Baylor University Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baylor University Medical Center, Dallas, TX in 2024, from traditional Medicare claims. Back to the Baylor University Medical Center profile, with quality ratings, finances and negotiated rates.
6,209
Medicare inpatient discharges
In 183 published DRGs
2.66
Case mix index
IPPS FY 2027
32%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
4,052
Medicare outpatient services
In 38 service groups
Inpatient stays by major diagnostic category
Respiratory system772 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 212 | $63,746 | $9,677 | $15,618 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 62 | $64,896 | $13,954 | $15,900 | 1.70 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 53 | $91,240 | $15,021 | $22,354 | 1.81 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 37 | $67,888 | $12,740 | $16,632 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 36 | $45,738 | $9,469 | $11,206 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 35 | $33,030 | $8,914 | $8,092 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 34 | $73,861 | $17,728 | $18,096 | 2.55 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 34 | $49,087 | $9,222 | $12,026 | 1.33 |
| Major chest procedures with MCCMS-DRG 163, surgical | 29 | $209,409 | $40,245 | $51,305 | 4.71 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 29 | $30,569 | $5,400 | $7,489 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 29 | $98,146 | $18,673 | $24,046 | 2.70 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 26 | $145,668 | $29,293 | $35,689 | 4.06 |
| Major chest trauma with CCMS-DRG 184, medical | 23 | $51,802 | $8,055 | $12,691 | 1.05 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 20 | $33,540 | $7,084 | $8,217 | 0.99 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 19 | $38,300 | $6,762 | $9,383 | 0.82 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 18 | $221,330 | $43,664 | $54,226 | 6.91 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 15 | $55,530 | $13,642 | $13,605 | 1.74 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 14 | $32,601 | $6,934 | $7,987 | 0.85 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 14 | $39,857 | $7,842 | $9,765 | 0.91 |
| Major chest trauma with MCCMS-DRG 183, medical | 11 | $54,175 | $12,556 | $13,273 | 1.57 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $90,303 | $13,669 | $22,124 | 1.55 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 11 | $39,383 | $7,059 | $9,649 | 0.96 |
Infectious and parasitic diseases748 discharges in 9 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 | 475 | $70,780 | $14,588 | $17,341 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 89 | $32,521 | $7,407 | $7,968 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 88 | $200,059 | $39,563 | $49,014 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 22 | $243,541 | $48,281 | $59,668 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 21 | $61,093 | $13,394 | $14,968 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $133,026 | $29,882 | $32,591 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $52,392 | $11,620 | $12,836 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 12 | $33,021 | $7,381 | $8,090 | 0.88 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 11 | $65,894 | $15,524 | $16,144 | 2.04 |
Circulatory system744 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 213 | $47,863 | $9,812 | $11,726 | 1.28 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 77 | $150,381 | $38,646 | $36,843 | 5.88 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 56 | $246,272 | $55,289 | $60,337 | 7.71 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 52 | $125,712 | $28,286 | $30,799 | 4.04 |
| Syncope and collapseMS-DRG 312, medical | 49 | $40,759 | $6,901 | $9,986 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 35 | $67,343 | $14,959 | $16,499 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 33 | $138,995 | $35,259 | $34,054 | 5.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 29 | $49,882 | $9,504 | $12,221 | 1.20 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 26 | $25,780 | $5,419 | $6,316 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 25 | $98,307 | $17,898 | $24,085 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 21 | $61,615 | $10,994 | $15,096 | 1.59 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 21 | $39,409 | $8,246 | $9,655 | 1.07 |
| Heart failure and shock with CCMS-DRG 292, medical | 19 | $26,968 | $6,469 | $6,607 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 19 | $55,328 | $10,065 | $13,555 | 1.58 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 18 | $38,269 | $7,450 | $9,376 | 0.97 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 14 | $56,496 | $6,842 | $13,842 | 1.08 |
| Hypertension without MCCMS-DRG 305, medical | 14 | $28,159 | $6,503 | $6,899 | 0.75 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $171,333 | $38,445 | $41,977 | 5.06 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $81,861 | $10,476 | $20,056 | 1.15 |
Digestive system720 discharges in 21 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 | 82 | $28,567 | $6,689 | $6,999 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 70 | $68,691 | $16,428 | $16,829 | 2.37 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 63 | $32,724 | $8,088 | $8,017 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 62 | $136,802 | $29,654 | $33,517 | 4.52 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 57 | $60,354 | $13,363 | $14,787 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 39 | $43,911 | $9,585 | $10,758 | 1.28 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 33 | $45,776 | $11,810 | $11,215 | 1.60 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 32 | $48,877 | $11,531 | $11,975 | 1.67 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 32 | $22,586 | $5,993 | $5,534 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 32 | $52,702 | $13,288 | $12,912 | 1.62 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 31 | $67,977 | $17,480 | $16,654 | 2.50 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 29 | $26,499 | $7,389 | $6,492 | 0.94 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 22 | $125,528 | $35,017 | $30,754 | 5.08 |
| Digestive malignancy with MCCMS-DRG 374, medical | 22 | $73,704 | $14,260 | $18,057 | 2.10 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 22 | $61,984 | $12,268 | $15,186 | 1.45 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 19 | $123,200 | $26,805 | $30,184 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 18 | $37,619 | $7,633 | $9,217 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 17 | $14,510 | $4,814 | $3,555 | 0.56 |
| Digestive malignancy with CCMS-DRG 375, medical | 15 | $44,084 | $9,486 | $10,801 | 1.20 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 12 | $59,903 | $17,313 | $14,676 | 2.20 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 11 | $54,327 | $12,553 | $13,310 | 1.72 |
Musculoskeletal system and connective tissue659 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 76 | $98,366 | $25,741 | $24,100 | 3.49 |
| Medical back problems without MCCMS-DRG 552, medical | 55 | $48,754 | $9,155 | $11,945 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 54 | $71,064 | $15,478 | $17,411 | 2.07 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 54 | $104,564 | $18,587 | $25,618 | 2.48 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 46 | $68,363 | $13,517 | $16,749 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 45 | $83,854 | $15,042 | $20,544 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 30 | $126,215 | $27,147 | $30,923 | 3.66 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 28 | $77,301 | $17,752 | $18,939 | 2.40 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 25 | $281,671 | $49,942 | $69,010 | 6.12 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 25 | $96,836 | $20,560 | $23,725 | 2.95 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 24 | $71,326 | $19,977 | $17,475 | 2.96 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 22 | $82,105 | $20,644 | $20,116 | 3.00 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $33,337 | $6,501 | $8,167 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 21 | $61,024 | $12,803 | $14,951 | 1.70 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 19 | $80,348 | $20,565 | $19,685 | 2.67 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 15 | $138,551 | $34,511 | $33,945 | 4.61 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 14 | $111,280 | $21,125 | $27,263 | 2.99 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 13 | $427,307 | $75,096 | $104,690 | 8.86 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 13 | $126,712 | $29,017 | $31,044 | 5.19 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 13 | $56,270 | $13,859 | $13,786 | 1.97 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 12 | $78,189 | $17,165 | $19,156 | 2.38 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 12 | $39,279 | $9,569 | $9,623 | 1.52 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 11 | $93,956 | $31,123 | $23,019 | 5.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 11 | $36,766 | $7,168 | $9,008 | 0.90 |
Nervous system657 discharges in 21 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 | $87,509 | $14,652 | $21,440 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 75 | $44,177 | $7,696 | $10,823 | 1.02 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 56 | $64,857 | $12,878 | $15,890 | 1.79 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 42 | $188,957 | $32,074 | $46,294 | 4.42 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 38 | $31,137 | $8,920 | $7,629 | 1.06 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 36 | $56,106 | $10,715 | $13,746 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 34 | $34,306 | $8,119 | $8,405 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 34 | $36,827 | $6,403 | $9,023 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 29 | $76,117 | $14,286 | $18,649 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 29 | $89,917 | $16,685 | $22,030 | 1.98 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 26 | $35,553 | $6,799 | $8,711 | 0.80 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 24 | $100,359 | $15,911 | $24,588 | 2.28 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 23 | $50,924 | $10,413 | $12,476 | 1.32 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 20 | $45,808 | $10,703 | $11,223 | 1.47 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 19 | $79,379 | $15,720 | $19,448 | 2.23 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 19 | $41,028 | $11,120 | $10,052 | 1.36 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 18 | $64,603 | $18,729 | $15,828 | 2.39 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 17 | $37,830 | $5,417 | $9,268 | 0.69 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 13 | $223,763 | $42,823 | $54,822 | 5.67 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $111,622 | $21,156 | $27,347 | 2.95 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $78,731 | $17,313 | $19,289 | 2.43 |
Kidney and urinary tract575 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 87 | $27,722 | $6,183 | $6,792 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 83 | $65,863 | $12,878 | $16,137 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 74 | $53,249 | $11,764 | $13,046 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 62 | $29,339 | $7,495 | $7,188 | 1.02 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 56 | $37,342 | $9,510 | $9,149 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 50 | $29,452 | $7,416 | $7,216 | 0.90 |
| Kidney transplantMS-DRG 652, surgical | 41 | $208,033 | $17,608 | $50,968 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 37 | $148,206 | $33,032 | $36,310 | 3.70 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 27 | $272,461 | $32,880 | $66,753 | 4.50 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $69,246 | $10,128 | $16,965 | 1.35 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 16 | $62,650 | $17,441 | $15,349 | 2.38 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 13 | $89,482 | $20,052 | $21,923 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 11 | $53,219 | $13,153 | $13,039 | 1.84 |
Endocrine, nutritional and metabolic294 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 with MCCMS-DRG 640, medical | 88 | $47,447 | $10,089 | $11,624 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 87 | $31,386 | $6,493 | $7,690 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 33 | $29,492 | $7,138 | $7,225 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 30 | $48,966 | $10,250 | $11,997 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 20 | $97,853 | $15,397 | $23,974 | 1.98 |
| Endocrine disorders with MCCMS-DRG 643, medical | 20 | $50,371 | $11,854 | $12,341 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $34,633 | $7,655 | $8,485 | 1.06 |
Liver, gallbladder and pancreas224 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 35 | $55,816 | $13,359 | $13,675 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 27 | $69,812 | $14,774 | $17,104 | 1.83 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 26 | $67,510 | $13,278 | $16,540 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 25 | $62,801 | $11,268 | $15,386 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 20 | $25,569 | $7,741 | $6,265 | 0.95 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $47,190 | $8,906 | $11,561 | 1.09 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 16 | $33,256 | $6,800 | $8,148 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $53,789 | $10,598 | $13,178 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 15 | $21,416 | $6,026 | $5,247 | 0.86 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 13 | $130,205 | $36,832 | $31,900 | 5.51 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $70,931 | $9,311 | $17,378 | 1.63 |
Transplants, ECMO and tracheostomy (pre-MDC)155 discharges in 7 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 | 51 | $874,311 | $179,428 | $214,206 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 25 | $826,670 | $193,801 | $202,534 | 27.10 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 22 | $409,905 | $81,365 | $100,427 | 14.70 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 16 | $1,723,851 | $384,870 | $422,343 | 36.84 |
| Lung transplantMS-DRG 007, surgical | 15 | $677,967 | $98,298 | $166,102 | 12.27 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 14 | $253,605 | $58,025 | $62,133 | 6.18 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 12 | $587,663 | $115,042 | $143,977 | 11.46 |
Blood cancers and poorly differentiated neoplasms155 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 39 | $74,617 | $14,170 | $18,281 | 1.21 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 28 | $114,596 | $22,075 | $28,076 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 24 | $271,167 | $47,438 | $66,436 | 4.84 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 24 | $97,434 | $24,550 | $23,871 | 3.13 |
| Acute leukemia with MCCMS-DRG 834, medical | 15 | $270,555 | $45,155 | $66,286 | 5.60 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 13 | $39,130 | $9,483 | $9,587 | 1.57 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 12 | $96,572 | $22,418 | $23,660 | 3.15 |
Other123 discharges in 4 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 | 56 | $150,025 | $37,938 | $36,756 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 31 | $81,583 | $18,042 | $19,988 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 25 | $156,988 | $25,854 | $38,462 | 3.38 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 11 | $58,312 | $13,299 | $14,286 | 1.70 |
Blood and immune system116 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 39 | $46,314 | $10,382 | $11,347 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 29 | $28,301 | $7,552 | $6,934 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 20 | $89,757 | $15,021 | $21,990 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 17 | $76,975 | $14,892 | $18,859 | 2.19 |
| Coagulation disordersMS-DRG 813, medical | 11 | $64,222 | $12,449 | $15,734 | 1.56 |
Injuries, poisonings and toxic effects of drugs92 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 31 | $125,113 | $22,155 | $30,653 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 26 | $223,097 | $43,297 | $54,659 | 3.72 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 19 | $68,842 | $14,236 | $16,866 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 16 | $26,123 | $8,457 | $6,400 | 1.03 |
Skin, subcutaneous tissue and breast71 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 42 | $26,007 | $6,825 | $6,372 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $44,240 | $12,547 | $10,839 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with MCCMS-DRG 579, surgical | 14 | $61,165 | $25,190 | $14,985 | 3.34 |
Factors influencing health status39 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms with MCCMS-DRG 947, medical | 23 | $43,098 | $7,793 | $10,559 | 1.25 |
| Signs and symptoms without MCCMS-DRG 948, medical | 16 | $25,101 | $6,028 | $6,150 | 0.80 |
Ear, nose, mouth and throat38 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 27 | $66,925 | $14,835 | $16,397 | 2.07 |
| Other ear, nose, mouth and throat o.r. procedures with CCMS-DRG 144, surgical | 11 | $71,597 | $13,660 | $17,541 | 1.73 |
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 | $36,974 | $7,056 | $9,059 | 0.86 |
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 | $131,982 | $25,892 | $32,336 | 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 |
|---|---|---|---|---|---|
| Level 2 Upper GI ProceduresAPC 5302 | 600 | 466 | $11,923 | $1,308 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 499 | 460 | $8,951 | $1,095 | $1,220 |
| Level 4 Airway EndoscopyAPC 5154 | 214 | 179 | $22,207 | $2,552 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 207 | 205 | $49,162 | $7,190 | $8,164 |
| Comprehensive Observation ServicesAPC 8011 | 183 | 181 | $24,800 | $1,843 | $2,090 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 169 | 168 | $73,106 | $14,479 | $15,763 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 137 | 134 | $32,437 | $4,035 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 134 | 116 | $21,604 | $2,438 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 128 | 123 | $16,179 | $2,088 | $2,405 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 123 | 118 | $19,473 | $1,969 | $2,141 |
| Level 6 Gynecologic ProceduresAPC 5416 | 123 | 123 | $30,870 | $5,194 | $5,836 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 121 | 119 | $30,066 | $4,957 | $5,339 |
| Level 5 Airway EndoscopyAPC 5155 | 114 | 109 | $33,102 | $4,652 | $5,183 |
| Level 5 Urology and Related ServicesAPC 5375 | 113 | 109 | $27,330 | $3,645 | $3,918 |
| Level 5 ENT ProceduresAPC 5165 | 103 | 103 | $33,599 | $3,925 | $4,436 |
| Level 3 Urology and Related ServicesAPC 5373 | 95 | 61 | $12,713 | $1,380 | $1,516 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 92 | 90 | $53,100 | $9,013 | $10,772 |
| Level 3 Airway EndoscopyAPC 5153 | 89 | 80 | $14,805 | $1,182 | $1,264 |
| Level 3 Upper GI ProceduresAPC 5303 | 81 | 77 | $17,171 | $2,596 | $2,888 |
| Complex GI ProceduresAPC 5331 | 80 | 67 | $28,355 | $3,865 | $4,263 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 74 | 52 | $18,332 | $2,430 | $2,636 |
| Level 2 Vascular ProceduresAPC 5182 | 66 | 60 | $9,599 | $1,128 | $1,204 |
| Level 4 Gynecologic ProceduresAPC 5414 | 52 | 51 | $22,272 | $2,203 | $2,389 |
| Level 4 Vascular ProceduresAPC 5184 | 47 | 45 | $28,474 | $3,541 | $3,946 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 46 | 46 | $32,121 | $4,494 | $4,982 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 45 | 42 | $13,382 | $1,132 | $1,196 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 40 | $26,192 | $2,685 | $2,930 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 42 | 40 | $67,813 | $17,665 | $18,465 |
| Level 3 Endovascular ProceduresAPC 5193 | 39 | 34 | $48,851 | $7,876 | $8,874 |
| Level 5 Gynecologic ProceduresAPC 5415 | 32 | 32 | $25,615 | $3,504 | $3,792 |
| Level 3 Lower GI ProceduresAPC 5313 | 30 | 26 | $18,236 | $1,929 | $2,176 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 29 | 29 | $99,630 | $24,858 | $26,719 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 24 | 23 | $23,637 | $2,090 | $2,373 |
| Level 6 Urology and Related ServicesAPC 5376 | 21 | 21 | $35,711 | $6,513 | $7,291 |
| Level 2 Endovascular ProceduresAPC 5192 | 18 | 17 | $47,448 | $3,356 | $4,338 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 15 | 13 | $18,054 | $2,722 | $2,969 |
| Level 1 Nerve ProceduresAPC 5431 | 13 | 13 | $11,394 | $1,360 | $1,407 |
| Level 4 ENT ProceduresAPC 5164 | 12 | 12 | $18,068 | $2,268 | $2,217 |
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.