Baptist Health Lexington Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baptist Health Lexington, Lexington, KY in 2024, from traditional Medicare claims. Back to the Baptist Health Lexington profile, with quality ratings, finances and negotiated rates.
3,648
Medicare inpatient discharges
In 101 published DRGs
1.86
Case mix index
IPPS FY 2027
25%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
3,574
Medicare outpatient services
In 41 service groups
Inpatient stays by major diagnostic category
Circulatory system1,031 discharges in 28 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 219 | $47,073 | $7,319 | $7,155 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 99 | $298,491 | $19,964 | $45,371 | 3.24 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 63 | $30,803 | $3,701 | $4,682 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 57 | $64,944 | $9,225 | $9,872 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 51 | $38,340 | $4,707 | $5,828 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 51 | $183,965 | $10,205 | $27,963 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 41 | $491,417 | $37,757 | $74,695 | 4.88 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 40 | $53,561 | $7,668 | $8,141 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 34 | $255,948 | $19,087 | $38,904 | 2.87 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 33 | $231,685 | $25,228 | $35,216 | 4.04 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 28 | $68,856 | $5,375 | $10,466 | 1.08 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 27 | $316,045 | $29,738 | $48,039 | 5.20 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 25 | $306,145 | $38,450 | $46,534 | 5.88 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 25 | $18,580 | $2,396 | $2,824 | 0.55 |
| Heart failure and shock with CCMS-DRG 292, medical | 23 | $34,999 | $4,915 | $5,320 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 23 | $107,603 | $12,985 | $16,356 | 2.09 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 23 | $42,165 | $5,255 | $6,409 | 0.97 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $230,609 | $16,297 | $35,053 | 2.28 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 18 | $341,164 | $27,742 | $51,857 | 4.16 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 18 | $53,209 | $4,089 | $8,088 | 0.91 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $42,084 | $3,694 | $6,397 | 0.75 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 15 | $585,303 | $53,811 | $88,966 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 15 | $82,185 | $12,458 | $12,492 | 2.16 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 14 | $268,434 | $21,116 | $40,802 | 3.46 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 13 | $348,872 | $35,982 | $53,029 | 5.04 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $354,160 | $37,696 | $53,832 | 3.46 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 12 | $353,318 | $21,574 | $53,704 | 3.18 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 11 | $323,125 | $45,210 | $49,115 | 7.80 |
Respiratory system635 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 | 141 | $62,896 | $9,281 | $9,560 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 122 | $48,091 | $7,341 | $7,310 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 71 | $38,000 | $6,082 | $5,776 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 70 | $38,961 | $3,965 | $5,922 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 64 | $57,028 | $6,680 | $8,668 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 29 | $43,227 | $5,277 | $6,570 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 20 | $184,607 | $14,742 | $28,060 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 19 | $36,104 | $4,748 | $5,488 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 18 | $35,166 | $4,951 | $5,345 | 0.96 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 17 | $55,005 | $8,292 | $8,361 | 1.40 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $34,611 | $4,360 | $5,261 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 13 | $104,723 | $10,027 | $15,918 | 1.88 |
| Major chest procedures with MCCMS-DRG 163, surgical | 12 | $232,460 | $30,821 | $35,334 | 4.71 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 11 | $41,104 | $4,030 | $6,248 | 0.76 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 11 | $26,428 | $2,736 | $4,017 | 0.63 |
Infectious and parasitic diseases458 discharges in 4 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 | 295 | $74,949 | $11,169 | $11,392 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 84 | $44,470 | $5,520 | $6,759 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 57 | $206,942 | $32,303 | $31,455 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 22 | $87,877 | $9,368 | $13,357 | 2.04 |
Nervous system395 discharges in 15 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 | 95 | $61,351 | $5,347 | $9,325 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 54 | $84,356 | $11,627 | $12,822 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 30 | $72,781 | $7,144 | $11,063 | 1.36 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 27 | $45,722 | $3,335 | $6,950 | 0.69 |
| Seizures without MCCMS-DRG 101, medical | 27 | $54,291 | $5,130 | $8,252 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 26 | $64,812 | $6,036 | $9,851 | 1.14 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 22 | $378,893 | $36,844 | $57,592 | 5.67 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 16 | $115,332 | $10,526 | $17,530 | 1.81 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 16 | $45,819 | $5,896 | $6,964 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 16 | $57,295 | $10,825 | $8,709 | 1.98 |
| Extracranial procedures with CCMS-DRG 038, surgical | 15 | $89,805 | $9,257 | $13,650 | 1.60 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 15 | $44,201 | $4,165 | $6,718 | 0.80 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $50,112 | $5,536 | $7,617 | 1.06 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 12 | $120,393 | $14,186 | $18,300 | 2.30 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $320,749 | $23,364 | $48,754 | 2.43 |
Digestive system350 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 69 | $53,386 | $5,659 | $8,115 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 60 | $34,403 | $4,065 | $5,229 | 0.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 38 | $65,489 | $8,119 | $9,954 | 1.67 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 33 | $29,133 | $4,065 | $4,428 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 32 | $113,456 | $13,945 | $17,245 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 26 | $71,976 | $10,564 | $10,940 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 24 | $42,181 | $7,416 | $6,412 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 23 | $155,602 | $24,068 | $23,651 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 18 | $41,863 | $5,126 | $6,363 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 15 | $62,779 | $9,737 | $9,542 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 12 | $32,663 | $5,862 | $4,965 | 1.04 |
Kidney and urinary tract322 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 99 | $36,190 | $4,234 | $5,501 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 67 | $48,270 | $6,328 | $7,337 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 49 | $37,945 | $4,688 | $5,768 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 44 | $55,280 | $8,008 | $8,403 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 38 | $58,350 | $10,092 | $8,869 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 14 | $47,050 | $5,615 | $7,152 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 11 | $64,847 | $6,822 | $9,857 | 1.35 |
Musculoskeletal system and connective tissue165 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 48 | $117,008 | $11,815 | $17,785 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 27 | $119,999 | $12,140 | $18,240 | 2.07 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 21 | $189,516 | $15,427 | $28,806 | 2.48 |
| Medical back problems without MCCMS-DRG 552, medical | 21 | $39,789 | $5,118 | $6,048 | 0.97 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 13 | $320,914 | $24,027 | $48,779 | 2.67 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 12 | $172,483 | $18,789 | $26,217 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 12 | $40,369 | $4,570 | $6,136 | 0.90 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 11 | $30,850 | $3,830 | $4,689 | 0.79 |
Endocrine, nutritional and metabolic147 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 without MCCMS-DRG 641, medical | 58 | $37,291 | $4,034 | $5,668 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 39 | $47,837 | $7,248 | $7,271 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 21 | $35,437 | $4,925 | $5,386 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 17 | $51,703 | $8,172 | $7,859 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $109,454 | $10,546 | $16,637 | 1.98 |
Blood and immune system46 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 | 30 | $38,849 | $4,989 | $5,905 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 16 | $72,882 | $8,408 | $11,078 | 1.40 |
Skin, subcutaneous tissue and breast41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 29 | $43,524 | $4,605 | $6,616 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $50,105 | $8,787 | $7,616 | 1.49 |
Liver, gallbladder and pancreas26 discharges in 2 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 | $64,978 | $8,936 | $9,877 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 11 | $99,015 | $8,280 | $15,050 | 1.76 |
Factors influencing health status18 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 | 18 | $41,195 | $4,348 | $6,262 | 0.80 |
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 | $216,395 | $23,478 | $32,892 | 4.74 |
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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 629 | 597 | $28,930 | $1,868 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 388 | 387 | $39,257 | $1,980 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 286 | 262 | $17,898 | $1,098 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 275 | 266 | $112,466 | $9,571 | $10,772 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 234 | 225 | $448,807 | $18,799 | $21,117 |
| Level 3 Endovascular ProceduresAPC 5193 | 141 | 137 | $145,675 | $7,777 | $8,874 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 140 | 140 | $189,626 | $14,264 | $15,763 |
| Level 5 Urology and Related ServicesAPC 5375 | 139 | 130 | $31,346 | $3,543 | $3,918 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 97 | 94 | $60,499 | $4,933 | $5,339 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 94 | 94 | $75,041 | $7,055 | $8,164 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 83 | 82 | $44,748 | $3,885 | $4,358 |
| Level 3 Vascular ProceduresAPC 5183 | 79 | 78 | $33,079 | $2,199 | $2,405 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 76 | 76 | $122,913 | $7,504 | $8,569 |
| Level 5 Airway EndoscopyAPC 5155 | 63 | 60 | $34,735 | $4,647 | $5,183 |
| Level 2 Upper GI ProceduresAPC 5302 | 61 | 55 | $21,429 | $1,319 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 56 | 53 | $23,782 | $1,906 | $2,141 |
| Level 4 Urology and Related ServicesAPC 5374 | 55 | 50 | $25,155 | $2,323 | $2,629 |
| Level 2 Vascular ProceduresAPC 5182 | 51 | 50 | $12,696 | $1,105 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 49 | 47 | $37,441 | $2,290 | $2,636 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 47 | 47 | $242,280 | $14,897 | $17,052 |
| Level 4 Endovascular ProceduresAPC 5194 | 46 | 46 | $215,602 | $13,524 | $14,606 |
| Level 3 Urology and Related ServicesAPC 5373 | 46 | 44 | $17,724 | $1,398 | $1,516 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 42 | 42 | $333,532 | $26,132 | $29,375 |
| Level 4 Airway EndoscopyAPC 5154 | 39 | 39 | $27,915 | $2,555 | $2,833 |
| Level 4 Vascular ProceduresAPC 5184 | 39 | 36 | $75,679 | $3,522 | $3,946 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 34 | 32 | $30,241 | $2,629 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 34 | 33 | $49,539 | $4,389 | $4,982 |
| Level 6 Urology and Related ServicesAPC 5376 | 29 | 29 | $87,745 | $6,350 | $7,291 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 24 | 24 | $51,923 | $2,140 | $2,373 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 24 | 24 | $106,066 | $5,857 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 24 | 24 | $268,882 | $24,154 | $26,719 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 21 | 21 | $14,869 | $1,109 | $1,196 |
| Complex GI ProceduresAPC 5331 | 21 | 15 | $53,331 | $3,932 | $4,263 |
| Level 2 Endovascular ProceduresAPC 5192 | 16 | 16 | $75,913 | $3,387 | $4,338 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 16 | 16 | $219,083 | $18,155 | $21,011 |
| Level 5 Gynecologic ProceduresAPC 5415 | 15 | $32,716 | $3,432 | $3,792 | |
| Level 3 Airway EndoscopyAPC 5153 | 14 | 14 | $15,727 | $1,081 | $1,264 |
| Level 3 Upper GI ProceduresAPC 5303 | 14 | 14 | $26,035 | $2,642 | $2,888 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 11 | 11 | $66,451 | $5,153 | $5,682 |
| Level 1 Nerve ProceduresAPC 5431 | 11 | $23,525 | $1,332 | $1,407 | |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 11 | 11 | $193,200 | $15,768 | $18,465 |
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.