Memorialcare Saddleback Medical Center
MemorialCare Saddleback Medical Center in Laguna Hills, CA charges 9.6x the Medicare reimbursement rate across 55 analyzed procedures, with 31% showing significant price variations.
Laguna Hills, CA 92653 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
F
Very high
Avg markup vs Medicare
9.56x
Charge / Medicare rate
Max markup
16.09x
Worst procedure
Procedures analyzed
55
With pricing data
Outlier procedures
30.9%
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 |
|---|---|---|---|---|---|
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $84,621 | $42,311 | — | 16.1x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $120,533 | $60,267 | — | 14.4x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $73,422 | $36,711 | — | 13.2x |
| SEIZURES WITHOUT MCC | 101 | $90,131 | $45,066 | — | 13.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $69,079 | $34,540 | — | 13x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $61,197 | $30,599 | — | 12.6x |
| DIABETES WITH CC | 638 | $77,049 | $38,525 | — | 12.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $77,837 | $38,918 | — | 12x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $80,505 | $40,253 | — | 11.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $99,725 | $49,863 | — | 11.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $78,113 | $39,057 | — | 11.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $91,780 | $45,890 | — | 11.4x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $112,927 | $56,463 | — | 11.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $61,041 | $30,521 | — | 11.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $34,589 | $17,295 | — | 11x |
| RENAL FAILURE WITH CC | 683 | $71,340 | $35,670 | — | 11x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $145,762 | $72,881 | — | 11x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $72,783 | $36,392 | — | 10.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $115,601 | $57,800 | — | 10.5x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $201,889 | $100,945 | — | 10.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $65,830 | $32,915 | — | 10.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $153,065 | $76,533 | — | 10.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $53,162 | $26,581 | — | 10x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $55,549 | $27,775 | — | 9.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $89,875 | $44,938 | — | 9.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $107,816 | $53,908 | — | 9.5x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $247,195 | $123,597 | — | 9.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $93,748 | $46,874 | — | 9.4x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $51,418 | $25,709 | — | 9.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $192,804 | $96,402 | — | 8.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $67,411 | $33,706 | — | 8.9x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $75,417 | $37,709 | — | 8.7x |
| CELLULITIS WITHOUT MCC | 603 | $50,740 | $25,370 | — | 8.7x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $61,842 | $30,921 | — | 8.7x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $97,392 | $48,696 | — | 8.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $76,315 | $38,158 | — | 8.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $46,385 | $23,193 | — | 8.5x |
| DIABETES WITH MCC | 637 | $93,529 | $46,764 | — | 8.5x |
| SEIZURES WITH MCC | 100 | $133,993 | $66,997 | — | 8x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $451,389 | $225,694 | — | 7.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $113,733 | $56,866 | — | 7.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $75,278 | $37,639 | — | 7.8x |
| RENAL FAILURE WITH MCC | 682 | $84,264 | $42,132 | — | 7.7x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $304,648 | $152,324 | — | 7.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $65,287 | $32,643 | — | 7.6x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $109,298 | $54,649 | — | 7.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $83,344 | $41,672 | — | 7.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $53,235 | $26,618 | — | 7.3x |
| MAJOR CHEST PROCEDURES WITH MCC | 163 | $238,190 | $119,095 | — | 7.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $115,370 | $57,685 | — | 7x |
Showing 50 of 55 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