Baptist Health Louisville Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baptist Health Louisville, Louisville, KY in 2024, from traditional Medicare claims. Back to the Baptist Health Louisville profile, with quality ratings, finances and negotiated rates.
7,005
Medicare inpatient discharges
In 162 published DRGs
1.83
Case mix index
IPPS FY 2027
24%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
6,968
Medicare outpatient services
In 40 service groups
Inpatient stays by major diagnostic category
Circulatory system1,524 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 410 | $40,018 | $7,084 | $6,603 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 84 | $40,638 | $4,426 | $6,705 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 75 | $193,278 | $9,292 | $31,891 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 68 | $498,644 | $40,180 | $82,276 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 66 | $32,461 | $3,533 | $5,356 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 62 | $92,366 | $12,699 | $15,240 | 2.16 |
| Heart failure and shock with CCMS-DRG 292, medical | 61 | $37,998 | $4,670 | $6,270 | 0.86 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 57 | $53,125 | $8,587 | $8,766 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 57 | $48,385 | $6,477 | $7,984 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 51 | $253,318 | $16,681 | $41,797 | 2.87 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 45 | $22,962 | $2,325 | $3,789 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 40 | $74,653 | $5,570 | $12,318 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 33 | $57,915 | $4,357 | $9,556 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 28 | $83,711 | $11,998 | $13,812 | 2.09 |
| Hypertension without MCCMS-DRG 305, medical | 26 | $37,875 | $3,080 | $6,249 | 0.75 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 25 | $225,167 | $19,035 | $37,153 | 4.04 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 25 | $271,146 | $20,236 | $44,739 | 3.24 |
| Chest painMS-DRG 313, medical | 25 | $42,216 | $3,094 | $6,966 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 23 | $263,994 | $19,311 | $43,559 | 5.20 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 23 | $33,704 | $5,322 | $5,561 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $203,927 | $13,472 | $33,648 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 22 | $142,311 | $14,386 | $23,481 | 2.55 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 21 | $213,257 | $22,876 | $35,187 | 3.35 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 20 | $271,210 | $25,421 | $44,750 | 5.24 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 19 | $492,611 | $43,779 | $81,281 | 6.25 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 18 | $307,582 | $39,717 | $50,751 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $364,851 | $25,158 | $60,200 | 4.16 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 14 | $323,976 | $21,728 | $53,456 | 3.18 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $287,915 | $22,654 | $47,506 | 3.46 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 13 | $264,359 | $20,290 | $43,619 | 3.46 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 13 | $93,223 | $6,749 | $15,382 | 1.74 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 13 | $215,536 | $31,826 | $35,563 | 5.06 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 12 | $55,835 | $9,222 | $9,213 | 1.58 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $37,621 | $4,505 | $6,208 | 0.97 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 221, surgical | 11 | $279,329 | $26,816 | $46,089 | 4.65 |
Respiratory system1,093 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 217 | $60,054 | $9,198 | $9,909 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 176 | $44,717 | $7,016 | $7,378 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 97 | $30,604 | $3,954 | $5,050 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 96 | $41,185 | $5,910 | $6,796 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 79 | $47,270 | $6,671 | $7,800 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 78 | $42,670 | $4,918 | $7,041 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 58 | $31,775 | $4,628 | $5,243 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 48 | $38,101 | $3,862 | $6,287 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 39 | $59,121 | $7,556 | $9,755 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 37 | $167,058 | $13,982 | $27,565 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 37 | $30,842 | $3,985 | $5,089 | 0.85 |
| Major chest procedures with MCCMS-DRG 163, surgical | 19 | $262,895 | $24,199 | $43,378 | 4.71 |
| Major chest trauma with CCMS-DRG 184, medical | 19 | $47,149 | $5,618 | $7,780 | 1.05 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 18 | $125,639 | $9,862 | $20,730 | 1.88 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 18 | $40,174 | $3,364 | $6,629 | 0.76 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 18 | $98,406 | $15,969 | $16,237 | 2.70 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 14 | $21,249 | $2,483 | $3,506 | 0.63 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 13 | $122,929 | $22,453 | $20,283 | 4.06 |
| Respiratory signs and symptomsMS-DRG 204, medical | 12 | $40,500 | $4,395 | $6,682 | 0.82 |
Infectious and parasitic diseases755 discharges in 6 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 | 466 | $64,459 | $10,834 | $10,636 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 144 | $38,088 | $5,080 | $6,284 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 73 | $194,834 | $29,815 | $32,148 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 43 | $67,116 | $10,755 | $11,074 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $205,856 | $37,576 | $33,966 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $70,471 | $8,964 | $11,628 | 1.84 |
Musculoskeletal system and connective tissue755 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 100 | $35,907 | $4,829 | $5,925 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 78 | $116,960 | $11,016 | $19,298 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 75 | $133,986 | $11,625 | $22,108 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 71 | $105,433 | $11,544 | $17,396 | 2.07 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 52 | $269,182 | $18,421 | $44,415 | 2.67 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 41 | $296,004 | $26,341 | $48,841 | 3.49 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 41 | $25,624 | $3,759 | $4,228 | 0.79 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 40 | $127,215 | $16,600 | $20,990 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 35 | $31,026 | $4,365 | $5,119 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 24 | $143,811 | $16,793 | $23,729 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 24 | $48,320 | $5,066 | $7,973 | 1.09 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 22 | $330,238 | $27,521 | $54,489 | 3.66 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 22 | $153,376 | $13,421 | $25,307 | 2.38 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 22 | $140,815 | $14,842 | $23,234 | 2.48 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 21 | $26,841 | $4,050 | $4,429 | 0.82 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 20 | $108,690 | $10,163 | $17,934 | 1.97 |
| Medical back problems with MCCMS-DRG 551, medical | 18 | $68,255 | $8,885 | $11,262 | 1.70 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 13 | $128,697 | $12,957 | $21,235 | 2.40 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $100,973 | $8,673 | $16,661 | 1.59 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 12 | $32,405 | $6,460 | $5,347 | 1.30 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 12 | $32,929 | $4,314 | $5,433 | 0.88 |
Digestive system730 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 | 162 | $34,562 | $3,746 | $5,703 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 110 | $53,962 | $4,813 | $8,904 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 50 | $116,316 | $11,885 | $19,192 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 50 | $55,690 | $6,908 | $9,189 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 47 | $67,273 | $10,141 | $11,100 | 1.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 45 | $91,213 | $8,948 | $15,050 | 1.67 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 42 | $27,346 | $3,768 | $4,512 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 39 | $180,775 | $26,304 | $29,828 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 31 | $37,049 | $4,840 | $6,113 | 0.94 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 28 | $48,562 | $8,203 | $8,013 | 1.45 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 26 | $24,910 | $2,161 | $4,110 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 25 | $44,189 | $5,684 | $7,291 | 1.04 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 18 | $56,324 | $9,724 | $9,294 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 16 | $52,604 | $9,836 | $8,680 | 1.75 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 15 | $181,281 | $26,947 | $29,911 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $111,266 | $14,390 | $18,359 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 13 | $100,792 | $8,787 | $16,631 | 1.60 |
Kidney and urinary tract654 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 187 | $29,254 | $3,832 | $4,827 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 123 | $33,377 | $4,367 | $5,507 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 122 | $38,218 | $6,092 | $6,306 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 78 | $40,442 | $7,893 | $6,673 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 55 | $50,008 | $9,000 | $8,251 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 27 | $29,436 | $5,528 | $4,857 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 25 | $66,035 | $6,397 | $10,896 | 1.35 |
| Renal failure without cc/mccMS-DRG 684, medical | 13 | $28,543 | $2,554 | $4,710 | 0.61 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 12 | $85,409 | $8,384 | $14,092 | 1.48 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 12 | $81,515 | $15,476 | $13,450 | 2.59 |
Nervous system574 discharges in 22 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 | 106 | $66,707 | $4,985 | $11,007 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 55 | $74,048 | $10,773 | $12,218 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 46 | $34,618 | $7,003 | $5,712 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 40 | $326,003 | $36,453 | $53,790 | 5.67 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 31 | $59,510 | $5,260 | $9,819 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 30 | $300,943 | $34,789 | $49,656 | 4.42 |
| Seizures with MCCMS-DRG 100, medical | 27 | $73,107 | $11,442 | $12,063 | 1.98 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 24 | $46,533 | $5,207 | $7,678 | 1.06 |
| Seizures without MCCMS-DRG 101, medical | 24 | $57,036 | $5,044 | $9,411 | 0.91 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 22 | $46,170 | $3,853 | $7,618 | 0.80 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 20 | $40,654 | $2,815 | $6,708 | 0.69 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $47,148 | $12,638 | $7,779 | 2.39 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 18 | $54,841 | $7,298 | $9,049 | 1.32 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 15 | $96,299 | $10,006 | $15,889 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 15 | $67,715 | $7,762 | $11,173 | 1.36 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 14 | $47,682 | $5,433 | $7,868 | 1.14 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 12 | $338,314 | $25,212 | $55,822 | 2.43 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 12 | $56,417 | $10,142 | $9,309 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 11 | $278,556 | $21,294 | $45,962 | 3.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 11 | $370,095 | $33,322 | $61,066 | 2.95 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 11 | $56,900 | $8,339 | $9,388 | 1.47 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $92,166 | $5,044 | $15,207 | 1.03 |
Endocrine, nutritional and metabolic285 discharges in 7 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 | 95 | $31,335 | $3,846 | $5,170 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 83 | $45,481 | $6,904 | $7,504 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 33 | $34,984 | $4,130 | $5,772 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 25 | $64,542 | $8,075 | $10,649 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 17 | $60,811 | $9,758 | $10,034 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 17 | $44,533 | $5,265 | $7,348 | 1.06 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 15 | $72,693 | $5,894 | $11,994 | 1.52 |
Liver, gallbladder and pancreas163 discharges in 8 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 | 41 | $82,409 | $8,733 | $13,598 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 22 | $31,629 | $3,703 | $5,219 | 0.86 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 22 | $56,474 | $5,493 | $9,318 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 21 | $32,324 | $4,861 | $5,333 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 19 | $102,830 | $13,820 | $16,967 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 15 | $77,994 | $7,021 | $12,869 | 1.31 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 12 | $65,024 | $7,754 | $10,729 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 11 | $63,076 | $9,873 | $10,408 | 1.92 |
Skin, subcutaneous tissue and breast125 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 88 | $29,266 | $4,322 | $4,829 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 22 | $42,353 | $8,002 | $6,988 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 15 | $39,049 | $4,523 | $6,443 | 0.91 |
Factors influencing health status111 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 57 | $34,312 | $4,031 | $5,662 | 0.80 |
| Other factors influencing health statusMS-DRG 951, medical | 35 | $16,526 | $2,824 | $2,727 | 0.59 |
| Signs and symptoms with MCCMS-DRG 947, medical | 19 | $77,491 | $10,031 | $12,786 | 1.25 |
Blood and immune system106 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 | 55 | $38,137 | $4,595 | $6,293 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 40 | $60,924 | $7,579 | $10,052 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $56,427 | $6,507 | $9,310 | 1.20 |
Other47 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 | 19 | $192,799 | $25,170 | $31,812 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $135,819 | $14,626 | $22,410 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 12 | $131,181 | $19,468 | $21,645 | 3.38 |
Mental diseases and disorders29 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 | 29 | $46,903 | $9,136 | $7,739 | 1.76 |
Alcohol and drug use17 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 | 17 | $40,709 | $4,145 | $6,717 | 0.86 |
Injuries, poisonings and toxic effects of drugs14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $54,653 | $7,326 | $9,018 | 1.60 |
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 | $30,240 | $3,226 | $4,990 | 0.74 |
Multiple significant trauma11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 11 | $115,527 | $22,454 | $19,062 | 3.88 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 2,158 | 1,947 | $25,609 | $1,843 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 775 | 738 | $102,617 | $9,542 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 512 | 505 | $40,039 | $1,995 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 413 | 384 | $16,799 | $1,085 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 282 | 280 | $47,057 | $3,894 | $4,358 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 228 | 226 | $59,932 | $4,842 | $5,339 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 222 | 217 | $144,297 | $14,196 | $15,763 |
| Level 4 Urology and Related ServicesAPC 5374 | 212 | 182 | $27,853 | $2,353 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 176 | 156 | $16,823 | $1,279 | $1,445 |
| Level 3 Endovascular ProceduresAPC 5193 | 169 | 162 | $142,331 | $7,747 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 152 | 149 | $25,562 | $2,160 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 133 | 129 | $324,442 | $18,338 | $21,117 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 126 | 122 | $29,090 | $1,947 | $2,141 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 118 | 118 | $137,964 | $7,531 | $8,569 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 111 | 102 | $30,476 | $2,604 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 109 | 107 | $26,721 | $2,144 | $2,373 |
| Level 4 Vascular ProceduresAPC 5184 | 88 | 61 | $59,856 | $2,829 | $3,946 |
| Level 5 Urology and Related ServicesAPC 5375 | 73 | 71 | $37,553 | $3,552 | $3,918 |
| Level 5 Airway EndoscopyAPC 5155 | 72 | 72 | $43,716 | $4,630 | $5,183 |
| Level 3 Airway EndoscopyAPC 5153 | 68 | 63 | $18,844 | $1,164 | $1,264 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 66 | 66 | $67,595 | $4,474 | $4,982 |
| Level 4 Endovascular ProceduresAPC 5194 | 65 | 65 | $205,035 | $13,232 | $14,606 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 60 | 60 | $34,845 | $2,375 | $2,636 |
| Level 2 Vascular ProceduresAPC 5182 | 59 | 55 | $16,864 | $1,096 | $1,204 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 57 | 57 | $107,226 | $5,626 | $6,514 |
| Level 4 Airway EndoscopyAPC 5154 | 52 | 50 | $28,840 | $2,531 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 52 | 52 | $89,393 | $7,229 | $8,164 |
| Level 3 Urology and Related ServicesAPC 5373 | 52 | 46 | $19,431 | $1,371 | $1,516 |
| Level 1 Nerve ProceduresAPC 5431 | 48 | 47 | $19,127 | $1,325 | $1,407 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 39 | 39 | $16,169 | $1,075 | $1,196 |
| Level 4 Gynecologic ProceduresAPC 5414 | 31 | 31 | $23,551 | $2,074 | $2,389 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 28 | 27 | $92,805 | $5,120 | $5,682 |
| Level 3 Lower GI ProceduresAPC 5313 | 28 | 28 | $27,318 | $1,931 | $2,176 |
| Level 5 ENT ProceduresAPC 5165 | 25 | 25 | $46,644 | $3,886 | $4,436 |
| Level 2 Endovascular ProceduresAPC 5192 | 21 | 20 | $77,771 | $3,737 | $4,338 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 20 | 20 | $233,075 | $15,120 | $17,052 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 19 | 19 | $387,673 | $26,630 | $29,375 |
| Level 6 Urology and Related ServicesAPC 5376 | 19 | 18 | $83,654 | $6,324 | $7,291 |
| Level 5 Gynecologic ProceduresAPC 5415 | 16 | 16 | $46,898 | $3,293 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 14 | 14 | $34,408 | $2,547 | $2,888 |
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.