12/100
#2,349 nationally
Palomar Medical Center Poway
15615 Pomerado Road, Poway, CA 92064 · (858) 485-6511
Among the highest charge markups in the country
For every $1 of care Medicare actually paid for here, Palomar Medical Center Poway billed $9.65 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
- 9.6x
- volume-weighted across all its priced work
- Procedures priced
- 50
- inpatient and outpatient combined
- Rank in CA
- #196
- lower markup ranks higher
- CMS quality stars
- 4/5
- 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 5% of U.S. hospitals.
Better than 25% of U.S. hospitals.
Better than 9% of U.S. hospitals.
Better than 9% 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 |
|---|---|---|---|---|
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
249 | $45,957 | $2,892 | +136% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
189 | $160,548 | $16,425 | +146% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
133 | $68,451 | $11,347 | +10% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
76 | $90,702 | $8,848 | +109% |
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
73 | $22,660 | $2,396 | +93% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
60 | $134,013 | $12,529 | +144% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
57 | $119,269 | $10,483 | +156% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
57 | $51,605 | $5,408 | +47% |
|
Level 6 Musculoskeletal Procedures
APC 5116 · Hospital outpatient visit |
42 | $87,516 | $15,780 | +5% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
40 | $13,744 | $1,239 | +36% |
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 |
|---|---|---|---|
|
COPD (severe)
MS-DRG 190 · Inpatient stay |
$128,554 | $6,810 | +207% |
|
Kidney Failure (severe)
MS-DRG 682 · Inpatient stay |
$160,585 | $15,173 | +203% |
|
Respiratory Failure
MS-DRG 189 · Inpatient stay |
$137,029 | $10,882 | +183% |
|
Pneumonia (with complications)
MS-DRG 194 · Inpatient stay |
$88,895 | $6,330 | +180% |
|
Stroke (with complications)
MS-DRG 065 · Inpatient stay |
$122,778 | $8,467 | +170% |
|
Fluid and Electrolyte Disorder (without major complications)
MS-DRG 641 · Inpatient stay |
$81,180 | $5,978 | +166% |
|
Gastrointestinal Obstruction with Complications
MS-DRG 389 · Inpatient stay |
$82,296 | $6,799 | +163% |
|
Sepsis (without major complications)
MS-DRG 872 · Inpatient stay |
$102,816 | $8,169 | +162% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 3 Airway Endoscopy
APC 5153 · Hospital outpatient visit |
$5,375 | $2,087 | -53% |
|
Level 6 Musculoskeletal Procedures
APC 5116 · Hospital outpatient visit |
$87,516 | $15,780 | +5% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
$68,451 | $11,347 | +10% |
|
Level 3 Pacemaker and Similar Procedures
APC 5223 · Hospital outpatient visit |
$58,050 | $9,137 | +13% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$14,565 | $1,934 | +13% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$14,142 | $2,000 | +20% |
|
Hip or Knee Replacement (without major complications)
MS-DRG 470 · Inpatient stay |
$104,859 | $11,129 | +31% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
$52,493 | $7,002 | +32% |
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.