Advocate Sherman Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Advocate Sherman Hospital, Elgin, IL in 2024, from traditional Medicare claims. Back to the Advocate Sherman Hospital profile, with quality ratings, finances and negotiated rates.
2,963
Medicare inpatient discharges
In 86 published DRGs
1.69
Case mix index
IPPS FY 2027
12%
Surgical stays
69%
Stays with complications
In DRGs with a CC or MCC
3,220
Medicare outpatient services
In 39 service groups
Inpatient stays by major diagnostic category
Circulatory system716 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 240 | $48,449 | $8,577 | $10,174 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 68 | $39,448 | $4,682 | $8,284 | 0.74 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 45 | $117,204 | $22,890 | $24,613 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 44 | $153,523 | $34,458 | $32,240 | 4.88 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 35 | $30,258 | $3,175 | $6,354 | 0.55 |
| Syncope and collapseMS-DRG 312, medical | 33 | $34,204 | $5,701 | $7,183 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 26 | $81,828 | $12,523 | $17,184 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 25 | $87,697 | $13,644 | $18,416 | 2.16 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 25 | $51,552 | $8,046 | $10,826 | 1.20 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 20 | $36,908 | $6,749 | $7,751 | 1.07 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 19 | $76,963 | $11,301 | $16,162 | 1.59 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $71,832 | $15,883 | $15,085 | 2.28 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $53,334 | $9,377 | $11,200 | 1.58 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 18 | $116,375 | $18,932 | $24,439 | 2.87 |
| Hypertension without MCCMS-DRG 305, medical | 16 | $30,636 | $4,584 | $6,433 | 0.75 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 15 | $96,105 | $14,628 | $20,182 | 2.09 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 14 | $51,164 | $5,676 | $10,744 | 0.91 |
| Chest painMS-DRG 313, medical | 13 | $26,322 | $4,259 | $5,528 | 0.72 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 12 | $61,066 | $5,934 | $12,824 | 1.08 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $32,899 | $6,909 | $6,909 | 0.97 |
Infectious and parasitic diseases421 discharges in 3 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 | 318 | $76,479 | $13,205 | $16,061 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 60 | $42,307 | $6,211 | $8,884 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 43 | $173,395 | $32,533 | $36,413 | 5.00 |
Respiratory system405 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 111 | $51,299 | $8,844 | $10,773 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 88 | $46,338 | $8,548 | $9,731 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 68 | $62,133 | $11,500 | $13,048 | 1.70 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 27 | $40,787 | $6,046 | $8,565 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 26 | $35,620 | $5,231 | $7,480 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 20 | $57,969 | $9,662 | $12,173 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 20 | $36,481 | $7,708 | $7,661 | 1.10 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 19 | $42,212 | $6,162 | $8,865 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $41,476 | $4,823 | $8,710 | 0.82 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 13 | $33,122 | $5,712 | $6,956 | 0.85 |
Kidney and urinary tract374 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 81 | $30,585 | $5,189 | $6,423 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 74 | $38,334 | $7,710 | $8,050 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 56 | $34,856 | $6,042 | $7,320 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 51 | $55,322 | $11,793 | $11,618 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 47 | $60,769 | $10,580 | $12,762 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 35 | $37,791 | $6,945 | $7,936 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 17 | $47,477 | $8,435 | $9,970 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 13 | $60,122 | $16,108 | $12,626 | 2.59 |
Digestive system346 discharges in 12 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 | 94 | $36,007 | $4,928 | $7,561 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 67 | $48,013 | $6,436 | $10,083 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 43 | $32,356 | $4,830 | $6,795 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 23 | $45,492 | $8,297 | $9,553 | 1.28 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 21 | $46,698 | $6,964 | $9,807 | 1.04 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 19 | $67,319 | $12,667 | $14,137 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 17 | $35,738 | $5,629 | $7,505 | 0.94 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $51,159 | $10,420 | $10,743 | 1.45 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 14 | $46,702 | $11,295 | $9,807 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 12 | $87,984 | $12,558 | $18,477 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 11 | $176,713 | $31,605 | $37,110 | 4.52 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 11 | $25,649 | $3,097 | $5,386 | 0.56 |
Musculoskeletal system and connective tissue189 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 52 | $35,633 | $6,142 | $7,483 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 24 | $79,934 | $14,382 | $16,786 | 2.07 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 22 | $34,589 | $5,758 | $7,264 | 0.90 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 16 | $109,578 | $20,067 | $23,011 | 2.95 |
| Medical back problems with MCCMS-DRG 551, medical | 16 | $61,929 | $10,027 | $13,005 | 1.70 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 13 | $101,017 | $15,430 | $21,214 | 2.38 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 12 | $88,538 | $14,610 | $18,593 | 2.11 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 12 | $26,512 | $4,553 | $5,567 | 0.79 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 11 | $99,357 | $21,953 | $20,865 | 3.49 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 11 | $43,336 | $6,566 | $9,100 | 1.00 |
Endocrine, nutritional and metabolic162 discharges in 6 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 | 51 | $46,789 | $8,993 | $9,826 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 51 | $33,019 | $4,929 | $6,934 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 19 | $37,092 | $5,951 | $7,789 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 15 | $56,519 | $8,771 | $11,869 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $31,327 | $7,022 | $6,579 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $36,219 | $11,083 | $7,606 | 1.65 |
Nervous system108 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 31 | $49,104 | $6,477 | $10,312 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 19 | $70,965 | $11,288 | $14,903 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 18 | $33,987 | $7,948 | $7,137 | 1.36 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 15 | $43,254 | $7,058 | $9,083 | 1.03 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 14 | $39,284 | $6,538 | $8,250 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 11 | $126,102 | $28,267 | $26,481 | 4.42 |
Skin, subcutaneous tissue and breast77 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 62 | $28,690 | $5,463 | $6,025 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $42,127 | $8,618 | $8,847 | 1.49 |
Blood and immune system77 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 40 | $53,595 | $6,327 | $11,255 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 22 | $71,408 | $10,492 | $14,996 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 15 | $55,865 | $11,072 | $11,732 | 1.56 |
Mental diseases and disorders19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 19 | $34,367 | $10,976 | $7,217 | 1.76 |
Liver, gallbladder and pancreas15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 15 | $76,981 | $8,960 | $16,166 | 1.63 |
Factors influencing health status15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 15 | $27,269 | $5,393 | $5,727 | 0.80 |
Alcohol and drug use14 discharges in 1 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 | 14 | $35,084 | $6,268 | $7,368 | 0.86 |
Other14 discharges in 1 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 | 14 | $134,101 | $31,402 | $28,161 | 4.74 |
Injuries, poisonings and toxic effects of drugs11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 11 | $36,071 | $6,382 | $7,575 | 0.86 |
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 | 561 | 518 | $19,173 | $2,058 | $2,090 |
| Level 1 Intraocular ProceduresAPC 5491 | 402 | 242 | $10,060 | $1,805 | $1,752 |
| Level 2 Upper GI ProceduresAPC 5302 | 171 | 138 | $18,812 | $1,475 | $1,445 |
| Level 1 Nerve ProceduresAPC 5431 | 156 | 129 | $8,903 | $1,498 | $1,407 |
| Level 1 Endovascular ProceduresAPC 5191 | 147 | 146 | $24,578 | $2,272 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 136 | 127 | $11,996 | $1,252 | $1,220 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 120 | 114 | $140,220 | $21,507 | $21,117 |
| Level 3 Urology and Related ServicesAPC 5373 | 113 | 100 | $13,008 | $1,556 | $1,516 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 111 | 105 | $61,278 | $11,204 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 111 | 110 | $36,176 | $4,329 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 108 | 83 | $15,782 | $2,637 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 87 | 84 | $19,364 | $2,481 | $2,405 |
| Level 2 Intraocular ProceduresAPC 5492 | 80 | 63 | $20,029 | $3,160 | $3,116 |
| Level 3 Endovascular ProceduresAPC 5193 | 72 | 66 | $60,204 | $9,103 | $8,874 |
| Level 2 Urology and Related ServicesAPC 5372 | 70 | 54 | $9,412 | $513 | $502 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 68 | 67 | $37,396 | $5,400 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 67 | 63 | $24,349 | $3,967 | $3,918 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 62 | 62 | $30,685 | $8,786 | $8,569 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 47 | 34 | $15,707 | $2,685 | $2,636 |
| Level 4 Endovascular ProceduresAPC 5194 | 45 | 37 | $76,625 | $15,115 | $14,606 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 43 | 43 | $26,027 | $6,654 | $6,514 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 34 | 33 | $20,110 | $2,141 | $2,141 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 33 | 29 | $16,303 | $2,135 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 33 | 33 | $17,781 | $1,321 | $1,264 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 31 | 30 | $83,459 | $15,998 | $15,763 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 30 | 30 | $46,990 | $5,075 | $4,982 |
| Complex GI ProceduresAPC 5331 | 29 | 21 | $23,790 | $3,824 | $4,263 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 28 | 28 | $27,389 | $2,861 | $2,930 |
| Level 2 Endovascular ProceduresAPC 5192 | 27 | 22 | $27,809 | $4,445 | $4,338 |
| Level 3 Upper GI ProceduresAPC 5303 | 26 | 26 | $23,173 | $2,866 | $2,888 |
| Level 2 Vascular ProceduresAPC 5182 | 25 | 25 | $8,546 | $1,242 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 25 | 25 | $81,320 | $29,191 | $29,375 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 24 | 24 | $61,923 | $8,065 | $8,164 |
| Level 4 Gynecologic ProceduresAPC 5414 | 23 | 23 | $20,335 | $2,433 | $2,389 |
| Level 4 Airway EndoscopyAPC 5154 | 21 | 21 | $26,933 | $2,915 | $2,833 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 17 | 17 | $13,928 | $1,177 | $1,196 |
| Level 4 Vascular ProceduresAPC 5184 | 14 | 14 | $47,505 | $4,277 | $3,946 |
| Level 3 Lower GI ProceduresAPC 5313 | 12 | 12 | $18,395 | $2,037 | $2,176 |
| Level 5 Gynecologic ProceduresAPC 5415 | 11 | 11 | $34,036 | $3,871 | $3,792 |
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.