Baystate Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Baystate Medical Center, Springfield, MA in 2024, from traditional Medicare claims. Back to the Baystate Medical Center profile, with quality ratings, finances and negotiated rates.
10,223
Medicare inpatient discharges
In 223 published DRGs
2.06
Case mix index
IPPS FY 2027
30%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
7,853
Medicare outpatient services
In 50 service groups
Inpatient stays by major diagnostic category
Circulatory system3,008 discharges in 52 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 601 | $24,149 | $11,836 | $10,698 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 216 | $116,214 | $47,244 | $51,483 | 4.88 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 192 | $54,997 | $15,803 | $24,363 | 1.82 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 156 | $77,644 | $31,108 | $34,396 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 136 | $31,854 | $14,897 | $14,111 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 100 | $12,670 | $6,168 | $5,613 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 92 | $17,007 | $7,944 | $7,534 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 88 | $24,388 | $9,284 | $10,804 | 1.08 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 81 | $44,865 | $19,945 | $19,875 | 2.16 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 79 | $23,354 | $7,935 | $10,346 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 78 | $69,747 | $28,236 | $30,898 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 61 | $41,401 | $19,703 | $18,341 | 2.09 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 60 | $27,388 | $11,107 | $12,133 | 1.20 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 59 | $36,671 | $21,885 | $16,245 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 57 | $62,570 | $23,904 | $27,719 | 2.55 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 51 | $157,083 | $63,264 | $69,588 | 6.25 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 45 | $129,774 | $47,454 | $57,490 | 5.24 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 43 | $16,940 | $9,287 | $7,505 | 1.07 |
| Hypertension without MCCMS-DRG 305, medical | 43 | $14,637 | $6,275 | $6,484 | 0.75 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 43 | $13,776 | $3,950 | $6,103 | 0.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 39 | $22,479 | $8,692 | $9,958 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 38 | $129,055 | $44,660 | $57,171 | 5.20 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 38 | $50,570 | $31,301 | $22,402 | 3.46 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 38 | $18,394 | $5,908 | $8,148 | 0.72 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 37 | $95,889 | $34,174 | $42,479 | 4.04 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 35 | $211,832 | $78,258 | $93,842 | 7.71 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 33 | $208,437 | $80,045 | $92,338 | 7.80 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 33 | $82,719 | $34,084 | $36,645 | 3.35 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 28 | $41,154 | $14,890 | $18,231 | 1.74 |
| Heart failure and shock with CCMS-DRG 292, medical | 28 | $19,175 | $7,057 | $8,495 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 28 | $25,140 | $13,797 | $11,137 | 1.58 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 27 | $86,134 | $36,066 | $38,157 | 4.16 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 27 | $119,809 | $48,991 | $53,075 | 5.06 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 26 | $76,262 | $25,485 | $33,784 | 2.81 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 23 | $79,172 | $34,010 | $35,073 | 3.46 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 22 | $32,091 | $16,337 | $14,216 | 1.83 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 21 | $139,791 | $54,356 | $61,927 | 5.88 |
| Hypertension with MCCMS-DRG 304, medical | 19 | $19,509 | $11,009 | $8,643 | 1.15 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 18 | $21,367 | $13,954 | $9,465 | 1.54 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 15 | $152,594 | $48,490 | $67,599 | 5.04 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 15 | $91,223 | $32,883 | $40,412 | 3.18 |
| Chest painMS-DRG 313, medical | 15 | $12,449 | $6,164 | $5,515 | 0.72 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 14 | $49,385 | $31,733 | $21,877 | 3.27 |
| Atherosclerosis without MCCMS-DRG 303, medical | 14 | $18,038 | $5,774 | $7,991 | 0.66 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 13 | $34,173 | $18,755 | $15,139 | 1.97 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 13 | $11,628 | $5,832 | $5,151 | 0.71 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 12 | $89,957 | $45,138 | $39,851 | 4.81 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 12 | $132,981 | $70,647 | $58,911 | 7.04 |
| Cardiac arrest, unexplained with MCCMS-DRG 296, medical | 12 | $59,505 | $17,666 | $26,361 | 1.60 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 12 | $77,392 | $29,585 | $34,285 | 2.97 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 11 | $253,711 | $94,504 | $112,394 | 9.71 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 11 | $98,002 | $33,536 | $43,415 | 3.90 |
Infectious and parasitic diseases1,248 discharges in 7 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 | 807 | $38,751 | $18,069 | $17,167 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 186 | $101,269 | $46,649 | $44,862 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 133 | $23,264 | $9,159 | $10,306 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 47 | $150,513 | $65,481 | $66,677 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 42 | $37,559 | $18,348 | $16,639 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 19 | $43,909 | $15,890 | $19,452 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $37,795 | $20,098 | $16,743 | 2.14 |
Respiratory system1,112 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 175 | $27,323 | $11,684 | $12,104 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 152 | $27,090 | $15,383 | $12,001 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 136 | $21,779 | $12,017 | $9,648 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 64 | $17,070 | $9,808 | $7,562 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 52 | $15,030 | $8,608 | $6,658 | 0.99 |
| Major chest trauma with CCMS-DRG 184, medical | 50 | $19,026 | $9,054 | $8,429 | 1.05 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 50 | $13,352 | $7,187 | $5,915 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 45 | $54,606 | $25,448 | $24,190 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 37 | $52,206 | $19,300 | $23,127 | 1.74 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 34 | $30,256 | $12,929 | $13,403 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 29 | $75,413 | $24,473 | $33,408 | 2.55 |
| Major chest trauma with MCCMS-DRG 183, medical | 28 | $34,779 | $14,395 | $15,407 | 1.57 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 25 | $13,269 | $7,472 | $5,878 | 0.85 |
| Major chest procedures with MCCMS-DRG 163, surgical | 23 | $96,030 | $43,551 | $42,541 | 4.71 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 23 | $15,391 | $8,884 | $6,818 | 0.96 |
| Pneumothorax with CCMS-DRG 200, medical | 20 | $22,437 | $9,165 | $9,939 | 1.08 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 20 | $170,978 | $69,404 | $75,743 | 6.91 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 17 | $60,461 | $16,606 | $26,784 | 1.88 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 17 | $14,557 | $7,136 | $6,449 | 0.82 |
| Pleural effusion with MCCMS-DRG 186, medical | 17 | $26,240 | $14,016 | $11,624 | 1.55 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 16 | $25,021 | $7,834 | $11,084 | 1.10 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 15 | $62,937 | $34,767 | $27,881 | 4.06 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $28,709 | $15,995 | $12,718 | 1.81 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 15 | $19,631 | $7,600 | $8,697 | 0.91 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 13 | $14,982 | $6,262 | $6,637 | 0.76 |
| Major chest trauma without cc/mccMS-DRG 185, medical | 13 | $11,843 | $6,049 | $5,247 | 0.76 |
| Pneumothorax with MCCMS-DRG 199, medical | 11 | $27,839 | $15,154 | $12,333 | 1.77 |
Nervous system930 discharges in 28 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 132 | $43,400 | $18,445 | $19,226 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 93 | $23,240 | $8,668 | $10,295 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 59 | $25,263 | $11,412 | $11,192 | 1.36 |
| Seizures without MCCMS-DRG 101, medical | 58 | $23,681 | $8,072 | $10,491 | 0.91 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 45 | $16,352 | $11,872 | $7,244 | 1.32 |
| Seizures with MCCMS-DRG 100, medical | 45 | $47,451 | $18,763 | $21,021 | 1.98 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 44 | $28,361 | $10,460 | $12,564 | 1.14 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 39 | $122,368 | $53,420 | $54,209 | 5.67 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 35 | $104,995 | $43,272 | $46,513 | 4.42 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 30 | $20,972 | $8,581 | $9,290 | 1.03 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 26 | $22,877 | $10,060 | $10,134 | 1.03 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 25 | $37,133 | $16,785 | $16,450 | 1.81 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 24 | $82,082 | $31,081 | $36,362 | 2.43 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 24 | $27,584 | $18,948 | $12,220 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 23 | $20,060 | $9,068 | $8,887 | 1.06 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 23 | $41,967 | $20,580 | $18,591 | 2.27 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 22 | $27,386 | $12,812 | $12,132 | 1.36 |
| Extracranial procedures with CCMS-DRG 038, surgical | 21 | $34,949 | $13,215 | $15,483 | 1.60 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 21 | $15,979 | $5,139 | $7,079 | 0.69 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 20 | $53,633 | $22,542 | $23,759 | 2.28 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 19 | $26,565 | $10,011 | $11,769 | 1.47 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 19 | $35,544 | $16,267 | $15,746 | 1.79 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $29,843 | $16,429 | $13,220 | 1.79 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 14 | $160,216 | $88,546 | $70,976 | 8.45 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 13 | $76,449 | $34,595 | $33,867 | 3.79 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 13 | $16,740 | $7,987 | $7,416 | 0.87 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 13 | $15,926 | $6,422 | $7,055 | 0.80 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $81,584 | $29,179 | $36,142 | 2.95 |
Musculoskeletal system and connective tissue879 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 192 | $39,655 | $17,424 | $17,567 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 145 | $40,363 | $19,054 | $17,881 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 63 | $61,246 | $30,194 | $27,132 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 59 | $17,470 | $7,958 | $7,739 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 36 | $40,508 | $19,780 | $17,945 | 2.11 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 34 | $28,959 | $14,952 | $12,829 | 1.59 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 34 | $46,639 | $23,334 | $20,661 | 2.40 |
| Medical back problems with MCCMS-DRG 551, medical | 25 | $33,427 | $15,609 | $14,808 | 1.70 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 25 | $19,670 | $7,237 | $8,714 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 23 | $36,341 | $17,302 | $16,099 | 1.87 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 22 | $62,159 | $33,225 | $27,536 | 3.66 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 22 | $47,592 | $22,995 | $21,083 | 2.48 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $16,542 | $6,672 | $7,328 | 0.79 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 17 | $38,433 | $14,671 | $17,026 | 1.82 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 16 | $25,177 | $12,804 | $11,153 | 1.52 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 15 | $29,471 | $25,390 | $13,056 | 2.67 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 15 | $61,067 | $32,164 | $27,053 | 3.46 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 14 | $56,111 | $26,595 | $24,857 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 14 | $21,096 | $9,272 | $9,345 | 1.09 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $19,290 | $9,015 | $8,545 | 1.00 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 13 | $54,076 | $29,134 | $23,956 | 3.49 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 13 | $21,799 | $6,872 | $9,657 | 0.82 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 12 | $55,617 | $27,353 | $24,638 | 3.00 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 12 | $36,289 | $17,757 | $16,076 | 2.04 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 12 | $38,005 | $18,506 | $16,836 | 1.97 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 11 | $35,982 | $21,016 | $15,940 | 2.38 |
Digestive system826 discharges in 22 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 | 119 | $14,939 | $6,782 | $6,618 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 107 | $24,168 | $8,792 | $10,706 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 59 | $45,924 | $17,921 | $20,344 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 52 | $86,671 | $41,341 | $38,395 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 52 | $28,633 | $11,675 | $12,684 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 49 | $17,761 | $6,794 | $7,868 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 48 | $22,497 | $8,471 | $9,966 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 45 | $55,807 | $20,326 | $24,722 | 2.37 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 33 | $36,413 | $15,613 | $16,131 | 1.62 |
| Digestive malignancy with MCCMS-DRG 374, medical | 31 | $43,999 | $18,154 | $19,491 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 27 | $19,375 | $9,964 | $8,583 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 25 | $38,000 | $14,403 | $16,834 | 1.67 |
| Digestive malignancy with CCMS-DRG 375, medical | 25 | $28,523 | $10,495 | $12,636 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 23 | $108,218 | $44,891 | $47,941 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 22 | $31,483 | $11,503 | $13,947 | 1.45 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 18 | $55,254 | $21,958 | $24,477 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 18 | $48,530 | $14,870 | $21,499 | 1.60 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 17 | $66,114 | $41,148 | $29,288 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $36,940 | $14,038 | $16,364 | 1.75 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 14 | $15,509 | $5,119 | $6,870 | 0.63 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 14 | $14,007 | $4,316 | $6,205 | 0.56 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 11 | $99,316 | $38,505 | $43,997 | 3.58 |
Kidney and urinary tract796 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 | 145 | $15,115 | $7,163 | $6,696 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 143 | $31,454 | $16,086 | $13,934 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 130 | $18,888 | $10,504 | $8,368 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 116 | $15,599 | $7,810 | $6,911 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 88 | $26,151 | $13,357 | $11,585 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 70 | $18,563 | $9,443 | $8,223 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 36 | $22,765 | $11,992 | $10,085 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 20 | $41,285 | $25,300 | $18,289 | 2.59 |
| Kidney transplantMS-DRG 652, surgical | 16 | $216,793 | $27,890 | $96,039 | 3.00 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 16 | $18,074 | $9,265 | $8,007 | 1.05 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $132,223 | $50,527 | $58,575 | 3.70 |
Endocrine, nutritional and metabolic382 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 | 94 | $21,966 | $11,764 | $9,731 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 94 | $15,001 | $6,560 | $6,645 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 71 | $15,215 | $7,838 | $6,740 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 51 | $25,557 | $13,520 | $11,322 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 28 | $27,161 | $13,907 | $12,033 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 23 | $19,625 | $9,373 | $8,694 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 21 | $32,558 | $17,475 | $14,423 | 1.98 |
Liver, gallbladder and pancreas283 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 42 | $36,096 | $18,460 | $15,991 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 33 | $27,812 | $14,981 | $12,321 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 31 | $29,154 | $10,672 | $12,915 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 29 | $40,045 | $16,421 | $17,740 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 22 | $45,575 | $21,447 | $20,190 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 20 | $37,603 | $13,816 | $16,658 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 19 | $43,077 | $15,661 | $19,083 | 0.95 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 18 | $24,869 | $9,580 | $11,017 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $35,296 | $16,204 | $15,636 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 14 | $37,224 | $11,044 | $16,490 | 1.31 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $16,276 | $8,055 | $7,210 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 14 | $37,427 | $17,692 | $16,580 | 1.83 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 12 | $14,427 | $6,856 | $6,391 | 0.80 |
Blood and immune system186 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 69 | $20,921 | $7,883 | $9,268 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 58 | $25,962 | $12,483 | $11,501 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 23 | $26,144 | $14,557 | $11,582 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 22 | $21,475 | $11,590 | $9,514 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 14 | $97,917 | $35,267 | $43,377 | 2.19 |
Injuries, poisonings and toxic effects of drugs149 discharges in 7 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 | 36 | $61,437 | $18,463 | $27,217 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 25 | $31,938 | $17,591 | $14,148 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 22 | $19,484 | $8,992 | $8,631 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 20 | $46,972 | $17,490 | $20,808 | 2.00 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 18 | $16,380 | $6,728 | $7,256 | 0.86 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 17 | $62,861 | $35,682 | $27,847 | 3.72 |
| Allergic reactions without MCCMS-DRG 916, medical | 11 | $16,962 | $5,428 | $7,514 | 0.66 |
Skin, subcutaneous tissue and breast119 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 79 | $14,227 | $7,654 | $6,302 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 25 | $21,787 | $7,422 | $9,651 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 15 | $37,791 | $14,391 | $16,742 | 1.49 |
Mental diseases and disorders71 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 53 | $23,850 | $15,256 | $10,565 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 18 | $21,021 | $8,230 | $9,312 | 0.95 |
Other52 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 | 24 | $98,301 | $44,954 | $43,547 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $67,966 | $23,228 | $30,109 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 13 | $64,557 | $29,590 | $28,599 | 3.38 |
Alcohol and drug use51 discharges in 2 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 | 26 | $17,695 | $7,492 | $7,839 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 25 | $32,221 | $17,095 | $14,274 | 1.78 |
Factors influencing health status35 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 | 20 | $15,776 | $7,144 | $6,989 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 15 | $19,276 | $12,179 | $8,539 | 1.25 |
Multiple significant trauma32 discharges in 2 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 | 17 | $51,274 | $36,638 | $22,714 | 3.88 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 15 | $51,036 | $26,769 | $22,609 | 2.73 |
Transplants, ECMO and tracheostomy (pre-MDC)21 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 | 21 | $562,453 | $235,834 | $249,167 | 21.32 |
Blood cancers and poorly differentiated neoplasms19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 19 | $67,097 | $27,172 | $29,724 | 3.13 |
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 | $13,868 | $5,832 | $6,143 | 0.74 |
Female reproductive system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 11 | $57,832 | $18,400 | $25,620 | 1.97 |
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 | 1,293 | 1,147 | $10,949 | $2,305 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 741 | 713 | $29,034 | $12,393 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 684 | 680 | $12,403 | $2,490 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 603 | 535 | $5,397 | $1,375 | $1,220 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 278 | 269 | $15,192 | $6,039 | $5,339 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 271 | 269 | $83,717 | $23,714 | $21,117 |
| Level 2 Upper GI ProceduresAPC 5302 | 271 | 229 | $8,508 | $1,609 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 265 | 255 | $10,398 | $2,716 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 220 | 210 | $38,132 | $10,074 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 187 | 185 | $16,885 | $4,830 | $4,358 |
| Level 3 Urology and Related ServicesAPC 5373 | 181 | 111 | $5,551 | $1,741 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 159 | 145 | $13,335 | $4,428 | $3,918 |
| Level 1 Nerve ProceduresAPC 5431 | 155 | 126 | $6,198 | $1,631 | $1,407 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 153 | 152 | $44,193 | $18,212 | $15,763 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 140 | 140 | $10,744 | $2,429 | $2,141 |
| Level 2 Intraocular ProceduresAPC 5492 | 137 | 121 | $9,128 | $3,479 | $3,116 |
| Level 4 Vascular ProceduresAPC 5184 | 129 | 103 | $20,711 | $4,009 | $3,946 |
| Level 2 Urology and Related ServicesAPC 5372 | 129 | 129 | $1,261 | $582 | $502 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 119 | 119 | $28,479 | $9,411 | $8,164 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 105 | 81 | $8,162 | $2,932 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 105 | 105 | $7,833 | $2,548 | $2,389 |
| Level 2 Endovascular ProceduresAPC 5192 | 104 | 96 | $20,773 | $4,889 | $4,338 |
| Level 4 Endovascular ProceduresAPC 5194 | 95 | 79 | $46,329 | $14,267 | $14,606 |
| Level 4 Urology and Related ServicesAPC 5374 | 95 | 90 | $8,107 | $2,983 | $2,629 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 87 | 87 | $21,071 | $9,820 | $8,569 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 86 | 83 | $9,657 | $2,770 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 83 | 83 | $4,852 | $1,358 | $1,196 |
| Level 4 Airway EndoscopyAPC 5154 | 81 | 77 | $12,129 | $3,124 | $2,833 |
| Level 2 Vascular ProceduresAPC 5182 | 79 | 78 | $6,197 | $1,367 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 76 | 73 | $12,077 | $3,262 | $2,930 |
| Level 5 ENT ProceduresAPC 5165 | 73 | 73 | $14,033 | $5,011 | $4,436 |
| Level 5 Gynecologic ProceduresAPC 5415 | 73 | 73 | $11,418 | $4,256 | $3,792 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 63 | 63 | $60,613 | $33,056 | $29,375 |
| Level 3 Lower GI ProceduresAPC 5313 | 60 | 57 | $8,013 | $2,407 | $2,176 |
| Level 3 Upper GI ProceduresAPC 5303 | 48 | 44 | $13,436 | $3,276 | $2,888 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 45 | 45 | $24,263 | $5,580 | $4,982 |
| Level 5 Airway EndoscopyAPC 5155 | 45 | 45 | $17,688 | $5,857 | $5,183 |
| Level 1 Intraocular ProceduresAPC 5491 | 39 | 36 | $6,940 | $1,943 | $1,752 |
| Level 3 Airway EndoscopyAPC 5153 | 38 | 35 | $5,804 | $1,372 | $1,264 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 37 | 37 | $15,306 | $7,468 | $6,514 |
| Complex GI ProceduresAPC 5331 | 35 | 29 | $19,677 | $4,877 | $4,263 |
| Level 6 Gynecologic ProceduresAPC 5416 | 34 | 34 | $17,163 | $6,102 | $5,836 |
| Level 3 Intraocular ProceduresAPC 5493 | 33 | 29 | $12,977 | $4,472 | $4,004 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 23 | 23 | $79,092 | $31,614 | $26,719 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 21 | 21 | $95,346 | $29,488 | $26,955 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 18 | 18 | $45,114 | $19,238 | $17,052 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 16 | 16 | $7,059 | $2,000 | $1,780 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 15 | 13 | $41,656 | $20,330 | $18,465 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $7,765 | $2,755 | $2,217 |
| Level 8 Urology and Related ServicesAPC 5378 | 12 | 12 | $52,443 | $19,976 | $17,428 |
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.