Baylor Scott & White Medical Center – Temple Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baylor Scott & White Medical Center – Temple, Temple, TX in 2024, from traditional Medicare claims. Back to the Baylor Scott & White Medical Center – Temple profile, with quality ratings, finances and negotiated rates.
4,664
Medicare inpatient discharges
In 144 published DRGs
2.18
Case mix index
IPPS FY 2027
28%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
7,830
Medicare outpatient services
In 53 service groups
Inpatient stays by major diagnostic category
Circulatory system831 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 | 136 | $54,127 | $10,335 | $10,825 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 73 | $116,573 | $26,171 | $23,315 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 61 | $40,009 | $7,046 | $8,002 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 60 | $172,037 | $39,249 | $34,407 | 4.88 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 46 | $211,344 | $52,008 | $42,269 | 6.25 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 40 | $32,516 | $6,557 | $6,503 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 35 | $47,996 | $12,130 | $9,599 | 1.59 |
| Chest painMS-DRG 313, medical | 34 | $35,295 | $6,465 | $7,059 | 0.72 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 26 | $54,384 | $9,576 | $10,877 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 25 | $125,849 | $17,520 | $25,170 | 2.16 |
| Heart failure and shock with CCMS-DRG 292, medical | 22 | $34,706 | $7,117 | $6,941 | 0.86 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 21 | $113,238 | $18,006 | $22,648 | 2.28 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $178,224 | $32,148 | $35,645 | 5.06 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 21 | $111,891 | $13,313 | $22,378 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 20 | $54,714 | $7,215 | $10,943 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 20 | $86,115 | $16,412 | $17,223 | 2.09 |
| Other vascular procedures with CCMS-DRG 253, surgical | 19 | $81,708 | $19,916 | $16,342 | 2.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $150,806 | $21,052 | $30,161 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 17 | $62,183 | $8,990 | $12,437 | 1.08 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 15 | $119,120 | $31,320 | $23,824 | 4.16 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 14 | $66,041 | $13,805 | $13,208 | 1.83 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 14 | $79,158 | $25,081 | $15,832 | 3.27 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $113,026 | $26,173 | $22,605 | 3.46 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 13 | $29,886 | $4,077 | $5,977 | 0.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $55,385 | $7,450 | $11,077 | 0.97 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 11 | $321,350 | $56,791 | $64,270 | 7.71 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 11 | $156,654 | $23,984 | $31,331 | 3.46 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 11 | $117,227 | $23,224 | $23,445 | 3.35 |
Respiratory system652 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 301 | $58,347 | $9,993 | $11,669 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 46 | $50,920 | $13,594 | $10,184 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 40 | $63,992 | $11,179 | $12,798 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 35 | $32,266 | $6,585 | $6,453 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 30 | $58,703 | $8,776 | $11,741 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 28 | $65,221 | $10,569 | $13,044 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $113,722 | $19,979 | $22,744 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 25 | $110,908 | $18,905 | $22,182 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 21 | $148,242 | $30,425 | $29,648 | 4.71 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 17 | $41,543 | $8,181 | $8,309 | 0.99 |
| Major chest trauma with CCMS-DRG 184, medical | 16 | $47,983 | $8,842 | $9,597 | 1.05 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $42,300 | $6,938 | $8,460 | 0.82 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 15 | $43,935 | $7,635 | $8,787 | 0.85 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 12 | $99,658 | $15,174 | $19,932 | 1.88 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $301,473 | $42,006 | $60,295 | 6.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 11 | $102,263 | $23,872 | $20,453 | 4.06 |
Nervous system614 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 82 | $101,005 | $15,436 | $20,201 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 70 | $52,900 | $8,512 | $10,580 | 1.02 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 52 | $46,287 | $9,210 | $9,257 | 1.06 |
| Seizures without MCCMS-DRG 101, medical | 40 | $41,459 | $7,457 | $8,292 | 0.91 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 37 | $195,005 | $35,180 | $39,001 | 4.42 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 37 | $61,835 | $13,905 | $12,367 | 1.79 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 25 | $114,764 | $27,943 | $22,953 | 3.85 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 24 | $39,517 | $6,703 | $7,903 | 0.80 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 24 | $60,695 | $13,528 | $12,139 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 23 | $125,697 | $17,566 | $25,139 | 1.98 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 21 | $39,786 | $9,933 | $7,957 | 1.36 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 20 | $102,039 | $16,513 | $20,408 | 2.23 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 20 | $48,143 | $11,450 | $9,629 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 20 | $51,956 | $10,345 | $10,391 | 1.32 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 18 | $48,253 | $7,551 | $9,651 | 1.03 |
| Headaches without MCCMS-DRG 103, medical | 17 | $35,136 | $6,629 | $7,027 | 0.84 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $76,632 | $12,494 | $15,326 | 1.47 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 16 | $79,359 | $18,904 | $15,872 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 14 | $177,009 | $41,000 | $35,402 | 5.67 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 14 | $58,905 | $15,088 | $11,781 | 2.39 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 13 | $40,429 | $7,665 | $8,086 | 0.92 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $43,837 | $7,946 | $8,767 | 1.03 |
Infectious and parasitic diseases590 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 | 397 | $71,260 | $15,347 | $14,252 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 78 | $170,012 | $36,724 | $34,002 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 73 | $38,432 | $7,979 | $7,686 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 15 | $66,745 | $15,057 | $13,349 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 15 | $277,256 | $51,205 | $55,451 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 12 | $68,464 | $14,543 | $13,693 | 2.14 |
Kidney and urinary tract454 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 | 97 | $32,199 | $6,861 | $6,440 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 70 | $32,951 | $7,206 | $6,590 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 70 | $47,590 | $10,466 | $9,518 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 68 | $57,196 | $12,757 | $11,439 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 59 | $65,750 | $12,604 | $13,150 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 34 | $36,926 | $7,903 | $7,385 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 20 | $123,160 | $23,019 | $24,632 | 2.59 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 13 | $62,975 | $11,042 | $12,595 | 1.35 |
| Kidney transplantMS-DRG 652, surgical | 12 | $274,166 | $22,880 | $54,833 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 11 | $169,457 | $36,824 | $33,891 | 3.70 |
Digestive system380 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 59 | $38,823 | $8,016 | $7,765 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 55 | $31,160 | $6,550 | $6,232 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 50 | $77,078 | $18,363 | $15,416 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 37 | $171,705 | $33,739 | $34,341 | 4.52 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 30 | $77,921 | $14,718 | $15,584 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $39,305 | $9,889 | $7,861 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 26 | $38,913 | $6,423 | $7,783 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 24 | $27,267 | $6,907 | $5,453 | 0.80 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 17 | $63,515 | $13,498 | $12,703 | 1.67 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 15 | $78,185 | $9,713 | $15,637 | 1.60 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $162,727 | $41,384 | $32,545 | 5.08 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 13 | $65,172 | $12,695 | $13,034 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $42,609 | $10,760 | $8,522 | 1.45 |
Musculoskeletal system and connective tissue356 discharges in 16 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 | 62 | $69,331 | $15,079 | $13,866 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 39 | $58,817 | $13,372 | $11,763 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 28 | $87,816 | $15,979 | $17,563 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 28 | $36,205 | $7,577 | $7,241 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 26 | $95,092 | $21,864 | $19,018 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $37,503 | $7,577 | $7,501 | 0.90 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 18 | $91,706 | $24,152 | $18,341 | 3.49 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 17 | $106,345 | $25,431 | $21,269 | 3.66 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 17 | $58,972 | $16,460 | $11,794 | 2.04 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 16 | $79,570 | $19,181 | $15,914 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 16 | $44,787 | $6,172 | $8,957 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 16 | $71,645 | $13,422 | $14,329 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $78,646 | $20,538 | $15,729 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $118,700 | $23,539 | $23,740 | 2.99 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 12 | $62,139 | $19,564 | $12,428 | 2.67 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 12 | $29,507 | $6,611 | $5,901 | 0.82 |
Endocrine, nutritional and metabolic295 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 | 86 | $53,691 | $11,039 | $10,738 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 76 | $30,251 | $6,513 | $6,050 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 43 | $35,082 | $6,852 | $7,016 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 22 | $58,543 | $12,240 | $11,709 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 21 | $65,953 | $15,021 | $13,191 | 1.98 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 20 | $45,535 | $11,673 | $9,107 | 1.52 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $33,963 | $9,083 | $6,793 | 1.06 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 13 | $66,769 | $17,141 | $13,354 | 2.26 |
Blood and immune system121 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 61 | $52,738 | $10,893 | $10,548 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 31 | $40,635 | $7,678 | $8,127 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 15 | $37,015 | $10,213 | $7,403 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 14 | $78,540 | $18,719 | $15,708 | 2.19 |
Liver, gallbladder and pancreas79 discharges in 6 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 | 19 | $73,024 | $13,026 | $14,605 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 16 | $32,720 | $7,663 | $6,544 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $57,637 | $10,739 | $11,527 | 1.31 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 11 | $39,327 | $7,741 | $7,865 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 11 | $64,139 | $12,623 | $12,828 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 11 | $49,923 | $9,496 | $9,985 | 1.09 |
Other77 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 | 37 | $154,249 | $34,272 | $30,850 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 26 | $100,756 | $18,618 | $20,151 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 14 | $75,457 | $14,363 | $15,091 | 1.70 |
Skin, subcutaneous tissue and breast62 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 46 | $27,258 | $6,906 | $5,452 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 16 | $56,793 | $12,303 | $11,359 | 1.49 |
Injuries, poisonings and toxic effects of drugs42 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $121,346 | $18,263 | $24,269 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $86,318 | $11,558 | $17,264 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 11 | $185,238 | $24,451 | $37,048 | 3.72 |
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 | 18 | $38,260 | $6,889 | $7,652 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 14 | $53,191 | $9,961 | $10,638 | 1.25 |
Transplants, ECMO and tracheostomy (pre-MDC)26 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 26 | $598,691 | $141,789 | $119,738 | 21.32 |
Alcohol and drug use16 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 | 16 | $35,407 | $7,423 | $7,081 | 0.86 |
Ear, nose, mouth and throat13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 13 | $42,014 | $6,659 | $8,403 | 0.74 |
Blood cancers and poorly differentiated neoplasms13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute leukemia with MCCMS-DRG 834, medical | 13 | $182,828 | $45,236 | $36,566 | 5.60 |
Male reproductive system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 11 | $59,202 | $11,152 | $11,840 | 1.45 |
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 1 Intraocular ProceduresAPC 5491 | 1,024 | 623 | $9,317 | $1,634 | $1,752 |
| Level 2 Urology and Related ServicesAPC 5372 | 785 | 507 | $2,430 | $483 | $502 |
| Level 1 Nerve ProceduresAPC 5431 | 721 | 551 | $8,683 | $1,376 | $1,407 |
| Comprehensive Observation ServicesAPC 8011 | 529 | 496 | $24,198 | $1,913 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 469 | 418 | $8,199 | $1,150 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 285 | 271 | $51,020 | $10,181 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 274 | 198 | $8,904 | $1,278 | $1,516 |
| Level 3 Vascular ProceduresAPC 5183 | 242 | 211 | $15,600 | $2,234 | $2,405 |
| Level 3 Airway EndoscopyAPC 5153 | 240 | 152 | $6,396 | $1,176 | $1,264 |
| Level 5 Urology and Related ServicesAPC 5375 | 202 | 193 | $31,599 | $3,744 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 193 | 171 | $15,855 | $2,494 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 181 | 160 | $9,114 | $1,302 | $1,445 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 172 | 156 | $13,945 | $2,189 | $2,373 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 163 | 158 | $31,765 | $5,042 | $5,339 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 151 | 145 | $17,384 | $2,025 | $2,141 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 147 | 133 | $8,312 | $1,128 | $1,196 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 146 | 142 | $32,446 | $4,081 | $4,358 |
| Level 1 Endovascular ProceduresAPC 5191 | 118 | 111 | $24,012 | $2,029 | $2,208 |
| Level 2 Endovascular ProceduresAPC 5192 | 114 | 94 | $30,450 | $3,937 | $4,338 |
| Level 2 Intraocular ProceduresAPC 5492 | 109 | 93 | $15,421 | $2,858 | $3,116 |
| Level 4 Airway EndoscopyAPC 5154 | 106 | 97 | $17,291 | $2,543 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 91 | 91 | $48,041 | $7,586 | $8,164 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 85 | 81 | $8,639 | $1,637 | $1,780 |
| Level 5 Airway EndoscopyAPC 5155 | 77 | 75 | $26,033 | $4,847 | $5,183 |
| Level 2 Vascular ProceduresAPC 5182 | 77 | 69 | $5,297 | $1,131 | $1,204 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 72 | 70 | $67,735 | $14,913 | $15,763 |
| Level 3 Endovascular ProceduresAPC 5193 | 70 | 62 | $52,656 | $8,395 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 70 | 69 | $126,595 | $19,988 | $21,117 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 67 | 67 | $26,114 | $4,671 | $4,982 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 60 | 36 | $15,581 | $2,984 | $4,524 |
| Level 4 Vascular ProceduresAPC 5184 | 57 | 49 | $27,793 | $3,715 | $3,946 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 55 | 51 | $17,852 | $2,721 | $2,930 |
| Level 5 ENT ProceduresAPC 5165 | 52 | 50 | $27,239 | $4,094 | $4,436 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 50 | 50 | $52,480 | $7,944 | $8,569 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 50 | 49 | $89,265 | $26,092 | $26,719 |
| Level 4 Gynecologic ProceduresAPC 5414 | 49 | 49 | $14,841 | $2,134 | $2,389 |
| Level 3 Intraocular ProceduresAPC 5493 | 47 | 34 | $19,529 | $3,800 | $4,004 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 44 | 40 | $18,295 | $2,407 | $2,636 |
| Level 3 ENT ProceduresAPC 5163 | 36 | 22 | $4,691 | $1,109 | $1,106 |
| Level 4 Endovascular ProceduresAPC 5194 | 36 | 35 | $94,124 | $14,339 | $14,606 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 36 | 36 | $39,880 | $6,000 | $6,514 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 35 | 35 | $137,195 | $27,495 | $29,375 |
| Level 4 ENT ProceduresAPC 5164 | 32 | 27 | $12,581 | $2,268 | $2,217 |
| Level 3 Upper GI ProceduresAPC 5303 | 32 | 30 | $22,718 | $2,785 | $2,888 |
| Complex GI ProceduresAPC 5331 | 27 | 16 | $29,410 | $4,144 | $4,263 |
| Level 6 Gynecologic ProceduresAPC 5416 | 27 | 27 | $33,537 | $5,291 | $5,836 |
| Level 6 Urology and Related ServicesAPC 5376 | 25 | 22 | $42,920 | $6,774 | $7,291 |
| Level 5 Gynecologic ProceduresAPC 5415 | 23 | 23 | $34,606 | $3,459 | $3,792 |
| Level 3 Lower GI ProceduresAPC 5313 | 22 | 20 | $14,823 | $1,955 | $2,176 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 16 | 16 | $15,565 | $2,811 | $2,969 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 14 | 14 | $148,764 | $24,818 | $26,955 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 14 | 13 | $66,956 | $16,978 | $18,465 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | 11 | $76,562 | $16,111 | $17,052 |
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.