Baptist St Anthony Hospital: Stewart Randy Md Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baptist St Anthony Hospital: Stewart Randy Md, Amarillo, TX in 2024, from traditional Medicare claims. Back to the Baptist St Anthony Hospital: Stewart Randy Md profile, with quality ratings, finances and negotiated rates.
5,517
Medicare inpatient discharges
In 145 published DRGs
1.90
Case mix index
IPPS FY 2027
24%
Surgical stays
69%
Stays with complications
In DRGs with a CC or MCC
2,514
Medicare outpatient services
In 35 service groups
Inpatient stays by major diagnostic category
Circulatory system1,316 discharges in 30 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 318 | $51,350 | $7,870 | $9,756 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 88 | $38,135 | $4,321 | $7,246 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 77 | $81,432 | $10,763 | $15,472 | 1.82 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 72 | $151,296 | $20,480 | $28,746 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 70 | $42,466 | $5,076 | $8,068 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 54 | $26,305 | $3,106 | $4,998 | 0.55 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 53 | $63,796 | $7,581 | $12,121 | 1.20 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 52 | $57,126 | $9,677 | $10,854 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 49 | $205,836 | $31,724 | $39,109 | 4.88 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 42 | $117,765 | $17,652 | $22,375 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 36 | $43,292 | $5,409 | $8,225 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 36 | $69,741 | $12,914 | $13,251 | 2.09 |
| Hypertension without MCCMS-DRG 305, medical | 34 | $42,683 | $4,312 | $8,110 | 0.75 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 32 | $44,589 | $5,839 | $8,472 | 0.91 |
| Chest painMS-DRG 313, medical | 32 | $32,541 | $4,091 | $6,183 | 0.72 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 27 | $219,466 | $24,312 | $41,699 | 4.04 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 27 | $93,371 | $12,366 | $17,741 | 2.16 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $142,843 | $24,295 | $27,140 | 3.35 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 22 | $93,146 | $19,628 | $17,698 | 3.27 |
| Other vascular procedures with CCMS-DRG 253, surgical | 21 | $106,978 | $15,736 | $20,326 | 2.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 19 | $121,275 | $21,470 | $23,042 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 19 | $92,359 | $12,199 | $17,548 | 2.28 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 19 | $28,602 | $3,859 | $5,434 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 17 | $35,533 | $5,686 | $6,751 | 0.97 |
| Atherosclerosis without MCCMS-DRG 303, medical | 15 | $30,859 | $3,918 | $5,863 | 0.66 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $135,448 | $22,496 | $25,735 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 14 | $42,767 | $5,476 | $8,126 | 0.86 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 12 | $76,075 | $11,424 | $14,454 | 1.83 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 11 | $47,810 | $6,114 | $9,084 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $45,831 | $6,049 | $8,708 | 1.15 |
Infectious and parasitic diseases745 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 | 497 | $85,772 | $12,239 | $16,297 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 106 | $181,713 | $28,847 | $34,526 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 85 | $46,231 | $5,830 | $8,784 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 24 | $257,223 | $41,771 | $48,872 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 19 | $73,757 | $10,691 | $14,014 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $87,029 | $11,083 | $16,535 | 1.84 |
Respiratory system688 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 178 | $67,005 | $8,222 | $12,731 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 117 | $66,272 | $10,364 | $12,592 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 62 | $67,166 | $8,099 | $12,762 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 58 | $56,162 | $6,766 | $10,671 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 54 | $43,565 | $4,830 | $8,277 | 0.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 35 | $194,317 | $29,240 | $36,920 | 4.71 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 34 | $56,821 | $8,600 | $10,796 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 24 | $104,822 | $17,580 | $19,916 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 23 | $63,317 | $10,994 | $12,030 | 1.74 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 19 | $40,236 | $6,428 | $7,645 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 18 | $151,255 | $16,990 | $28,738 | 2.55 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 16 | $39,942 | $4,152 | $7,589 | 0.82 |
| Pneumothorax with CCMS-DRG 200, medical | 14 | $54,840 | $6,036 | $10,420 | 1.08 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $43,110 | $5,680 | $8,191 | 0.96 |
| Major chest trauma with CCMS-DRG 184, medical | 12 | $52,163 | $6,609 | $9,911 | 1.05 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 11 | $70,017 | $11,351 | $13,303 | 1.81 |
Digestive system621 discharges in 18 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 | 104 | $38,669 | $4,995 | $7,347 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 89 | $43,085 | $5,616 | $8,186 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 58 | $103,933 | $13,976 | $19,747 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 56 | $49,695 | $8,046 | $9,442 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 47 | $176,131 | $28,663 | $33,465 | 4.52 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 46 | $73,547 | $10,878 | $13,974 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $34,360 | $4,500 | $6,528 | 0.80 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 31 | $45,709 | $6,497 | $8,685 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 29 | $97,213 | $10,320 | $18,470 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 20 | $61,549 | $10,122 | $11,694 | 1.75 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 19 | $45,206 | $5,568 | $8,589 | 0.94 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 17 | $22,934 | $3,310 | $4,357 | 0.56 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 14 | $33,502 | $3,633 | $6,365 | 0.63 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $197,573 | $29,827 | $37,539 | 5.08 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 12 | $73,286 | $9,057 | $13,924 | 1.60 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $77,234 | $12,230 | $14,674 | 2.11 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $45,888 | $9,204 | $8,719 | 1.45 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 11 | $54,242 | $10,866 | $10,306 | 1.62 |
Kidney and urinary tract527 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 114 | $34,482 | $4,596 | $6,552 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 93 | $50,072 | $7,535 | $9,514 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 71 | $65,755 | $10,187 | $12,493 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 65 | $38,206 | $5,344 | $7,259 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 60 | $53,692 | $9,268 | $10,202 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 42 | $40,837 | $6,616 | $7,759 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 23 | $96,201 | $25,424 | $18,278 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 19 | $58,837 | $8,589 | $11,179 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 15 | $49,641 | $6,359 | $9,432 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $100,479 | $15,405 | $19,091 | 2.59 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 11 | $99,024 | $15,591 | $18,814 | 2.38 |
Nervous system464 discharges in 16 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 | 99 | $46,615 | $6,113 | $8,857 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 54 | $63,768 | $11,939 | $12,116 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 50 | $37,184 | $4,743 | $7,065 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 40 | $49,118 | $5,498 | $9,332 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 29 | $48,050 | $8,232 | $9,129 | 1.36 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 27 | $70,587 | $11,700 | $13,412 | 1.81 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 22 | $36,695 | $3,634 | $6,972 | 0.69 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 20 | $61,136 | $5,005 | $11,616 | 1.03 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 19 | $54,831 | $8,227 | $10,418 | 1.32 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 17 | $53,760 | $7,655 | $10,214 | 1.14 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 17 | $46,058 | $6,557 | $8,751 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 17 | $74,640 | $12,120 | $14,182 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 14 | $137,759 | $26,748 | $26,174 | 4.42 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 14 | $66,600 | $12,268 | $12,654 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $42,337 | $6,738 | $8,044 | 1.06 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 12 | $57,765 | $11,804 | $10,975 | 1.79 |
Musculoskeletal system and connective tissue434 discharges in 17 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 | 81 | $87,809 | $12,589 | $16,684 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 60 | $82,631 | $12,949 | $15,700 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 45 | $45,316 | $5,402 | $8,610 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 31 | $118,524 | $18,038 | $22,520 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 28 | $44,970 | $5,083 | $8,544 | 0.90 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 23 | $67,617 | $9,540 | $12,847 | 1.59 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $34,139 | $4,492 | $6,486 | 0.79 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 19 | $85,189 | $11,984 | $16,186 | 1.88 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 19 | $98,350 | $13,235 | $18,687 | 2.04 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 18 | $159,069 | $22,605 | $30,223 | 3.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $43,596 | $6,730 | $8,283 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 15 | $95,106 | $15,304 | $18,070 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 12 | $112,505 | $17,631 | $21,376 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 12 | $75,133 | $11,140 | $14,275 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 11 | $96,216 | $17,099 | $18,281 | 2.96 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 11 | $48,537 | $8,801 | $9,222 | 1.52 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 11 | $55,171 | $4,726 | $10,483 | 1.00 |
Endocrine, nutritional and metabolic263 discharges in 8 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 | 94 | $60,849 | $7,862 | $11,561 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 73 | $35,266 | $4,960 | $6,701 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 22 | $39,027 | $5,216 | $7,415 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 19 | $60,218 | $8,602 | $11,441 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 18 | $51,827 | $9,222 | $9,847 | 1.98 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 13 | $51,104 | $9,373 | $9,710 | 1.86 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $63,920 | $10,631 | $12,145 | 1.65 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 11 | $49,225 | $8,604 | $9,353 | 1.52 |
Liver, gallbladder and pancreas217 discharges in 11 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 | 31 | $78,895 | $9,681 | $14,990 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 29 | $99,580 | $14,232 | $18,920 | 2.32 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 28 | $65,862 | $11,249 | $12,514 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 28 | $83,249 | $12,778 | $15,817 | 1.83 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 21 | $65,490 | $8,141 | $12,443 | 1.31 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 15 | $41,350 | $5,760 | $7,856 | 0.95 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 14 | $44,388 | $6,797 | $8,434 | 1.03 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 14 | $63,661 | $5,952 | $12,095 | 1.09 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 13 | $60,660 | $10,373 | $11,525 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 12 | $37,524 | $5,158 | $7,130 | 0.86 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 12 | $80,177 | $10,811 | $15,234 | 1.63 |
Blood and immune system58 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 21 | $52,662 | $8,817 | $10,006 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 20 | $34,912 | $4,747 | $6,633 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 17 | $47,295 | $7,137 | $8,986 | 1.20 |
Skin, subcutaneous tissue and breast55 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 40 | $44,313 | $5,661 | $8,419 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $53,060 | $7,149 | $10,081 | 1.49 |
Other39 discharges in 2 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 | 27 | $144,235 | $28,161 | $27,405 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 12 | $102,529 | $15,493 | $19,480 | 2.49 |
Injuries, poisonings and toxic effects of drugs32 discharges in 2 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 | 19 | $60,645 | $9,689 | $11,522 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $55,694 | $11,644 | $10,582 | 1.82 |
Factors influencing health status22 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 | 22 | $48,625 | $5,474 | $9,239 | 0.80 |
Ear, nose, mouth and throat19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 19 | $31,158 | $4,134 | $5,920 | 0.74 |
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 | $60,052 | $5,782 | $11,410 | 0.86 |
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 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 335 | 309 | $12,878 | $1,101 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 232 | 216 | $19,119 | $2,173 | $2,405 |
| Comprehensive Observation ServicesAPC 8011 | 212 | 205 | $21,678 | $1,863 | $2,090 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 211 | 208 | $38,404 | $3,951 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 144 | 128 | $58,360 | $7,690 | $8,874 |
| Level 1 Endovascular ProceduresAPC 5191 | 121 | 120 | $11,564 | $1,962 | $2,208 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 110 | 110 | $55,353 | $7,161 | $8,164 |
| Level 2 Upper GI ProceduresAPC 5302 | 103 | 97 | $15,906 | $1,304 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 101 | 92 | $23,800 | $1,886 | $2,141 |
| Level 4 Urology and Related ServicesAPC 5374 | 89 | 75 | $23,006 | $2,410 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 82 | 77 | $28,489 | $3,490 | $3,918 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 72 | 72 | $43,251 | $4,446 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 72 | 57 | $30,010 | $3,944 | $4,338 |
| Level 3 Urology and Related ServicesAPC 5373 | 68 | 43 | $13,414 | $1,395 | $1,516 |
| Level 4 Endovascular ProceduresAPC 5194 | 50 | 47 | $94,807 | $13,551 | $14,606 |
| Level 4 Vascular ProceduresAPC 5184 | 49 | 45 | $39,131 | $3,721 | $3,946 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 47 | 47 | $29,812 | $2,313 | $2,636 |
| Level 2 Vascular ProceduresAPC 5182 | 45 | 39 | $12,538 | $1,107 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 41 | 38 | $26,049 | $2,598 | $2,930 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 38 | 37 | $47,752 | $4,946 | $5,339 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 35 | 35 | $64,100 | $9,774 | $10,772 |
| Complex GI ProceduresAPC 5331 | 34 | 21 | $40,872 | $3,820 | $4,263 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 25 | 25 | $47,096 | $7,318 | $8,569 |
| Level 4 Airway EndoscopyAPC 5154 | 24 | 24 | $41,345 | $2,494 | $2,833 |
| Level 3 Lower GI ProceduresAPC 5313 | 22 | 22 | $26,115 | $1,947 | $2,176 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 21 | 21 | $129,552 | $18,925 | $21,117 |
| Level 3 Airway EndoscopyAPC 5153 | 20 | 20 | $13,318 | $1,115 | $1,264 |
| Level 4 Gynecologic ProceduresAPC 5414 | 18 | 18 | $17,267 | $2,160 | $2,389 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 17 | 16 | $205,432 | $24,693 | $29,375 |
| Level 5 ENT ProceduresAPC 5165 | 14 | 14 | $43,785 | $4,049 | $4,436 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 14 | 14 | $43,646 | $5,163 | $5,682 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 13 | 13 | $44,191 | $5,873 | $6,514 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $57,686 | $4,732 | $5,183 |
| Level 3 Upper GI ProceduresAPC 5303 | 12 | 11 | $27,480 | $2,427 | $2,888 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 11 | 11 | $25,981 | $2,238 | $2,373 |
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.