Advocate Lutheran General Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Advocate Lutheran General Hospital, Park Ridge, IL in 2024, from traditional Medicare claims. Back to the Advocate Lutheran General Hospital profile, with quality ratings, finances and negotiated rates.
6,442
Medicare inpatient discharges
In 155 published DRGs
2.07
Case mix index
IPPS FY 2027
22%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
4,909
Medicare outpatient services
In 50 service groups
Inpatient stays by major diagnostic category
Circulatory system1,405 discharges in 34 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 392 | $58,733 | $10,606 | $14,155 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 154 | $70,010 | $12,629 | $16,872 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 113 | $146,347 | $40,423 | $35,270 | 4.88 |
| Syncope and collapseMS-DRG 312, medical | 93 | $44,841 | $6,782 | $10,807 | 0.86 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 54 | $99,743 | $26,209 | $24,038 | 3.24 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 48 | $33,645 | $5,511 | $8,109 | 0.74 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 43 | $47,148 | $7,092 | $11,363 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 34 | $86,908 | $17,330 | $20,945 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 30 | $162,347 | $22,626 | $39,126 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 29 | $85,987 | $17,730 | $20,723 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 29 | $104,236 | $12,093 | $25,121 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 27 | $45,947 | $9,930 | $11,073 | 1.20 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 26 | $45,514 | $11,991 | $10,969 | 1.58 |
| Chest painMS-DRG 313, medical | 25 | $31,931 | $5,311 | $7,695 | 0.72 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 24 | $170,273 | $49,588 | $41,036 | 6.25 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 23 | $42,891 | $8,817 | $10,337 | 1.07 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $215,146 | $48,351 | $51,850 | 5.06 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $33,497 | $5,541 | $8,073 | 0.75 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 17 | $275,015 | $59,001 | $66,279 | 7.71 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 17 | $228,669 | $36,842 | $55,109 | 5.24 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 17 | $169,684 | $43,640 | $40,894 | 5.04 |
| Other vascular procedures with CCMS-DRG 253, surgical | 16 | $110,188 | $19,904 | $26,555 | 2.55 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 15 | $196,828 | $28,155 | $47,436 | 4.04 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 15 | $44,092 | $7,445 | $10,626 | 0.97 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 14 | $120,515 | $26,627 | $29,044 | 3.18 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 14 | $136,731 | $29,681 | $32,952 | 3.35 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 14 | $51,522 | $7,993 | $12,417 | 1.08 |
| Other heart assist system implantMS-DRG 215, surgical | 13 | $350,569 | $89,166 | $84,487 | 10.21 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 13 | $240,687 | $43,445 | $58,006 | 5.20 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 12 | $99,014 | $18,025 | $23,862 | 1.97 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 12 | $126,193 | $25,433 | $30,413 | 2.97 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 11 | $174,760 | $37,889 | $42,117 | 3.90 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 11 | $35,717 | $4,788 | $8,608 | 0.72 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 11 | $32,613 | $3,524 | $7,860 | 0.55 |
Infectious and parasitic diseases1,166 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 | 819 | $85,600 | $16,304 | $20,630 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 141 | $54,022 | $8,103 | $13,019 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 87 | $180,022 | $40,055 | $43,385 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 67 | $213,129 | $52,934 | $51,364 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 26 | $80,964 | $15,041 | $19,512 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 15 | $77,601 | $12,289 | $18,702 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $181,091 | $38,902 | $43,643 | 4.43 |
Nervous system802 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 107 | $86,779 | $16,444 | $20,914 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 91 | $57,319 | $7,756 | $13,814 | 1.02 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 56 | $238,654 | $46,471 | $57,516 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 46 | $44,290 | $7,175 | $10,674 | 0.91 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 45 | $205,177 | $38,250 | $49,448 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 40 | $40,007 | $10,403 | $9,642 | 1.36 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 39 | $113,480 | $19,734 | $27,349 | 2.28 |
| Seizures with MCCMS-DRG 100, medical | 39 | $86,990 | $17,343 | $20,965 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 34 | $48,147 | $8,277 | $11,604 | 1.03 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 30 | $48,235 | $6,167 | $11,625 | 0.80 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 28 | $69,131 | $18,781 | $16,661 | 2.30 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 28 | $47,937 | $8,236 | $11,553 | 1.06 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 25 | $70,941 | $14,077 | $17,097 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 23 | $59,843 | $19,132 | $14,422 | 2.39 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 23 | $38,161 | $5,084 | $9,197 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 20 | $78,416 | $11,190 | $18,898 | 1.36 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 16 | $106,535 | $20,903 | $25,675 | 2.43 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 16 | $54,058 | $13,898 | $13,028 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 16 | $62,873 | $10,562 | $15,152 | 1.32 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 15 | $131,457 | $25,129 | $31,681 | 2.95 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 14 | $54,309 | $14,224 | $13,089 | 1.81 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 14 | $38,060 | $9,040 | $9,172 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 13 | $34,309 | $6,121 | $8,268 | 0.84 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 12 | $268,746 | $76,635 | $64,768 | 8.45 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 12 | $71,211 | $9,918 | $17,162 | 1.47 |
Respiratory system644 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 142 | $70,783 | $12,775 | $17,059 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 135 | $58,279 | $10,449 | $14,045 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 99 | $58,062 | $10,208 | $13,993 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 38 | $36,233 | $6,068 | $8,732 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 31 | $43,102 | $8,348 | $10,388 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 29 | $66,410 | $11,841 | $16,005 | 1.40 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 28 | $50,101 | $7,808 | $12,074 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 24 | $139,036 | $19,239 | $33,508 | 2.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 23 | $60,199 | $14,166 | $14,508 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 23 | $113,743 | $23,322 | $27,412 | 2.70 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $43,267 | $6,880 | $10,427 | 0.85 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 17 | $180,337 | $48,605 | $43,461 | 6.91 |
| Major chest procedures with MCCMS-DRG 163, surgical | 13 | $143,590 | $34,365 | $34,605 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 13 | $119,327 | $15,165 | $28,758 | 1.88 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $37,418 | $6,363 | $9,018 | 0.96 |
Digestive system621 discharges in 16 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 | 99 | $37,103 | $5,911 | $8,942 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 90 | $41,018 | $7,885 | $9,885 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 60 | $79,329 | $17,150 | $19,118 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 60 | $97,380 | $16,044 | $23,468 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 52 | $37,704 | $6,019 | $9,087 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 43 | $139,173 | $32,108 | $33,541 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 35 | $55,174 | $9,617 | $13,297 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 33 | $33,220 | $6,919 | $8,006 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 31 | $68,712 | $13,692 | $16,560 | 1.62 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 25 | $50,496 | $12,340 | $12,169 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 23 | $54,963 | $11,709 | $13,246 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 16 | $74,064 | $12,848 | $17,849 | 1.75 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 15 | $37,243 | $3,271 | $8,976 | 0.56 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 14 | $62,500 | $15,276 | $15,063 | 2.11 |
| Digestive malignancy with MCCMS-DRG 374, medical | 13 | $72,608 | $17,190 | $17,499 | 2.10 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 12 | $141,351 | $22,402 | $34,066 | 3.58 |
Musculoskeletal system and connective tissue542 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 80 | $41,119 | $7,520 | $9,910 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 70 | $68,917 | $16,445 | $16,609 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 40 | $100,920 | $24,701 | $24,322 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 39 | $58,356 | $14,206 | $14,064 | 1.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 38 | $77,666 | $19,373 | $18,717 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 35 | $74,491 | $16,860 | $17,952 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 29 | $39,658 | $6,658 | $9,558 | 0.90 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 25 | $114,015 | $45,328 | $27,478 | 6.12 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 24 | $53,653 | $8,579 | $12,930 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 24 | $60,101 | $13,465 | $14,484 | 1.70 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 19 | $31,697 | $6,437 | $7,639 | 0.82 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 18 | $77,969 | $23,502 | $18,791 | 3.33 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $51,220 | $15,336 | $12,344 | 1.97 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $35,391 | $5,373 | $8,529 | 0.79 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 16 | $63,806 | $25,770 | $15,377 | 3.49 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 15 | $82,874 | $26,455 | $19,973 | 3.66 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 14 | $82,963 | $14,260 | $19,994 | 1.82 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 11 | $41,988 | $10,350 | $10,119 | 1.30 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 11 | $45,669 | $11,746 | $11,006 | 1.52 |
Kidney and urinary tract497 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 128 | $47,856 | $9,521 | $11,533 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 112 | $34,089 | $6,184 | $8,215 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 75 | $75,155 | $12,961 | $18,112 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 62 | $63,979 | $12,131 | $15,419 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 62 | $38,036 | $7,020 | $9,167 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 34 | $45,229 | $7,746 | $10,900 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 12 | $51,051 | $9,934 | $12,303 | 1.35 |
| Urinary stones without MCCMS-DRG 694, medical | 12 | $28,931 | $5,105 | $6,972 | 0.78 |
Endocrine, nutritional and metabolic171 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 | 57 | $59,450 | $10,097 | $14,327 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 43 | $32,373 | $5,761 | $7,802 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 33 | $41,790 | $7,101 | $10,071 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 22 | $54,203 | $11,840 | $13,063 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $30,247 | $8,229 | $7,289 | 1.06 |
Skin, subcutaneous tissue and breast141 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 95 | $35,368 | $6,353 | $8,524 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 24 | $55,048 | $12,093 | $13,267 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 22 | $36,339 | $7,204 | $8,758 | 0.91 |
Other72 discharges in 3 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 | 43 | $167,634 | $38,342 | $40,400 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $112,014 | $19,818 | $26,995 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $138,765 | $27,063 | $33,442 | 3.38 |
Blood and immune system72 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 30 | $75,321 | $11,716 | $18,152 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 22 | $58,327 | $8,034 | $14,057 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 20 | $48,358 | $11,821 | $11,654 | 1.56 |
Liver, gallbladder and pancreas65 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 27 | $79,148 | $15,072 | $19,075 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 19 | $71,166 | $12,620 | $17,151 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 19 | $77,917 | $12,759 | $18,778 | 1.63 |
Injuries, poisonings and toxic effects of drugs49 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 23 | $69,015 | $15,788 | $16,633 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 14 | $46,868 | $8,360 | $11,295 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $75,529 | $13,504 | $18,203 | 1.60 |
Alcohol and drug use43 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 | 30 | $33,190 | $6,421 | $7,999 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 13 | $109,926 | $14,274 | $26,492 | 1.78 |
Mental diseases and disorders36 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 | 21 | $47,391 | $12,267 | $11,421 | 1.76 |
| PsychosesMS-DRG 885, medical | 15 | $32,799 | $11,206 | $7,905 | 1.37 |
Factors influencing health status35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 18 | $30,346 | $5,923 | $7,313 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 17 | $56,118 | $9,237 | $13,524 | 1.25 |
Ear, nose, mouth and throat24 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 24 | $34,983 | $5,828 | $8,431 | 0.74 |
Female reproductive system18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for non-malignancy without cc/mccMS-DRG 743, surgical | 18 | $31,182 | $9,245 | $7,515 | 1.16 |
Transplants, ECMO and tracheostomy (pre-MDC)13 discharges in 1 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 | 13 | $693,940 | $183,569 | $167,239 | 21.32 |
Blood cancers and poorly differentiated neoplasms13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 13 | $86,800 | $19,908 | $20,919 | 2.44 |
Multiple significant trauma13 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 | 13 | $138,719 | $33,472 | $33,431 | 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 | 1,095 | 986 | $21,025 | $2,036 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 407 | 390 | $43,128 | $10,721 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 316 | 294 | $11,546 | $1,169 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 294 | 267 | $10,586 | $1,425 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 212 | 207 | $107,029 | $20,858 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 158 | 148 | $13,463 | $2,394 | $2,405 |
| Level 1 Endovascular ProceduresAPC 5191 | 156 | 156 | $17,464 | $2,208 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 136 | 136 | $29,870 | $4,203 | $4,358 |
| Level 3 Urology and Related ServicesAPC 5373 | 129 | 61 | $7,199 | $1,383 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 112 | 108 | $17,606 | $3,876 | $3,918 |
| Level 2 Intraocular ProceduresAPC 5492 | 112 | 104 | $19,070 | $3,042 | $3,116 |
| Level 5 Airway EndoscopyAPC 5155 | 110 | 110 | $35,687 | $5,177 | $5,183 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 109 | 107 | $25,376 | $5,263 | $5,339 |
| Level 4 Urology and Related ServicesAPC 5374 | 108 | 99 | $13,098 | $2,587 | $2,629 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 88 | 75 | $13,774 | $2,556 | $2,636 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 82 | 75 | $14,441 | $1,939 | $2,141 |
| Level 3 Endovascular ProceduresAPC 5193 | 77 | 73 | $56,512 | $8,803 | $8,874 |
| Level 3 Lower GI ProceduresAPC 5313 | 70 | 70 | $13,376 | $2,142 | $2,176 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 69 | 69 | $29,786 | $4,861 | $4,982 |
| Level 4 Vascular ProceduresAPC 5184 | 68 | 62 | $28,244 | $4,047 | $3,946 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 64 | 64 | $43,123 | $8,130 | $8,164 |
| Level 4 Gynecologic ProceduresAPC 5414 | 63 | 60 | $14,224 | $2,326 | $2,389 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 59 | 58 | $11,569 | $2,407 | $2,373 |
| Level 4 Airway EndoscopyAPC 5154 | 55 | 53 | $22,882 | $2,833 | $2,833 |
| Level 4 Endovascular ProceduresAPC 5194 | 55 | 52 | $65,900 | $14,709 | $14,606 |
| Level 2 Vascular ProceduresAPC 5182 | 48 | 48 | $4,604 | $1,185 | $1,204 |
| Level 6 Urology and Related ServicesAPC 5376 | 47 | 46 | $24,258 | $6,959 | $7,291 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 46 | 46 | $61,802 | $15,674 | $15,763 |
| Level 2 Endovascular ProceduresAPC 5192 | 45 | 40 | $27,511 | $4,226 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 43 | 43 | $36,112 | $8,498 | $8,569 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 41 | 40 | $19,266 | $2,883 | $2,930 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 40 | 40 | $11,206 | $1,209 | $1,196 |
| Level 3 Upper GI ProceduresAPC 5303 | 40 | 39 | $12,605 | $2,897 | $2,888 |
| Level 2 Urology and Related ServicesAPC 5372 | 37 | 14 | $3,649 | $488 | $502 |
| Level 5 ENT ProceduresAPC 5165 | 29 | 28 | $22,932 | $4,430 | $4,436 |
| Level 5 Gynecologic ProceduresAPC 5415 | 28 | 28 | $18,361 | $3,625 | $3,792 |
| Complex GI ProceduresAPC 5331 | 27 | 20 | $16,536 | $4,151 | $4,263 |
| Level 6 Gynecologic ProceduresAPC 5416 | 27 | 27 | $31,576 | $5,293 | $5,836 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 23 | 23 | $28,603 | $6,434 | $6,514 |
| Level 1 Nerve ProceduresAPC 5431 | 22 | 21 | $9,088 | $1,461 | $1,407 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 21 | 21 | $70,199 | $16,024 | $17,052 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 21 | 21 | $72,228 | $19,083 | $18,465 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 18 | 18 | $109,930 | $27,863 | $29,375 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 17 | 16 | $19,995 | $5,173 | $4,524 |
| Level 3 Airway EndoscopyAPC 5153 | 15 | 15 | $15,281 | $1,284 | $1,264 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 15 | 15 | $86,374 | $25,911 | $26,719 |
| Level 3 Intraocular ProceduresAPC 5493 | 15 | 13 | $23,740 | $3,954 | $4,004 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 14 | 14 | $111,193 | $25,883 | $26,955 |
| Level 1 Intraocular ProceduresAPC 5491 | 14 | 13 | $18,131 | $1,752 | $1,752 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 12 | 12 | $97,238 | $17,241 | $21,011 |
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.