Albany Medical Center Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Albany Medical Center Hospital, Albany, NY in 2024, from traditional Medicare claims. Back to the Albany Medical Center Hospital profile, with quality ratings, finances and negotiated rates.
5,638
Medicare inpatient discharges
In 169 published DRGs
2.29
Case mix index
IPPS FY 2027
37%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
4,892
Medicare outpatient services
In 52 service groups
Inpatient stays by major diagnostic category
Circulatory system1,438 discharges in 36 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 199 | $51,142 | $31,476 | $15,650 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 181 | $118,000 | $47,625 | $36,108 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 124 | $58,797 | $15,833 | $17,992 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 106 | $171,013 | $61,042 | $52,330 | 6.25 |
| Heart failure and shock with MCCMS-DRG 291, medical | 78 | $52,081 | $12,837 | $15,937 | 1.28 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 62 | $41,264 | $8,048 | $12,627 | 0.91 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 46 | $25,609 | $6,602 | $7,836 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 45 | $83,901 | $16,753 | $25,674 | 1.82 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 38 | $124,806 | $33,737 | $38,190 | 3.35 |
| Syncope and collapseMS-DRG 312, medical | 38 | $33,021 | $7,642 | $10,104 | 0.86 |
| Other vascular procedures with CCMS-DRG 253, surgical | 37 | $75,739 | $20,860 | $23,176 | 2.55 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 32 | $74,021 | $36,586 | $22,650 | 3.90 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 28 | $107,678 | $19,849 | $32,950 | 2.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 26 | $240,391 | $67,405 | $73,560 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 25 | $65,132 | $41,425 | $19,931 | 4.16 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 24 | $165,947 | $48,448 | $50,780 | 5.06 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 24 | $57,439 | $19,796 | $17,576 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 23 | $124,142 | $28,609 | $37,987 | 2.87 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 22 | $82,358 | $34,963 | $25,202 | 3.46 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 21 | $186,900 | $48,055 | $57,191 | 5.88 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 21 | $116,510 | $34,337 | $35,652 | 3.46 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 21 | $85,247 | $19,487 | $26,086 | 1.97 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 21 | $20,807 | $4,197 | $6,367 | 0.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 19 | $35,653 | $11,444 | $10,910 | 1.20 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 18 | $198,471 | $51,420 | $60,732 | 4.81 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $79,197 | $22,350 | $24,234 | 2.28 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 18 | $51,465 | $8,274 | $15,748 | 1.08 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 18 | $36,905 | $9,247 | $11,293 | 0.97 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $28,017 | $9,033 | $8,573 | 1.07 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 15 | $151,915 | $38,800 | $46,486 | 5.24 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 14 | $294,207 | $76,535 | $90,027 | 7.80 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 12 | $158,189 | $40,468 | $48,406 | 4.04 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 12 | $30,525 | $6,087 | $9,341 | 0.72 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 12 | $67,660 | $14,858 | $20,704 | 1.58 |
| Hypertension without MCCMS-DRG 305, medical | 12 | $38,499 | $6,274 | $11,781 | 0.75 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 11 | $39,012 | $16,717 | $11,938 | 1.74 |
Nervous system959 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 153 | $71,516 | $18,837 | $21,884 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 105 | $46,050 | $8,978 | $14,091 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 86 | $104,500 | $40,926 | $31,977 | 4.42 |
| Seizures with MCCMS-DRG 100, medical | 53 | $77,107 | $18,478 | $23,595 | 1.98 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 43 | $90,446 | $21,624 | $27,677 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 41 | $138,444 | $55,050 | $42,364 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 40 | $36,491 | $7,278 | $11,166 | 0.91 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 35 | $55,190 | $13,805 | $16,888 | 1.47 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 33 | $40,993 | $12,266 | $12,544 | 1.36 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 30 | $61,537 | $20,333 | $18,830 | 2.43 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 29 | $66,574 | $17,537 | $20,372 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 27 | $37,840 | $5,403 | $11,579 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 25 | $53,757 | $12,814 | $16,450 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 24 | $73,254 | $15,341 | $22,416 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 23 | $46,458 | $9,882 | $14,216 | 1.06 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 22 | $74,154 | $21,569 | $22,691 | 2.27 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 19 | $101,436 | $31,853 | $31,039 | 3.79 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 19 | $35,688 | $10,088 | $10,920 | 1.14 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 18 | $72,112 | $22,761 | $22,066 | 2.39 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 17 | $236,785 | $80,966 | $72,456 | 8.45 |
| Extracranial procedures with CCMS-DRG 038, surgical | 17 | $57,473 | $15,459 | $17,587 | 1.60 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 16 | $39,537 | $12,516 | $12,098 | 1.32 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $61,790 | $24,470 | $18,908 | 2.95 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 13 | $41,691 | $9,877 | $12,758 | 1.03 |
| Spinal procedures with CC or spinal neurostimulatorsMS-DRG 029, surgical | 12 | $83,501 | $33,976 | $25,551 | 3.43 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 12 | $57,830 | $21,636 | $17,696 | 2.23 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $29,055 | $7,080 | $8,891 | 0.80 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $46,050 | $8,722 | $14,091 | 1.03 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 11 | $38,434 | $8,125 | $11,761 | 0.92 |
Infectious and parasitic diseases703 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 | 467 | $76,799 | $19,008 | $23,501 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 109 | $134,446 | $45,497 | $41,140 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 61 | $32,053 | $8,961 | $9,808 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 23 | $71,250 | $16,406 | $21,802 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 20 | $228,633 | $68,023 | $69,962 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 12 | $96,583 | $18,444 | $29,554 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $28,020 | $8,562 | $8,574 | 1.01 |
Respiratory system581 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 103 | $55,283 | $11,402 | $16,917 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 89 | $52,872 | $15,820 | $16,179 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 58 | $45,897 | $12,530 | $14,045 | 1.33 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 47 | $35,268 | $15,407 | $10,792 | 1.88 |
| Major chest procedures with MCCMS-DRG 163, surgical | 43 | $118,047 | $44,689 | $36,122 | 4.71 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 31 | $46,249 | $13,724 | $14,152 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 26 | $50,427 | $22,134 | $15,431 | 2.55 |
| Major chest trauma with MCCMS-DRG 183, medical | 22 | $61,055 | $13,941 | $18,683 | 1.57 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 21 | $32,445 | $8,310 | $9,928 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 21 | $36,545 | $9,508 | $11,183 | 1.10 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 20 | $28,234 | $7,239 | $8,639 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 20 | $36,364 | $9,702 | $11,127 | 1.05 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 17 | $88,761 | $26,733 | $27,161 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $30,466 | $6,918 | $9,323 | 0.82 |
| Pneumothorax with MCCMS-DRG 199, medical | 14 | $33,524 | $17,658 | $10,258 | 1.77 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $91,360 | $36,374 | $27,956 | 4.06 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $34,082 | $9,004 | $10,429 | 1.08 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 11 | $57,373 | $16,209 | $17,556 | 1.74 |
Musculoskeletal system and connective tissue471 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 71 | $69,524 | $20,119 | $21,274 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 64 | $38,813 | $8,969 | $11,877 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 38 | $113,004 | $27,573 | $34,579 | 2.95 |
| Medical back problems with MCCMS-DRG 551, medical | 33 | $58,211 | $16,330 | $17,813 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 31 | $66,179 | $20,007 | $20,251 | 2.11 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 25 | $62,881 | $27,330 | $19,242 | 2.96 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 24 | $61,009 | $31,667 | $18,669 | 3.66 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 18 | $77,976 | $32,355 | $23,861 | 3.49 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 18 | $36,250 | $6,925 | $11,092 | 0.79 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 18 | $40,933 | $7,702 | $12,526 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 16 | $51,893 | $18,032 | $15,879 | 1.87 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 15 | $78,495 | $20,151 | $24,019 | 2.40 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 14 | $113,493 | $50,559 | $34,729 | 5.19 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 14 | $49,055 | $23,003 | $15,011 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 13 | $80,980 | $18,309 | $24,780 | 2.04 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $51,814 | $11,079 | $15,855 | 1.59 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 12 | $92,256 | $25,018 | $28,230 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 12 | $47,353 | $9,476 | $14,490 | 1.09 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 12 | $37,415 | $7,110 | $11,449 | 1.00 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 11 | $46,824 | $13,821 | $14,328 | 1.52 |
Digestive system433 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 61 | $35,246 | $9,158 | $10,785 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 54 | $60,165 | $16,808 | $18,410 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 51 | $26,745 | $6,760 | $8,184 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 46 | $56,225 | $20,327 | $17,205 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 36 | $131,692 | $39,639 | $40,298 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 33 | $35,639 | $7,118 | $10,906 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 32 | $25,303 | $8,593 | $7,743 | 0.94 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 29 | $28,927 | $14,271 | $8,852 | 1.67 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 29 | $43,562 | $12,458 | $13,330 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 17 | $70,006 | $16,211 | $21,422 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $76,264 | $11,169 | $23,337 | 1.45 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 11 | $51,655 | $24,270 | $15,806 | 2.50 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 11 | $139,784 | $39,451 | $42,774 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 11 | $30,279 | $9,273 | $9,265 | 1.04 |
Kidney and urinary tract387 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 86 | $43,402 | $10,404 | $13,281 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 56 | $64,579 | $16,861 | $19,761 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 45 | $30,850 | $7,118 | $9,440 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 43 | $37,236 | $9,386 | $11,394 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 39 | $50,237 | $14,741 | $15,373 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 29 | $36,145 | $7,245 | $11,060 | 0.90 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 23 | $48,634 | $12,315 | $14,882 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 22 | $67,231 | $23,681 | $20,573 | 2.59 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 21 | $28,706 | $8,188 | $8,784 | 1.05 |
| Kidney transplantMS-DRG 652, surgical | 12 | $180,848 | $24,994 | $55,340 | 3.00 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 11 | $45,010 | $16,095 | $13,773 | 1.84 |
Liver, gallbladder and pancreas133 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 36 | $52,768 | $9,996 | $16,147 | 1.09 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 27 | $64,764 | $14,685 | $19,818 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 17 | $43,822 | $18,602 | $13,409 | 1.92 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 16 | $44,857 | $16,212 | $13,726 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 13 | $61,360 | $22,980 | $18,776 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 12 | $55,048 | $15,533 | $16,845 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 12 | $41,852 | $14,129 | $12,807 | 1.76 |
Endocrine, nutritional and metabolic117 discharges in 4 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 | 47 | $51,928 | $11,573 | $15,890 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 39 | $31,221 | $6,589 | $9,554 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 20 | $50,083 | $13,855 | $15,326 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 11 | $29,196 | $8,051 | $8,934 | 0.90 |
Skin, subcutaneous tissue and breast95 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 49 | $30,618 | $7,763 | $9,369 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 18 | $33,577 | $7,627 | $10,274 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 16 | $48,119 | $13,319 | $14,724 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 12 | $71,668 | $15,768 | $21,930 | 1.75 |
Blood cancers and poorly differentiated neoplasms64 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 27 | $36,256 | $12,802 | $11,094 | 1.21 |
| Acute leukemia with MCCMS-DRG 834, medical | 13 | $206,849 | $67,093 | $63,296 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 13 | $169,145 | $31,850 | $51,758 | 4.84 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $92,131 | $14,235 | $28,192 | 1.57 |
Other63 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 | 35 | $155,309 | $46,753 | $47,524 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 17 | $79,560 | $30,366 | $24,345 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $73,941 | $21,668 | $22,626 | 2.49 |
Injuries, poisonings and toxic effects of drugs62 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 | 22 | $73,291 | $17,404 | $22,427 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 14 | $119,885 | $32,767 | $36,685 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 14 | $34,421 | $8,517 | $10,533 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 12 | $84,315 | $15,834 | $25,800 | 1.60 |
Blood and immune system42 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 28 | $40,392 | $10,905 | $12,360 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 14 | $56,185 | $12,997 | $17,192 | 1.40 |
Transplants, ECMO and tracheostomy (pre-MDC)42 discharges in 2 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 | 27 | $620,093 | $195,854 | $189,749 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 15 | $383,790 | $143,542 | $117,440 | 14.70 |
Multiple significant trauma37 discharges in 3 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 | 14 | $91,311 | $33,112 | $27,941 | 3.88 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 12 | $49,641 | $11,953 | $15,190 | 1.50 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 11 | $176,991 | $67,330 | $54,159 | 7.23 |
Factors influencing health status11 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 | 11 | $28,275 | $6,910 | $8,652 | 0.80 |
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 |
|---|---|---|---|---|---|
| Level 2 Urology and Related ServicesAPC 5372 | 952 | 452 | $991 | $575 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 379 | 305 | $4,710 | $1,697 | $1,516 |
| Comprehensive Observation ServicesAPC 8011 | 343 | 330 | $17,811 | $2,277 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 294 | 265 | $8,171 | $1,324 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 251 | 250 | $26,967 | $2,433 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 183 | 168 | $9,864 | $2,634 | $2,405 |
| Level 2 Upper GI ProceduresAPC 5302 | 148 | 129 | $8,902 | $1,578 | $1,445 |
| Level 4 Urology and Related ServicesAPC 5374 | 145 | 120 | $10,643 | $2,871 | $2,629 |
| Level 3 Airway EndoscopyAPC 5153 | 133 | 78 | $1,968 | $1,423 | $1,264 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 127 | 122 | $25,463 | $12,201 | $10,772 |
| Level 3 Endovascular ProceduresAPC 5193 | 126 | 111 | $40,572 | $10,017 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 117 | 115 | $82,657 | $23,479 | $21,117 |
| Level 5 Urology and Related ServicesAPC 5375 | 117 | 111 | $14,564 | $4,258 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 116 | 112 | $16,498 | $2,358 | $2,141 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 105 | 103 | $17,758 | $4,785 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 94 | 92 | $18,682 | $5,850 | $5,339 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 82 | 81 | $26,400 | $9,157 | $8,164 |
| Level 4 Airway EndoscopyAPC 5154 | 68 | 64 | $15,000 | $3,163 | $2,833 |
| Level 4 Vascular ProceduresAPC 5184 | 62 | 59 | $20,191 | $4,567 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 61 | 61 | $37,713 | $9,676 | $8,569 |
| Level 2 Endovascular ProceduresAPC 5192 | 60 | 53 | $20,801 | $4,828 | $4,338 |
| Level 3 Upper GI ProceduresAPC 5303 | 59 | 58 | $20,884 | $3,239 | $2,888 |
| Level 5 ENT ProceduresAPC 5165 | 56 | 56 | $16,965 | $4,947 | $4,436 |
| Level 2 Vascular ProceduresAPC 5182 | 55 | 53 | $3,740 | $1,283 | $1,204 |
| Level 4 Endovascular ProceduresAPC 5194 | 51 | 49 | $60,462 | $16,585 | $14,606 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 48 | 45 | $12,108 | $2,700 | $2,373 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 47 | 46 | $16,831 | $3,151 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 45 | 45 | $22,948 | $5,264 | $4,982 |
| Level 1 Nerve ProceduresAPC 5431 | 44 | 41 | $8,119 | $1,591 | $1,407 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 34 | 34 | $34,480 | $17,547 | $15,763 |
| Level 3 Lower GI ProceduresAPC 5313 | 33 | 33 | $8,879 | $2,313 | $2,176 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 33 | 32 | $16,271 | $2,917 | $2,636 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 33 | 33 | $52,905 | $20,197 | $18,465 |
| Level 5 Gynecologic ProceduresAPC 5415 | 30 | 30 | $13,001 | $4,202 | $3,792 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 30 | 30 | $49,637 | $30,150 | $26,719 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 29 | 27 | $7,179 | $1,974 | $1,780 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 27 | 26 | $7,392 | $1,327 | $1,196 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 27 | 27 | $97,373 | $33,135 | $29,375 |
| Level 1 Intraocular ProceduresAPC 5491 | 25 | 21 | $9,749 | $1,969 | $1,752 |
| Level 5 Airway EndoscopyAPC 5155 | 24 | 24 | $19,675 | $5,782 | $5,183 |
| Level 4 ENT ProceduresAPC 5164 | 24 | 23 | $8,946 | $2,492 | $2,217 |
| Level 4 Gynecologic ProceduresAPC 5414 | 24 | 24 | $7,911 | $2,640 | $2,389 |
| Level 2 Intraocular ProceduresAPC 5492 | 23 | 22 | $14,278 | $3,435 | $3,116 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 20 | 19 | $24,367 | $7,371 | $6,514 |
| Complex GI ProceduresAPC 5331 | 18 | 18 | $21,530 | $4,814 | $4,263 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 16 | 16 | $12,160 | $3,266 | $2,969 |
| Cochlear Implant ProcedureAPC 5166 | 14 | 14 | $42,934 | $33,811 | $29,489 |
| Level 3 ENT ProceduresAPC 5163 | 13 | 13 | $7,865 | $1,288 | $1,106 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 12 | 12 | $47,624 | $18,976 | $17,052 |
| Level 8 Urology and Related ServicesAPC 5378 | 12 | 12 | $37,382 | $19,701 | $17,428 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 12 | 12 | $19,344 | $2,395 | $2,547 |
| Level 6 Gynecologic ProceduresAPC 5416 | 11 | 11 | $17,273 | $5,803 | $5,836 |
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.