| SEIZURES WITH MCC | 100 | $175,296 | $87,648 | — | 8.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $86,355 | $43,177 | — | 8.4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $57,258 | $28,629 | — | 8.4x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $185,022 | $92,511 | — | 8.4x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $112,015 | $56,008 | — | 8.3x |
Showing 50 of 138 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use