L a Downtown Medical Center
L A Downtown Medical Center in Los Angeles charges 3.6x the Medicare reimbursement rate across 19 analyzed procedures at this for-profit facility.
Los Angeles, CA 90026 · Acute Care Hospitals · CMS Rating: 2/5
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 — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
C
Average
Avg markup vs Medicare
3.58x
Charge / Medicare rate
Max markup
5.28x
Worst procedure
Procedures analyzed
19
With pricing data
Outlier procedures
0%
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 |
|---|---|---|---|---|---|
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $183,738 | $91,869 | — | 5.3x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $41,841 | $20,921 | — | 4.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $27,944 | $13,972 | — | 4.8x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $26,044 | $13,022 | — | 4.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $33,557 | $16,779 | — | 4.1x |
| CELLULITIS WITHOUT MCC | 603 | $27,615 | $13,807 | — | 3.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $38,883 | $19,441 | — | 3.8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $37,328 | $18,664 | — | 3.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $58,975 | $29,487 | — | 3.6x |
| RENAL FAILURE WITH CC | 683 | $26,275 | $13,137 | — | 3.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $31,131 | $15,565 | — | 3.4x |
| PSYCHOSES | 885 | $36,325 | $18,162 | — | 3.4x |
| DIABETES WITH CC | 638 | $23,912 | $11,956 | — | 3.3x |
| CELLULITIS WITH MCC | 602 | $35,657 | $17,828 | — | 3x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $24,621 | $12,311 | — | 2.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $29,264 | $14,632 | — | 2.8x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $30,720 | $15,360 | — | 2.5x |
| RENAL FAILURE WITH MCC | 682 | $29,631 | $14,815 | — | 2.5x |
| DIABETES WITH MCC | 637 | $27,948 | $13,974 | — | 2.3x |
How L A DOWNTOWN MEDICAL CENTER compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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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.
FAQ — for-profit hospital billing
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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