Scripps Memorial Hospital - Encinitas
Scripps Memorial Hospital - Encinitas in Encinitas, CA charges 8.4x the Medicare reimbursement rate on average, based on analysis of 93 common medical procedures at this nonprofit facility.
Encinitas, CA 92024 · Acute Care Hospitals · CMS Rating: 5/5
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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Pricing grade
F
Very high
Avg markup vs Medicare
8.41x
Charge / Medicare rate
Max markup
13.22x
Worst procedure
Procedures analyzed
93
With pricing data
Outlier procedures
8.6%
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 |
|---|---|---|---|---|---|
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $146,253 | $73,126 | — | 13.2x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $219,559 | $109,779 | — | 12.7x |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $122,274 | $61,137 | — | 12.1x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $60,484 | $30,242 | — | 11.5x |
| HYPERTENSION WITHOUT MCC | 305 | $51,908 | $25,954 | — | 11.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $208,509 | $104,255 | — | 11x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $77,918 | $38,959 | — | 11x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $56,718 | $28,359 | — | 10.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $55,914 | $27,957 | — | 10.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $74,646 | $37,323 | — | 10.3x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $200,870 | $100,435 | — | 10.2x |
| DYSEQUILIBRIUM | 149 | $52,981 | $26,490 | — | 10.1x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $64,640 | $32,320 | — | 10x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $143,369 | $71,684 | — | 10x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $133,185 | $66,592 | — | 10x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $154,661 | $77,330 | — | 9.8x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $127,472 | $63,736 | — | 9.8x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $79,324 | $39,662 | — | 9.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $167,137 | $83,569 | — | 9.7x |
| FRACTURES OF HIP AND PELVIS WITH MCC | 535 | $95,925 | $47,963 | — | 9.6x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $486,405 | $243,203 | — | 9.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $52,923 | $26,462 | — | 9.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $288,848 | $144,424 | — | 9.5x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $290,820 | $145,410 | — | 9.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $90,486 | $45,243 | — | 9.4x |
| HEART FAILURE AND SHOCK WITH CC | 292 | $59,541 | $29,770 | — | 9.4x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $64,961 | $32,480 | — | 9.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $46,598 | $23,299 | — | 9.3x |
| SEIZURES WITH MCC | 100 | $125,021 | $62,510 | — | 9.2x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $80,144 | $40,072 | — | 9.2x |
| CHEST PAIN | 313 | $41,410 | $20,705 | — | 9.2x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $196,389 | $98,194 | — | 9.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $49,525 | $24,762 | — | 9.2x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $149,049 | $74,525 | — | 9x |
| DIABETES WITH CC | 638 | $52,012 | $26,006 | — | 8.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $105,058 | $52,529 | — | 8.9x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $46,618 | $23,309 | — | 8.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $46,621 | $23,310 | — | 8.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $196,308 | $98,154 | — | 8.7x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $88,677 | $44,338 | — | 8.7x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $139,910 | $69,955 | — | 8.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $84,351 | $42,175 | — | 8.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $64,631 | $32,315 | — | 8.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $71,782 | $35,891 | — | 8.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $80,228 | $40,114 | — | 8.5x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $67,727 | $33,864 | — | 8.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $110,947 | $55,474 | — | 8.3x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $117,812 | $58,906 | — | 8.3x |
| RENAL FAILURE WITH CC | 683 | $54,009 | $27,004 | — | 8.3x |
| RENAL FAILURE WITH MCC | 682 | $90,157 | $45,079 | — | 8.2x |
Showing 50 of 93 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