Ascension St. Vincent Hospital - Indianapolis Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Ascension St. Vincent Hospital - Indianapolis, Indianapolis, IN in 2024, from traditional Medicare claims. Back to the Ascension St. Vincent Hospital - Indianapolis profile, with quality ratings, finances and negotiated rates.
4,946
Medicare inpatient discharges
In 167 published DRGs
2.42
Case mix index
IPPS FY 2027
35%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
3,616
Medicare outpatient services
In 46 service groups
Inpatient stays by major diagnostic category
Circulatory system796 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 154 | $57,091 | $9,975 | $11,647 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 105 | $131,715 | $23,784 | $26,870 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 56 | $84,797 | $11,967 | $17,299 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 38 | $140,316 | $16,793 | $28,624 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 38 | $42,869 | $6,913 | $8,745 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 36 | $35,174 | $5,429 | $7,175 | 0.74 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 28 | $280,305 | $46,799 | $57,182 | 5.06 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 26 | $84,425 | $10,911 | $17,223 | 1.20 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 24 | $147,305 | $26,609 | $30,050 | 3.46 |
| Hypertension without MCCMS-DRG 305, medical | 24 | $29,932 | $5,574 | $6,106 | 0.75 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 24 | $76,914 | $15,588 | $15,690 | 2.09 |
| Other vascular procedures with CCMS-DRG 253, surgical | 23 | $122,775 | $17,868 | $25,046 | 2.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 22 | $212,251 | $25,823 | $43,299 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 21 | $70,843 | $7,964 | $14,452 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $47,270 | $7,334 | $9,643 | 0.91 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $156,376 | $28,175 | $31,901 | 3.46 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 17 | $166,755 | $31,833 | $34,018 | 4.16 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 14 | $67,849 | $7,993 | $13,841 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 14 | $68,965 | $9,334 | $14,069 | 1.15 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $182,069 | $26,950 | $37,142 | 3.35 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 13 | $224,553 | $30,489 | $45,809 | 3.90 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 13 | $136,978 | $13,649 | $27,944 | 1.82 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 12 | $175,577 | $35,609 | $35,818 | 4.81 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 12 | $112,747 | $10,597 | $23,000 | 1.74 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $177,222 | $27,578 | $36,153 | 3.27 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 11 | $74,876 | $10,110 | $15,275 | 1.58 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 11 | $22,095 | $4,118 | $4,507 | 0.55 |
Nervous system769 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 | 117 | $79,087 | $14,785 | $16,134 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 97 | $49,199 | $7,542 | $10,037 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 55 | $170,122 | $32,666 | $34,705 | 4.42 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 54 | $97,327 | $17,432 | $19,855 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 35 | $234,105 | $45,293 | $47,757 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 35 | $86,348 | $15,876 | $17,615 | 1.98 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 31 | $40,972 | $5,999 | $8,358 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 27 | $49,355 | $7,692 | $10,068 | 1.06 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 26 | $86,720 | $14,496 | $17,691 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 26 | $45,034 | $10,128 | $9,187 | 1.36 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 25 | $69,156 | $8,591 | $14,108 | 1.14 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 25 | $41,465 | $9,737 | $8,459 | 1.32 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 21 | $43,766 | $4,877 | $8,928 | 0.69 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 21 | $63,208 | $17,823 | $12,894 | 2.27 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 19 | $125,624 | $22,692 | $25,627 | 2.95 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 19 | $56,255 | $9,233 | $11,476 | 1.03 |
| Extracranial procedures with CCMS-DRG 038, surgical | 18 | $80,784 | $11,658 | $16,480 | 1.60 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 17 | $99,728 | $17,331 | $20,344 | 2.43 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 17 | $47,078 | $11,486 | $9,604 | 1.47 |
| Seizures without MCCMS-DRG 101, medical | 17 | $31,945 | $7,010 | $6,517 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 16 | $49,824 | $8,899 | $10,164 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 16 | $77,237 | $11,831 | $15,756 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 12 | $155,554 | $29,357 | $31,733 | 3.79 |
| Spinal procedures with MCCMS-DRG 028, surgical | 12 | $282,747 | $52,868 | $57,680 | 6.03 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 11 | $89,708 | $11,906 | $18,300 | 1.62 |
Musculoskeletal system and connective tissue712 discharges in 23 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 | 86 | $96,633 | $14,869 | $19,713 | 2.07 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 66 | $182,135 | $26,542 | $37,155 | 3.66 |
| Medical back problems without MCCMS-DRG 552, medical | 56 | $42,207 | $7,121 | $8,610 | 0.97 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 55 | $228,109 | $45,985 | $46,534 | 6.12 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 41 | $113,829 | $21,452 | $23,221 | 2.95 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 40 | $157,225 | $20,749 | $32,074 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 40 | $118,689 | $17,687 | $24,213 | 2.40 |
| Medical back problems with MCCMS-DRG 551, medical | 39 | $69,123 | $13,353 | $14,101 | 1.70 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 37 | $192,350 | $32,943 | $39,239 | 4.61 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 37 | $97,937 | $15,850 | $19,979 | 2.11 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 24 | $135,853 | $29,646 | $27,714 | 2.99 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 20 | $158,853 | $25,993 | $32,406 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 20 | $162,418 | $28,369 | $33,133 | 3.46 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 19 | $125,099 | $19,472 | $25,520 | 2.48 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 18 | $3,838,130 | $1,436,668 | $782,979 | 5.19 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 18 | $107,497 | $13,990 | $21,929 | 1.88 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 18 | $142,777 | $47,848 | $29,126 | 0.90 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 14 | $146,553 | $17,253 | $29,897 | 2.46 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 14 | $103,602 | $13,272 | $21,135 | 1.87 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 13 | $325,577 | $71,238 | $66,418 | 8.86 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 13 | $87,521 | $15,086 | $17,854 | 2.04 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 13 | $55,083 | $9,506 | $11,237 | 1.30 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 11 | $39,078 | $5,467 | $7,972 | 0.79 |
Infectious and parasitic diseases571 discharges in 9 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 | 324 | $85,274 | $15,094 | $17,396 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 82 | $228,481 | $41,181 | $46,610 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 62 | $46,645 | $7,433 | $9,516 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 23 | $295,458 | $56,443 | $60,273 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 19 | $98,981 | $17,022 | $20,192 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 19 | $55,323 | $8,272 | $11,286 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 14 | $199,119 | $34,142 | $40,620 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $97,885 | $15,928 | $19,969 | 2.14 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $89,463 | $14,381 | $18,250 | 1.84 |
Digestive system528 discharges in 17 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 | 73 | $41,682 | $6,047 | $8,503 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 72 | $92,194 | $14,021 | $18,808 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 72 | $55,963 | $7,641 | $11,416 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 34 | $319,582 | $41,859 | $65,195 | 4.52 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 33 | $133,431 | $17,232 | $27,220 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 33 | $39,851 | $6,194 | $8,130 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 33 | $48,443 | $6,849 | $9,882 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 31 | $71,030 | $10,065 | $14,490 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 23 | $67,842 | $14,336 | $13,840 | 1.62 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 19 | $177,667 | $30,413 | $36,244 | 4.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 18 | $95,859 | $11,845 | $19,555 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 18 | $64,321 | $10,473 | $13,121 | 1.45 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 16 | $115,731 | $11,742 | $23,609 | 1.60 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 15 | $21,781 | $3,955 | $4,443 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 14 | $218,824 | $39,615 | $44,640 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $137,797 | $17,532 | $28,111 | 2.50 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $50,146 | $8,999 | $10,230 | 1.20 |
Respiratory system521 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 80 | $56,538 | $9,947 | $11,534 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 77 | $69,723 | $12,707 | $14,224 | 1.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 44 | $170,201 | $35,966 | $34,721 | 4.71 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 43 | $49,383 | $9,372 | $10,074 | 1.23 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 32 | $49,157 | $10,785 | $10,028 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 29 | $124,376 | $21,542 | $25,373 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 28 | $33,961 | $5,636 | $6,928 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 26 | $45,232 | $7,551 | $9,227 | 1.05 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 23 | $112,729 | $14,299 | $22,997 | 1.88 |
| Major chest procedures with CCMS-DRG 164, surgical | 21 | $128,052 | $18,500 | $26,123 | 2.55 |
| Major chest trauma with MCCMS-DRG 183, medical | 21 | $64,084 | $12,205 | $13,073 | 1.57 |
| Pneumothorax with MCCMS-DRG 199, medical | 17 | $100,499 | $17,100 | $20,502 | 1.77 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $28,613 | $6,093 | $5,837 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 15 | $54,350 | $7,766 | $11,087 | 1.10 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $262,932 | $51,639 | $53,638 | 6.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $158,227 | $30,292 | $32,278 | 4.06 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 12 | $54,593 | $6,783 | $11,137 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 12 | $118,587 | $13,754 | $24,192 | 1.74 |
Kidney and urinary tract357 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 52 | $39,361 | $6,081 | $8,030 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 51 | $74,572 | $11,739 | $15,213 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 47 | $47,192 | $6,556 | $9,627 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 47 | $94,142 | $8,845 | $19,205 | 1.02 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 46 | $45,802 | $8,788 | $9,344 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 40 | $70,097 | $12,714 | $14,300 | 1.65 |
| Kidney transplantMS-DRG 652, surgical | 32 | $305,582 | $21,680 | $62,339 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 28 | $60,431 | $10,248 | $12,328 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 14 | $57,528 | $7,397 | $11,736 | 1.05 |
Liver, gallbladder and pancreas140 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 26 | $56,140 | $8,627 | $11,453 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 22 | $118,748 | $12,615 | $24,225 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 20 | $72,616 | $12,642 | $14,814 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 19 | $84,412 | $13,879 | $17,220 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 17 | $133,743 | $17,115 | $27,284 | 2.32 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 13 | $47,005 | $6,567 | $9,589 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $115,978 | $17,356 | $23,659 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 11 | $60,738 | $14,848 | $12,391 | 1.92 |
Endocrine, nutritional and metabolic133 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 without MCCMS-DRG 641, medical | 41 | $37,341 | $5,697 | $7,618 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 35 | $77,968 | $10,829 | $15,905 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 18 | $37,192 | $6,970 | $7,587 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 14 | $76,423 | $12,128 | $15,590 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 13 | $40,372 | $8,036 | $8,236 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $116,973 | $13,673 | $23,863 | 1.98 |
Other110 discharges in 6 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 | 29 | $249,410 | $39,521 | $50,880 | 4.74 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 22 | $217,617 | $59,872 | $44,394 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 21 | $184,722 | $32,017 | $37,683 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $139,801 | $21,061 | $28,519 | 2.49 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 11 | $224,000 | $34,316 | $45,696 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 11 | $162,165 | $25,420 | $33,082 |
Skin, subcutaneous tissue and breast65 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 21 | $30,837 | $6,491 | $6,291 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 17 | $47,503 | $7,015 | $9,691 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $66,415 | $10,512 | $13,549 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast with MCCMS-DRG 604, medical | 12 | $93,974 | $19,733 | $19,171 | 1.51 |
Blood and immune system60 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 | 32 | $46,716 | $6,477 | $9,530 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 15 | $80,412 | $10,831 | $16,404 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 13 | $766,557 | $283,206 | $156,378 | 1.56 |
Injuries, poisonings and toxic effects of drugs43 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 15 | $160,146 | $30,691 | $32,670 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 14 | $96,008 | $16,249 | $19,586 | 2.00 |
| Complications of treatment with CCMS-DRG 920, medical | 14 | $51,780 | $8,040 | $10,563 | 1.03 |
Transplants, ECMO and tracheostomy (pre-MDC)33 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 20 | $1,293,707 | $234,797 | $263,916 | 27.10 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 13 | $619,862 | $147,011 | $126,452 | 21.32 |
Factors influencing health status32 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 | 17 | $45,225 | $6,135 | $9,226 | 0.80 |
| Other factors influencing health statusMS-DRG 951, medical | 15 | $24,828 | $4,714 | $5,065 | 0.59 |
Multiple significant trauma28 discharges in 2 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 | $138,849 | $27,377 | $28,325 | 3.88 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 13 | $99,131 | $21,399 | $20,223 | 2.73 |
Mental diseases and disorders18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 18 | $66,065 | $9,776 | $13,477 | 1.37 |
Alcohol and drug use18 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 | 18 | $36,735 | $6,808 | $7,494 | 0.86 |
Ear, nose, mouth and throat12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $25,642 | $5,566 | $5,231 | 0.74 |
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 3 Electrophysiologic ProceduresAPC 5213 | 365 | 358 | $159,721 | $19,460 | $21,117 |
| Comprehensive Observation ServicesAPC 8011 | 279 | 268 | $20,771 | $1,935 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 226 | 216 | $28,041 | $2,053 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 192 | 179 | $12,304 | $1,148 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 184 | 141 | $28,368 | $2,264 | $2,405 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 181 | 181 | $84,160 | $7,516 | $8,164 |
| Level 2 Upper GI ProceduresAPC 5302 | 167 | 159 | $19,976 | $1,352 | $1,445 |
| Level 5 Urology and Related ServicesAPC 5375 | 162 | 160 | $43,192 | $3,675 | $3,918 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 151 | 147 | $60,986 | $5,006 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 107 | 105 | $44,780 | $2,649 | $2,833 |
| Level 3 Endovascular ProceduresAPC 5193 | 96 | 87 | $78,703 | $8,190 | $8,874 |
| Level 2 Endovascular ProceduresAPC 5192 | 90 | 75 | $52,078 | $4,034 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 84 | 84 | $45,761 | $7,910 | $8,569 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 80 | 80 | $107,433 | $9,772 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 80 | 77 | $66,749 | $4,122 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 77 | 68 | $36,094 | $2,459 | $2,629 |
| Level 5 Airway EndoscopyAPC 5155 | 71 | 70 | $51,443 | $4,757 | $5,183 |
| Level 4 Gynecologic ProceduresAPC 5414 | 70 | 69 | $25,638 | $2,203 | $2,389 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 64 | 63 | $101,471 | $15,052 | $15,763 |
| Level 3 Urology and Related ServicesAPC 5373 | 63 | 58 | $15,535 | $1,360 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 60 | 59 | $31,777 | $2,275 | $2,373 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 56 | 56 | $131,589 | $27,803 | $29,375 |
| Level 1 Nerve ProceduresAPC 5431 | 56 | 53 | $26,192 | $1,307 | $1,407 |
| Level 4 Endovascular ProceduresAPC 5194 | 46 | 44 | $107,275 | $14,059 | $14,606 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 45 | 44 | $30,444 | $2,028 | $2,141 |
| Level 4 Vascular ProceduresAPC 5184 | 44 | 41 | $46,739 | $3,920 | $3,946 |
| Level 2 Vascular ProceduresAPC 5182 | 43 | 43 | $13,583 | $1,144 | $1,204 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 41 | 39 | $157,968 | $17,067 | $18,465 |
| Level 3 Airway EndoscopyAPC 5153 | 39 | 27 | $21,317 | $1,211 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 39 | 39 | $53,496 | $4,182 | $4,436 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 36 | 32 | $44,349 | $2,473 | $2,636 |
| Complex GI ProceduresAPC 5331 | 33 | 29 | $47,852 | $3,945 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 30 | 27 | $35,726 | $3,438 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 27 | 27 | $27,982 | $2,643 | $2,888 |
| Level 8 Urology and Related ServicesAPC 5378 | 27 | 25 | $110,176 | $15,805 | $17,428 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 26 | 26 | $31,571 | $5,339 | $5,682 |
| Level 6 Urology and Related ServicesAPC 5376 | 22 | 21 | $61,014 | $6,637 | $7,291 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 21 | 21 | $66,342 | $4,659 | $4,982 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 20 | 15 | $35,533 | $2,730 | $2,930 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 20 | 19 | $16,042 | $1,142 | $1,196 |
| Level 4 ENT ProceduresAPC 5164 | 20 | 18 | $32,796 | $2,073 | $2,217 |
| Cochlear Implant ProcedureAPC 5166 | 19 | 19 | $164,618 | $28,369 | $29,489 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 19 | 19 | $41,462 | $6,064 | $6,514 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 15 | 15 | $82,092 | $19,428 | $21,011 |
| Level 3 Lower GI ProceduresAPC 5313 | 12 | 12 | $22,104 | $1,876 | $2,176 |
| Level 2 Urology and Related ServicesAPC 5372 | 11 | 11 | $10,405 | $441 | $502 |
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.