Baptist Health Madisonville Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baptist Health Madisonville, Madisonville, KY in 2024, from traditional Medicare claims. Back to the Baptist Health Madisonville profile, with quality ratings, finances and negotiated rates.
923
Medicare inpatient discharges
In 34 published DRGs
1.87
Case mix index
IPPS FY 2027
18%
Surgical stays
79%
Stays with complications
In DRGs with a CC or MCC
1,460
Medicare outpatient services
In 27 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases209 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 | 157 | $73,028 | $13,009 | $13,802 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 22 | $225,255 | $34,303 | $42,573 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 19 | $43,301 | $6,365 | $8,184 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 11 | $144,371 | $49,447 | $27,286 | 6.96 |
Circulatory system183 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 80 | $58,211 | $8,300 | $11,002 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 38 | $88,351 | $11,151 | $16,698 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $219,386 | $19,362 | $41,464 | 2.87 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 17 | $50,280 | $7,825 | $9,503 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 15 | $107,508 | $14,499 | $20,319 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 14 | $196,509 | $10,997 | $37,140 | 1.82 |
Respiratory system178 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 53 | $58,776 | $11,133 | $11,109 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 51 | $48,976 | $8,223 | $9,256 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 48 | $43,413 | $8,107 | $8,205 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $38,508 | $4,210 | $7,278 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 12 | $102,802 | $18,905 | $19,429 | 2.70 |
Kidney and urinary tract160 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 31 | $39,592 | $5,341 | $7,483 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 30 | $54,162 | $11,181 | $10,237 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 29 | $64,699 | $9,971 | $12,228 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 24 | $52,688 | $7,421 | $9,958 | 1.17 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 21 | $68,582 | $8,533 | $12,962 | 1.35 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 13 | $39,277 | $4,573 | $7,423 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 12 | $53,402 | $6,554 | $10,093 | 1.02 |
Digestive system54 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 16 | $52,611 | $6,521 | $9,943 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 14 | $104,236 | $14,622 | $19,701 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 12 | $171,608 | $32,567 | $32,434 | 4.52 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 12 | $83,311 | $11,858 | $15,746 | 1.79 |
Nervous system53 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 29 | $127,421 | $12,841 | $24,083 | 1.81 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 13 | $71,920 | $12,410 | $13,593 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 11 | $55,671 | $5,523 | $10,522 | 1.02 |
Musculoskeletal system and connective tissue36 discharges in 3 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 | 14 | $169,085 | $14,149 | $31,957 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 11 | $128,530 | $13,575 | $24,292 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 11 | $177,318 | $20,729 | $33,513 | 2.99 |
Mental diseases and disorders31 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 31 | $27,095 | $8,651 | $5,121 | 1.37 |
Endocrine, nutritional and metabolic19 discharges in 1 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 | 19 | $47,169 | $8,214 | $8,915 | 1.32 |
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 | 499 | 424 | $27,899 | $1,989 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 111 | 110 | $54,720 | $2,128 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 100 | 97 | $185,353 | $10,422 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 73 | 62 | $16,480 | $1,177 | $1,220 |
| Level 3 Endovascular ProceduresAPC 5193 | 70 | 63 | $178,572 | $8,415 | $8,874 |
| Level 2 Upper GI ProceduresAPC 5302 | 59 | 50 | $17,294 | $1,407 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 52 | 52 | $60,675 | $4,168 | $4,358 |
| Level 3 Vascular ProceduresAPC 5183 | 45 | 44 | $33,766 | $2,350 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 45 | 28 | $23,941 | $2,569 | $2,629 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 38 | 36 | $26,080 | $2,269 | $2,373 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 36 | 33 | $69,180 | $4,834 | $5,339 |
| Level 2 Endovascular ProceduresAPC 5192 | 36 | 35 | $90,990 | $4,213 | $4,338 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 34 | 32 | $21,173 | $2,031 | $2,141 |
| Level 3 Urology and Related ServicesAPC 5373 | 31 | 31 | $15,909 | $1,501 | $1,516 |
| Level 5 Airway EndoscopyAPC 5155 | 26 | 25 | $52,032 | $5,045 | $5,183 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 26 | 26 | $50,132 | $2,543 | $2,636 |
| Level 5 Urology and Related ServicesAPC 5375 | 25 | 24 | $32,925 | $3,814 | $3,918 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 24 | 24 | $151,219 | $8,237 | $8,569 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 18 | 17 | $204,580 | $15,572 | $15,763 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 18 | 18 | $298,764 | $20,285 | $21,117 |
| Level 1 Nerve ProceduresAPC 5431 | 18 | 14 | $17,980 | $1,344 | $1,407 |
| Level 2 Urology and Related ServicesAPC 5372 | 17 | 12 | $11,145 | $500 | $502 |
| Level 4 Airway EndoscopyAPC 5154 | 13 | 13 | $38,862 | $2,760 | $2,833 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 12 | 11 | $33,944 | $2,810 | $2,930 |
| Level 3 Lower GI ProceduresAPC 5313 | 12 | 11 | $25,286 | $2,070 | $2,176 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 11 | $56,318 | $4,807 | $4,982 | |
| Level 4 Endovascular ProceduresAPC 5194 | 11 | 11 | $232,579 | $14,558 | $14,606 |
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.