45/100
#1,421 nationally
Hoag Memorial Hospital Presbyterian
One Hoag Drive, Newport Beach, CA 92663 · (949) 764-4624
Charges well above the national norm
For every $1 of care Medicare actually paid for here, Hoag Memorial Hospital Presbyterian billed $4.81 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 4.8x
- volume-weighted across all its priced work
- Procedures priced
- 222
- inpatient and outpatient combined
- Rank in CA
- #46
- lower markup ranks higher
- CMS quality stars
- 5/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 36% of U.S. hospitals.
Better than 65% of U.S. hospitals.
Better than 38% of U.S. hospitals.
Better than 51% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
1,082 | $82,100 | $17,894 | +26% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
905 | $24,574 | $3,347 | +26% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
890 | $11,486 | $1,985 | +14% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
660 | $9,801 | $2,332 | -17% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
414 | $24,025 | $4,006 | -5% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
348 | $51,581 | $7,046 | +47% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
341 | $55,678 | $12,198 | +28% |
|
Level 2 Laparoscopy and Related Services
APC 5362 · Hospital outpatient visit |
321 | $83,420 | $12,637 | +40% |
|
Level 3 Electrophysiologic Procedures
APC 5213 · Hospital outpatient visit |
305 | $102,088 | $29,114 | -23% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
297 | $18,603 | $3,919 | about average |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Pancreas, Liver and Shunt Procedures with Major Complications
MS-DRG 405 · Inpatient stay |
$718,601 | $134,623 | +175% |
|
Major Small and Large Bowel Procedures without Complications/mcc
MS-DRG 331 · Inpatient stay |
$139,215 | $16,126 | +87% |
|
Combined Anterior and Posterior Spinal Fusion with Complications
MS-DRG 454 · Inpatient stay |
$369,856 | $68,060 | +67% |
|
Other Operating Room Procedures for Injuries with Complications
MS-DRG 908 · Inpatient stay |
$147,995 | $24,154 | +64% |
|
Kidney and Ureter Procedures for Neoplasm without Complications/mcc
MS-DRG 658 · Inpatient stay |
$125,572 | $15,414 | +64% |
|
Major Gastrointestinal Disorders and Peritoneal Infections with Major Complications
MS-DRG 371 · Inpatient stay |
$110,536 | $25,433 | +61% |
|
Level 7 Radiation Therapy
APC 5627 · Hospital outpatient visit |
$94,028 | $9,568 | +59% |
|
Pancreas, Liver and Shunt Procedures with Complications
MS-DRG 406 · Inpatient stay |
$224,228 | $37,205 | +59% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Endocrine Disorders without Complications/mcc
MS-DRG 645 · Inpatient stay |
$24,870 | $8,701 | -43% |
|
Level 5 Neurostimulator and Related Procedures
APC 5465 · Hospital outpatient visit |
$67,428 | $38,054 | -40% |
|
Lymphoma and Non-acute Leukemia with Complications
MS-DRG 841 · Inpatient stay |
$58,061 | $14,397 | -36% |
|
Traumatic Stupor and Coma >1 Hour with Major Complications
MS-DRG 082 · Inpatient stay |
$63,560 | $21,797 | -34% |
|
Poisoning and Toxic Effects of Drugs with Major Complications
MS-DRG 917 · Inpatient stay |
$44,666 | $14,117 | -34% |
|
Level 4 Endovascular Procedures
APC 5194 · Hospital outpatient visit |
$64,739 | $16,607 | -32% |
|
Endocrine Disorders with Major Complications
MS-DRG 643 · Inpatient stay |
$46,639 | $15,255 | -29% |
|
Level 5 Airway Endoscopy
APC 5155 · Hospital outpatient visit |
$27,494 | $8,311 | -29% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.