Santa Monica - UCLA Med Ctr & Orthopaedic Hospital
SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL charges 5.6x the Medicare reimbursement rate across 101 analyzed procedures, with 20% showing significant pricing variations in this Santa Monica nonprofit facility.
Santa Monica, CA 90404 · 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
D
High
Avg markup vs Medicare
5.62x
Charge / Medicare rate
Max markup
8.95x
Worst procedure
Procedures analyzed
101
With pricing data
Outlier procedures
19.8%
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 |
|---|---|---|---|---|---|
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $91,279 | $45,640 | — | 9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $73,654 | $36,827 | — | 8.5x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $138,105 | $69,053 | — | 7.8x |
| DIABETES WITH CC | 638 | $69,937 | $34,968 | — | 7.7x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $72,010 | $36,005 | — | 7.6x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $55,422 | $27,711 | — | 7.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $87,506 | $43,753 | — | 7.6x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $71,551 | $35,776 | — | 7.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $71,654 | $35,827 | — | 7.5x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $108,034 | $54,017 | — | 7.5x |
| SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | 556 | $62,604 | $31,302 | — | 7.3x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $51,687 | $25,844 | — | 7.2x |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $114,697 | $57,348 | — | 7.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $109,401 | $54,701 | — | 7.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $49,886 | $24,943 | — | 7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $61,269 | $30,634 | — | 6.9x |
| RENAL FAILURE WITH CC | 683 | $56,040 | $28,020 | — | 6.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $103,924 | $51,962 | — | 6.8x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $101,186 | $50,593 | — | 6.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $90,567 | $45,283 | — | 6.7x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $64,411 | $32,205 | — | 6.6x |
| SYNCOPE AND COLLAPSE | 312 | $54,142 | $27,071 | — | 6.5x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $70,692 | $35,346 | — | 6.5x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $116,504 | $58,252 | — | 6.4x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $120,122 | $60,061 | — | 6.3x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $70,879 | $35,439 | — | 6.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $80,259 | $40,130 | — | 6.2x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $153,682 | $76,841 | — | 6.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $105,722 | $52,861 | — | 6.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $213,383 | $106,692 | — | 6.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $47,332 | $23,666 | — | 6.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $87,374 | $43,687 | — | 6.1x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $152,500 | $76,250 | — | 6.1x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $63,568 | $31,784 | — | 5.9x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 809 | $116,420 | $58,210 | — | 5.9x |
| RENAL FAILURE WITH MCC | 682 | $132,008 | $66,004 | — | 5.9x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $130,890 | $65,445 | — | 5.9x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | 438 | $112,916 | $56,458 | — | 5.9x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $52,569 | $26,285 | — | 5.8x |
| PERITONEAL ADHESIOLYSIS WITH CC | 336 | $109,062 | $54,531 | — | 5.8x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $109,674 | $54,837 | — | 5.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $56,030 | $28,015 | — | 5.8x |
| COMPLICATIONS OF TREATMENT WITH MCC | 919 | $103,737 | $51,868 | — | 5.8x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $59,778 | $29,889 | — | 5.7x |
| MAJOR BLADDER PROCEDURES WITH CC | 654 | $165,658 | $82,829 | — | 5.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $105,216 | $52,608 | — | 5.7x |
| CELLULITIS WITHOUT MCC | 603 | $48,753 | $24,376 | — | 5.7x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $107,813 | $53,906 | — | 5.7x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | 542 | $125,552 | $62,776 | — | 5.6x |
| CERVICAL SPINAL FUSION WITH CC | 472 | $161,297 | $80,648 | — | 5.4x |
Showing 50 of 101 procedures
How SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL 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.
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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