48/100
#1,319 nationally
Hoag Orthopedic Institute
16250 Sand Canyon Avenue, Irvine, CA 92618 · (949) 727-5000
Charges well above the national norm
For every $1 of care Medicare actually paid for here, Hoag Orthopedic Institute billed $4.67 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
- 4.7x
- volume-weighted across all its priced work
- Procedures priced
- 21
- inpatient and outpatient combined
- Rank in CA
- #35
- lower markup ranks higher
- CMS quality stars
- Not rated
- 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 34% of U.S. hospitals.
Better than 75% of U.S. hospitals.
Better than 36% of U.S. hospitals.
Better than 63% 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 |
|---|---|---|---|---|
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
1,238 | $69,835 | $15,979 | +12% |
|
Hip or Knee Replacement (without major complications)
MS-DRG 470 · Inpatient stay |
303 | $85,751 | $17,493 | +7% |
|
Level 6 Musculoskeletal Procedures
APC 5116 · Hospital outpatient visit |
252 | $115,075 | $22,852 | +39% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
100 | $49,022 | $8,721 | +23% |
|
Spinal Fusion Except Cervical without Major Complications
MS-DRG 460 · Inpatient stay |
57 | $146,728 | $35,754 | about average |
|
Combined Anterior and Posterior Spinal Fusion without Complications/mcc
MS-DRG 455 · Inpatient stay |
55 | $193,091 | $45,261 | +9% |
|
Combined Anterior and Posterior Spinal Fusion with Complications
MS-DRG 454 · Inpatient stay |
52 | $279,504 | $57,080 | +26% |
|
Major Joint or Limb Reattachment Procedures of Upper Extremities
MS-DRG 483 · Inpatient stay |
51 | $147,991 | $23,031 | +44% |
|
Revision of Hip or Knee Replacement without Complications/mcc
MS-DRG 468 · Inpatient stay |
43 | $144,051 | $25,325 | +33% |
|
Cervical Spinal Fusion with Complications
MS-DRG 472 · Inpatient stay |
42 | $127,819 | $27,320 | +7% |
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 |
|---|---|---|---|
|
Major Joint or Limb Reattachment Procedures of Upper Extremities
MS-DRG 483 · Inpatient stay |
$147,991 | $23,031 | +44% |
|
Cervical Spinal Fusion without Complications/mcc
MS-DRG 473 · Inpatient stay |
$130,075 | $23,076 | +44% |
|
Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical
MS-DRG 402 · Inpatient stay |
$201,535 | $35,470 | +41% |
|
Revision of Hip or Knee Replacement with Complications
MS-DRG 467 · Inpatient stay |
$180,851 | $35,571 | +39% |
|
Level 6 Musculoskeletal Procedures
APC 5116 · Hospital outpatient visit |
$115,075 | $22,852 | +39% |
|
Revision of Hip or Knee Replacement without Complications/mcc
MS-DRG 468 · Inpatient stay |
$144,051 | $25,325 | +33% |
|
Combined Anterior and Posterior Spinal Fusion with Complications
MS-DRG 454 · Inpatient stay |
$279,504 | $57,080 | +26% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
$49,022 | $8,721 | +23% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Hip or Knee Replacement (severe)
MS-DRG 469 · Inpatient stay |
$107,989 | $25,690 | -23% |
|
Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with
MS-DRG 427 · Inpatient stay |
$250,722 | $64,153 | -19% |
|
Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive
MS-DRG 457 · Inpatient stay |
$233,970 | $55,541 | -18% |
|
Back and Neck Procedures Except Spinal Fusion without Complications/mcc
MS-DRG 520 · Inpatient stay |
$65,024 | $13,201 | about average |
|
Spinal Fusion Except Cervical without Major Complications
MS-DRG 460 · Inpatient stay |
$146,728 | $35,754 | about average |
|
Cervical Spinal Fusion with Complications
MS-DRG 472 · Inpatient stay |
$127,819 | $27,320 | +7% |
|
Hip or Knee Replacement (without major complications)
MS-DRG 470 · Inpatient stay |
$85,751 | $17,493 | +7% |
|
Combined Anterior and Posterior Spinal Fusion without Complications/mcc
MS-DRG 455 · Inpatient stay |
$193,091 | $45,261 | +9% |
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.