Advocate Childrens Hospital - Oak Lawn Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Advocate Childrens Hospital - Oak Lawn, Oak Lawn, IL in 2024, from traditional Medicare claims. Back to the Advocate Childrens Hospital - Oak Lawn profile, with quality ratings, finances and negotiated rates.
6,533
Medicare inpatient discharges
In 168 published DRGs
2.24
Case mix index
IPPS FY 2027
24%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
4,185
Medicare outpatient services
In 45 service groups
Inpatient stays by major diagnostic category
Circulatory system1,908 discharges in 39 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 380 | $55,310 | $10,426 | $14,878 | 1.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 140 | $109,846 | $17,745 | $29,549 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 138 | $75,202 | $13,395 | $20,229 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 95 | $36,082 | $6,531 | $9,706 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 80 | $185,790 | $39,081 | $49,977 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 79 | $110,435 | $25,990 | $29,707 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 79 | $94,245 | $17,127 | $25,352 | 2.09 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 62 | $31,750 | $5,256 | $8,541 | 0.74 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 61 | $120,261 | $26,525 | $32,350 | 3.35 |
| Chest painMS-DRG 313, medical | 60 | $28,670 | $5,241 | $7,712 | 0.72 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 46 | $258,963 | $48,107 | $69,661 | 5.06 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 46 | $45,615 | $7,955 | $12,270 | 1.08 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 43 | $233,468 | $45,126 | $62,803 | 5.88 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 40 | $57,196 | $12,346 | $15,386 | 1.58 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 40 | $45,511 | $9,437 | $12,242 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 38 | $122,492 | $25,438 | $32,950 | 2.87 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 35 | $40,335 | $6,647 | $10,850 | 0.91 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 34 | $240,192 | $50,530 | $64,612 | 6.25 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 34 | $74,570 | $12,743 | $20,059 | 1.82 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 33 | $35,144 | $7,846 | $9,454 | 1.07 |
| Hypertension without MCCMS-DRG 305, medical | 31 | $31,371 | $5,360 | $8,439 | 0.75 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 29 | $319,624 | $66,060 | $85,979 | 7.80 |
| Other vascular procedures with CCMS-DRG 253, surgical | 28 | $117,394 | $19,857 | $31,579 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 27 | $366,672 | $70,491 | $98,635 | 7.71 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 27 | $28,751 | $7,451 | $7,734 | 0.97 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 26 | $190,711 | $34,730 | $51,301 | 4.81 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 21 | $156,988 | $31,434 | $42,230 | 4.16 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 15 | $325,457 | $76,136 | $87,548 | 9.71 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 14 | $86,317 | $29,085 | $23,219 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 14 | $67,797 | $18,375 | $18,237 | 2.28 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $108,044 | $24,571 | $29,064 | 3.46 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 13 | $226,589 | $44,526 | $60,953 | 5.04 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 13 | $201,156 | $38,879 | $54,111 | 5.20 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 13 | $84,863 | $15,973 | $22,828 | 1.97 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 13 | $215,635 | $49,141 | $58,006 | 4.14 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 12 | $161,551 | $30,895 | $43,457 | 4.04 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 12 | $121,085 | $21,111 | $32,572 | 2.81 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $162,223 | $30,091 | $43,638 | 3.90 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $207,804 | $42,910 | $55,899 | 3.27 |
Infectious and parasitic diseases847 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 593 | $84,873 | $16,292 | $22,831 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 105 | $223,425 | $43,591 | $60,101 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 67 | $42,557 | $7,995 | $11,448 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 27 | $249,725 | $50,779 | $67,176 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 21 | $77,659 | $14,319 | $20,890 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 17 | $190,866 | $35,705 | $51,343 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 17 | $88,594 | $18,835 | $23,832 | 2.14 |
Respiratory system686 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 99 | $43,524 | $9,859 | $11,708 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 98 | $60,098 | $12,414 | $16,166 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 80 | $47,454 | $10,127 | $12,765 | 1.33 |
| Major chest procedures with MCCMS-DRG 163, surgical | 69 | $164,148 | $34,468 | $44,156 | 4.71 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $44,676 | $8,776 | $12,018 | 1.10 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 35 | $109,576 | $21,318 | $29,476 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 33 | $74,452 | $10,932 | $20,028 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 28 | $115,462 | $19,135 | $31,059 | 2.55 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 27 | $30,600 | $5,871 | $8,231 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 25 | $35,192 | $7,346 | $9,467 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 22 | $72,883 | $13,703 | $19,606 | 1.74 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 18 | $222,022 | $44,149 | $59,724 | 6.91 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $29,598 | $5,962 | $7,962 | 0.85 |
| Pleural effusion with MCCMS-DRG 186, medical | 16 | $65,637 | $10,062 | $17,656 | 1.55 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 15 | $98,478 | $17,961 | $26,491 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $93,237 | $14,609 | $25,081 | 1.81 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 14 | $162,901 | $29,396 | $43,820 | 4.06 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 14 | $34,703 | $6,528 | $9,335 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $35,951 | $5,351 | $9,671 | 0.82 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 11 | $52,571 | $8,436 | $14,142 | 1.10 |
Nervous system667 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 98 | $85,827 | $15,096 | $23,087 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 70 | $41,460 | $7,513 | $11,153 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 44 | $39,568 | $10,015 | $10,644 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 44 | $71,672 | $15,190 | $19,280 | 1.98 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 41 | $64,317 | $17,662 | $17,301 | 2.39 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 34 | $64,640 | $13,885 | $17,388 | 1.79 |
| Seizures without MCCMS-DRG 101, medical | 34 | $31,400 | $7,244 | $8,447 | 0.91 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 29 | $201,378 | $37,238 | $54,171 | 4.42 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 26 | $96,503 | $17,976 | $25,959 | 2.28 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 25 | $37,593 | $7,596 | $10,112 | 1.03 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 24 | $41,609 | $7,358 | $11,193 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 23 | $228,441 | $46,115 | $61,451 | 5.67 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 21 | $47,880 | $13,092 | $12,880 | 1.51 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 20 | $78,736 | $17,515 | $21,180 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 19 | $32,699 | $4,843 | $8,796 | 0.69 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $87,781 | $12,625 | $23,613 | 1.47 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $45,888 | $7,199 | $12,344 | 1.06 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 13 | $46,543 | $8,800 | $12,520 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 13 | $32,601 | $4,279 | $8,770 | 0.84 |
| Extracranial procedures with CCMS-DRG 038, surgical | 12 | $50,809 | $11,040 | $13,668 | 1.60 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 12 | $44,056 | $8,944 | $11,851 | 1.14 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $41,178 | $6,186 | $11,077 | 0.80 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $49,010 | $16,094 | $13,184 | 2.27 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 11 | $30,442 | $5,939 | $8,189 | 0.77 |
Digestive system573 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 101 | $32,703 | $5,657 | $8,797 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 97 | $59,701 | $14,137 | $16,059 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 81 | $37,355 | $7,246 | $10,049 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 57 | $47,252 | $10,584 | $12,711 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 38 | $55,864 | $11,719 | $15,028 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 35 | $200,296 | $34,312 | $53,880 | 4.52 |
| Digestive malignancy with MCCMS-DRG 374, medical | 30 | $63,875 | $16,957 | $17,182 | 2.10 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 30 | $34,078 | $7,156 | $9,167 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 29 | $30,238 | $6,303 | $8,134 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 27 | $83,823 | $16,497 | $22,548 | 2.37 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 23 | $53,008 | $11,815 | $14,259 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 13 | $45,077 | $13,902 | $12,126 | 1.75 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $237,655 | $52,398 | $63,929 | 5.08 |
Musculoskeletal system and connective tissue487 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 83 | $33,161 | $6,813 | $8,920 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 59 | $74,505 | $16,181 | $20,042 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 38 | $68,230 | $15,005 | $18,354 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 30 | $115,124 | $25,167 | $30,968 | 2.95 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 30 | $30,291 | $6,221 | $8,148 | 0.82 |
| Medical back problems with MCCMS-DRG 551, medical | 28 | $67,943 | $13,745 | $18,277 | 1.70 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 22 | $76,277 | $12,791 | $20,519 | 1.82 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 21 | $228,430 | $47,341 | $61,448 | 6.12 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 21 | $76,788 | $13,099 | $20,656 | 1.97 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 20 | $93,190 | $19,486 | $25,068 | 2.40 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 18 | $28,998 | $6,219 | $7,800 | 0.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $35,757 | $7,413 | $9,619 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 17 | $30,412 | $6,762 | $8,181 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $105,177 | $24,124 | $28,293 | 2.99 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 13 | $78,209 | $16,649 | $21,038 | 2.11 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 13 | $102,383 | $21,243 | $27,541 | 2.49 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 11 | $116,679 | $42,290 | $31,387 | 5.66 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 11 | $74,295 | $14,459 | $19,985 | 2.04 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 11 | $30,694 | $5,620 | $8,257 | 0.79 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 11 | $33,824 | $8,088 | $9,099 | 1.00 |
Kidney and urinary tract389 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 78 | $56,613 | $12,208 | $15,229 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 74 | $28,217 | $5,850 | $7,590 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 70 | $31,512 | $6,582 | $8,477 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 62 | $54,308 | $13,080 | $14,609 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 48 | $39,646 | $8,608 | $10,665 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 27 | $34,242 | $7,346 | $9,211 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 17 | $170,793 | $34,064 | $45,943 | 3.70 |
| Kidney transplantMS-DRG 652, surgical | 13 | $308,889 | $28,787 | $83,091 | 3.00 |
Endocrine, nutritional and metabolic226 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 76 | $48,317 | $10,412 | $12,997 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 55 | $34,106 | $5,898 | $9,175 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 41 | $37,654 | $6,804 | $10,129 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 32 | $59,274 | $11,118 | $15,945 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 22 | $68,251 | $12,542 | $18,360 | 1.65 |
Blood and immune system123 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 54 | $47,798 | $12,607 | $12,858 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 43 | $42,694 | $11,156 | $11,485 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 26 | $34,176 | $6,419 | $9,193 | 0.90 |
Liver, gallbladder and pancreas96 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 20 | $53,987 | $12,887 | $14,523 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $66,556 | $14,514 | $17,903 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $87,240 | $13,224 | $23,468 | 1.76 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $72,076 | $13,892 | $19,388 | 1.67 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $63,659 | $9,912 | $17,124 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 12 | $45,823 | $8,889 | $12,326 | 1.09 |
Transplants, ECMO and tracheostomy (pre-MDC)85 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 36 | $591,420 | $150,488 | $159,092 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 27 | $486,433 | $113,307 | $130,850 | 14.70 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 22 | $1,395,649 | $292,976 | $375,430 | 27.10 |
Injuries, poisonings and toxic effects of drugs83 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 32 | $50,623 | $13,511 | $13,618 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 21 | $155,962 | $32,786 | $41,954 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $57,255 | $12,453 | $15,401 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $22,651 | $8,615 | $6,093 | 1.03 |
Other67 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 46 | $180,987 | $37,989 | $48,685 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 21 | $90,522 | $17,916 | $24,350 | 2.49 |
Mental diseases and disorders64 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 51 | $35,656 | $12,592 | $9,592 | 1.76 |
| PsychosesMS-DRG 885, medical | 13 | $24,072 | $10,580 | $6,475 | 1.37 |
Skin, subcutaneous tissue and breast62 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 30 | $30,965 | $6,811 | $8,330 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 17 | $51,956 | $10,838 | $13,976 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 15 | $23,998 | $7,152 | $6,455 | 0.89 |
Factors influencing health status49 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 23 | $29,284 | $5,510 | $7,877 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 13 | $49,402 | $9,686 | $13,289 | 1.25 |
| Other factors influencing health statusMS-DRG 951, medical | 13 | $21,827 | $5,009 | $5,872 | 0.59 |
Alcohol and drug use45 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 25 | $29,643 | $6,736 | $7,974 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 20 | $49,203 | $13,318 | $13,236 | 1.78 |
Ear, nose, mouth and throat41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 28 | $29,318 | $5,303 | $7,886 | 0.74 |
| Dental and oral diseases with CCMS-DRG 158, medical | 13 | $38,787 | $7,488 | $10,434 | 0.94 |
Blood cancers and poorly differentiated neoplasms20 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 20 | $150,955 | $34,865 | $40,607 | 3.13 |
Multiple significant trauma15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 15 | $171,932 | $34,027 | $46,250 | 3.88 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 773 | 723 | $14,458 | $2,002 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 334 | 308 | $11,761 | $1,205 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 300 | 299 | $17,009 | $2,206 | $2,208 |
| Level 2 Upper GI ProceduresAPC 5302 | 262 | 238 | $8,824 | $1,422 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 246 | 214 | $16,676 | $2,369 | $2,405 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 197 | 190 | $57,104 | $10,509 | $10,772 |
| Level 5 Airway EndoscopyAPC 5155 | 137 | 135 | $38,488 | $5,136 | $5,183 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 134 | 130 | $27,985 | $4,264 | $4,358 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 124 | 121 | $119,541 | $20,832 | $21,117 |
| Level 1 Intraocular ProceduresAPC 5491 | 112 | 84 | $13,330 | $1,758 | $1,752 |
| Level 3 Endovascular ProceduresAPC 5193 | 103 | 99 | $46,724 | $8,628 | $8,874 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 101 | 101 | $32,170 | $5,245 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 81 | 79 | $19,787 | $3,761 | $3,918 |
| Level 4 Endovascular ProceduresAPC 5194 | 77 | 70 | $74,779 | $14,764 | $14,606 |
| Level 4 Airway EndoscopyAPC 5154 | 75 | 72 | $26,118 | $2,795 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 74 | 74 | $47,860 | $7,929 | $8,164 |
| Level 4 Urology and Related ServicesAPC 5374 | 68 | 55 | $15,806 | $2,598 | $2,629 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 67 | 62 | $15,411 | $2,225 | $2,373 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 66 | 64 | $18,457 | $2,074 | $2,141 |
| Level 2 Vascular ProceduresAPC 5182 | 62 | 59 | $6,518 | $1,190 | $1,204 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 58 | 57 | $47,409 | $4,933 | $4,982 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 56 | 40 | $15,173 | $2,524 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 55 | 50 | $10,484 | $1,458 | $1,407 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 54 | 53 | $22,921 | $2,830 | $2,930 |
| Level 4 Gynecologic ProceduresAPC 5414 | 46 | 45 | $18,471 | $2,311 | $2,389 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 39 | 36 | $7,196 | $1,169 | $1,196 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 37 | 37 | $42,861 | $8,480 | $8,569 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 36 | 36 | $78,397 | $14,663 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 36 | 33 | $10,751 | $1,239 | $1,264 |
| Level 2 Endovascular ProceduresAPC 5192 | 36 | 35 | $31,629 | $4,081 | $4,338 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 36 | 36 | $109,179 | $29,212 | $29,375 |
| Level 3 Upper GI ProceduresAPC 5303 | 34 | 31 | $10,462 | $2,822 | $2,888 |
| Level 4 Vascular ProceduresAPC 5184 | 30 | 30 | $27,517 | $4,153 | $3,946 |
| Level 2 Intraocular ProceduresAPC 5492 | 30 | 30 | $17,454 | $3,063 | $3,116 |
| Level 3 Urology and Related ServicesAPC 5373 | 29 | 19 | $10,416 | $1,538 | $1,516 |
| Level 5 ENT ProceduresAPC 5165 | 26 | 26 | $24,286 | $4,251 | $4,436 |
| Complex GI ProceduresAPC 5331 | 24 | 20 | $11,663 | $3,754 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 21 | 19 | $22,181 | $3,762 | $3,792 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 19 | 19 | $72,267 | $16,780 | $17,052 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 19 | 17 | $13,762 | $1,766 | $1,780 |
| Level 3 Lower GI ProceduresAPC 5313 | 17 | 17 | $11,864 | $2,168 | $2,176 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 15 | 15 | $121,919 | $25,911 | $26,719 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 14 | 14 | $34,138 | $6,434 | $6,514 |
| Level 3 Intraocular ProceduresAPC 5493 | 13 | 13 | $22,578 | $3,954 | $4,004 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 12 | 12 | $150,612 | $25,883 | $26,955 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.