Beth Israel Deaconess Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Beth Israel Deaconess Medical Center, Boston, MA in 2024, from traditional Medicare claims. Back to the Beth Israel Deaconess Medical Center profile, with quality ratings, finances and negotiated rates.
9,345
Medicare inpatient discharges
In 242 published DRGs
2.46
Case mix index
IPPS FY 2027
35%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
9,471
Medicare outpatient services
In 50 service groups
Inpatient stays by major diagnostic category
Circulatory system2,572 discharges in 51 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 396 | $40,476 | $14,255 | $20,400 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 245 | $126,615 | $55,495 | $63,814 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 127 | $44,355 | $18,320 | $22,355 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 101 | $79,342 | $29,181 | $39,988 | 2.16 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 99 | $108,876 | $38,698 | $54,874 | 3.24 |
| Other vascular procedures with CCMS-DRG 253, surgical | 75 | $79,100 | $29,191 | $39,866 | 2.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 67 | $24,258 | $11,053 | $12,226 | 1.07 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 64 | $50,543 | $23,322 | $25,474 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 63 | $83,196 | $35,182 | $41,931 | 2.87 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 63 | $51,699 | $18,884 | $26,056 | 1.82 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 60 | $80,717 | $42,672 | $40,681 | 4.04 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 60 | $27,471 | $9,846 | $13,845 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 60 | $28,762 | $11,646 | $14,496 | 1.08 |
| Syncope and collapseMS-DRG 312, medical | 60 | $20,660 | $9,415 | $10,413 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 56 | $182,078 | $86,491 | $91,767 | 6.25 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 51 | $53,441 | $25,143 | $26,934 | 2.28 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 51 | $99,095 | $42,381 | $49,944 | 3.35 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 47 | $108,817 | $54,012 | $54,844 | 5.88 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 47 | $109,824 | $49,304 | $55,351 | 3.46 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 46 | $142,973 | $99,937 | $72,058 | 9.71 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 45 | $28,789 | $10,188 | $14,510 | 0.97 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 44 | $140,399 | $64,065 | $70,761 | 5.06 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 43 | $183,337 | $96,476 | $92,402 | 7.71 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 43 | $76,373 | $38,949 | $38,492 | 3.46 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 41 | $22,722 | $7,638 | $11,452 | 0.74 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 39 | $77,555 | $44,795 | $39,088 | 4.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 37 | $54,708 | $19,507 | $27,573 | 1.58 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 34 | $32,183 | $12,710 | $16,220 | 1.20 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 26 | $91,573 | $47,385 | $46,153 | 5.24 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 26 | $141,016 | $53,720 | $71,072 | 3.90 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 25 | $101,735 | $48,089 | $51,275 | 4.14 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 23 | $130,948 | $78,701 | $65,998 | 7.80 |
| Heart failure and shock with CCMS-DRG 292, medical | 22 | $22,981 | $9,222 | $11,583 | 0.86 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 20 | $78,428 | $32,288 | $39,528 | 2.81 |
| Cardiac congenital and valvular disorders without MCCMS-DRG 307, medical | 20 | $27,013 | $10,297 | $13,615 | 0.94 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 19 | $136,170 | $75,125 | $68,629 | 5.04 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 19 | $106,426 | $54,307 | $53,639 | 5.20 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 19 | $84,000 | $55,230 | $42,336 | 4.78 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 18 | $22,291 | $7,685 | $11,235 | 0.72 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 18 | $39,160 | $16,697 | $19,737 | 1.54 |
| Atherosclerosis without MCCMS-DRG 303, medical | 16 | $15,739 | $6,568 | $7,933 | 0.66 |
| Hypertension without MCCMS-DRG 305, medical | 16 | $14,882 | $7,900 | $7,500 | 0.75 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 16 | $13,643 | $5,176 | $6,876 | 0.55 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 15 | $49,062 | $19,167 | $24,727 | 1.74 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 217, surgical | 14 | $116,437 | $67,003 | $58,684 | 6.37 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 14 | $178,820 | $86,543 | $90,125 | 6.21 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 14 | $69,625 | $34,538 | $35,091 | 2.97 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $44,569 | $19,801 | $22,463 | 1.83 |
| Percutaneous cardiovascular procedures without intraluminal device with MCCMS-DRG 250, surgical | 13 | $65,220 | $26,616 | $32,871 | 2.35 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 11 | $108,585 | $54,324 | $54,727 | 4.81 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 11 | $148,674 | $86,645 | $74,931 | 6.85 |
Nervous system1,001 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 125 | $68,415 | $26,054 | $34,481 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 87 | $101,993 | $55,206 | $51,405 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 87 | $31,722 | $10,768 | $15,988 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 69 | $29,134 | $13,508 | $14,684 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 49 | $36,602 | $10,851 | $18,447 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 46 | $53,755 | $26,628 | $27,093 | 2.39 |
| Seizures without MCCMS-DRG 101, medical | 44 | $37,825 | $9,541 | $19,064 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 43 | $119,559 | $67,474 | $60,258 | 5.67 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 39 | $76,112 | $40,131 | $38,361 | 3.79 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 37 | $45,776 | $25,936 | $23,071 | 2.28 |
| Seizures with MCCMS-DRG 100, medical | 36 | $100,201 | $37,111 | $50,501 | 1.98 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 35 | $50,758 | $16,779 | $25,582 | 1.47 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 32 | $47,261 | $27,087 | $23,819 | 2.43 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 32 | $56,825 | $20,976 | $28,640 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 28 | $32,046 | $8,778 | $16,151 | 0.69 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 26 | $39,904 | $11,871 | $20,111 | 1.03 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 24 | $22,527 | $11,556 | $11,354 | 1.14 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 24 | $32,798 | $15,057 | $16,530 | 1.36 |
| Extracranial procedures with CCMS-DRG 038, surgical | 21 | $35,309 | $17,580 | $17,796 | 1.60 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 21 | $24,702 | $13,745 | $12,450 | 1.32 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 19 | $52,056 | $19,454 | $26,236 | 1.79 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 18 | $22,211 | $8,093 | $11,194 | 0.80 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 18 | $74,977 | $31,705 | $37,788 | 2.27 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 15 | $45,337 | $17,518 | $22,850 | 1.51 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 14 | $36,555 | $32,857 | $18,424 | 2.95 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 12 | $35,512 | $11,567 | $17,898 | 1.06 |
Digestive system941 discharges in 24 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 | 113 | $21,894 | $8,034 | $11,034 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 101 | $25,469 | $10,396 | $12,836 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 89 | $45,408 | $25,109 | $22,886 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 80 | $35,602 | $14,393 | $17,944 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 65 | $58,501 | $22,995 | $29,484 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 59 | $25,585 | $10,151 | $12,895 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 54 | $95,672 | $54,416 | $48,218 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 50 | $41,314 | $18,840 | $20,822 | 1.62 |
| Digestive malignancy with MCCMS-DRG 374, medical | 43 | $73,005 | $26,054 | $36,795 | 2.10 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 39 | $19,133 | $7,878 | $9,643 | 0.80 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 27 | $51,964 | $27,309 | $26,190 | 2.50 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 27 | $30,757 | $10,316 | $15,502 | 0.97 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 26 | $29,412 | $17,177 | $14,824 | 1.67 |
| Digestive malignancy with CCMS-DRG 375, medical | 20 | $30,801 | $12,782 | $15,523 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $14,694 | $4,999 | $7,406 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 17 | $141,263 | $64,869 | $71,196 | 5.08 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 17 | $28,872 | $16,064 | $14,552 | 1.60 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 17 | $129,391 | $60,524 | $65,213 | 4.28 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 17 | $44,101 | $16,967 | $22,227 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 14 | $29,172 | $11,062 | $14,703 | 1.04 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 13 | $51,555 | $19,511 | $25,984 | 1.72 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $38,120 | $22,050 | $19,212 | 2.11 |
| Inflammatory bowel disease with MCCMS-DRG 385, medical | 11 | $52,565 | $16,859 | $26,493 | 1.57 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 11 | $22,689 | $5,700 | $11,435 | 0.65 |
Respiratory system895 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 175 | $40,275 | $18,217 | $20,299 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 63 | $38,624 | $14,512 | $19,466 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 62 | $32,849 | $13,974 | $16,556 | 1.33 |
| Major chest procedures with CCMS-DRG 164, surgical | 59 | $45,028 | $27,004 | $22,694 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 50 | $96,891 | $50,548 | $48,833 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 44 | $58,245 | $20,526 | $29,355 | 1.74 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 42 | $27,621 | $10,290 | $13,921 | 0.99 |
| Major chest trauma with CCMS-DRG 184, medical | 42 | $23,303 | $10,378 | $11,745 | 1.05 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 35 | $102,577 | $38,913 | $51,699 | 2.70 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 32 | $91,669 | $44,874 | $46,201 | 4.06 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 31 | $28,626 | $11,255 | $14,428 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 30 | $43,320 | $14,607 | $21,833 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 27 | $26,365 | $8,644 | $13,288 | 0.82 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 26 | $66,755 | $24,626 | $33,645 | 1.90 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 22 | $27,748 | $8,479 | $13,985 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 21 | $39,991 | $19,344 | $20,155 | 1.88 |
| Major chest trauma with MCCMS-DRG 183, medical | 21 | $24,329 | $15,857 | $12,262 | 1.57 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 20 | $20,901 | $9,956 | $10,534 | 0.96 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 19 | $18,671 | $9,168 | $9,410 | 0.85 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 15 | $48,077 | $23,376 | $24,231 | 1.81 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 12 | $31,475 | $19,265 | $15,863 | 1.82 |
| Pneumothorax with MCCMS-DRG 199, medical | 12 | $49,707 | $21,655 | $25,052 | 1.77 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $16,510 | $11,560 | $8,321 | 1.08 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $29,204 | $9,441 | $14,719 | 0.91 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 11 | $216,884 | $90,853 | $109,310 | 6.91 |
Infectious and parasitic diseases847 discharges in 11 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 | 481 | $60,344 | $23,582 | $30,413 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 122 | $163,644 | $73,314 | $82,477 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 75 | $30,276 | $10,763 | $15,259 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 36 | $50,876 | $22,855 | $25,642 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 35 | $234,239 | $102,818 | $118,056 | 6.96 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 21 | $16,950 | $10,189 | $8,543 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 18 | $52,369 | $22,270 | $26,394 | 2.14 |
| Viral illness with MCCMS-DRG 865, medical | 18 | $29,742 | $17,710 | $14,990 | 1.64 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $154,085 | $59,900 | $77,659 | 4.43 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 13 | $36,844 | $21,557 | $18,569 | 2.04 |
| Viral illness without MCCMS-DRG 866, medical | 12 | $20,226 | $9,739 | $10,194 | 0.92 |
Musculoskeletal system and connective tissue800 discharges in 30 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 | 92 | $46,062 | $22,028 | $23,215 | 2.07 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 81 | $39,399 | $19,886 | $19,857 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 53 | $24,642 | $9,550 | $12,420 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 51 | $75,446 | $36,132 | $38,025 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 45 | $42,191 | $26,180 | $21,264 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 35 | $68,466 | $19,243 | $34,507 | 1.82 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 33 | $48,770 | $21,706 | $24,580 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 32 | $30,242 | $10,941 | $15,242 | 1.09 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 31 | $53,475 | $40,631 | $26,951 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 28 | $45,420 | $32,637 | $22,891 | 2.96 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 28 | $77,128 | $34,667 | $38,873 | 2.49 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 21 | $58,634 | $29,260 | $29,552 | 3.00 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 21 | $62,250 | $38,077 | $31,374 | 3.49 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 21 | $57,423 | $24,510 | $28,941 | 2.04 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 20 | $71,926 | $33,965 | $36,251 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 20 | $19,963 | $8,857 | $10,061 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 18 | $58,065 | $35,323 | $29,265 | 3.46 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 16 | $105,350 | $53,856 | $53,096 | 5.66 |
| Medical back problems with MCCMS-DRG 551, medical | 16 | $29,330 | $17,070 | $14,782 | 1.70 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 14 | $131,103 | $48,172 | $66,076 | 4.92 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 14 | $43,945 | $23,404 | $22,148 | 1.97 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 13 | $55,816 | $20,447 | $28,131 | 1.74 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 13 | $20,229 | $14,852 | $10,195 | 1.49 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 13 | $17,812 | $7,753 | $8,977 | 0.79 |
| Connective tissue disorders with CCMS-DRG 546, medical | 13 | $46,056 | $14,261 | $23,212 | 1.20 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 12 | $56,330 | $26,793 | $28,390 | 2.38 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 12 | $41,182 | $27,569 | $20,756 | 2.48 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 12 | $19,437 | $8,701 | $9,796 | 0.82 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 11 | $107,263 | $53,690 | $54,061 | 5.19 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 11 | $38,305 | $27,109 | $19,306 | 2.46 |
Kidney and urinary tract602 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 120 | $24,432 | $9,320 | $12,314 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 106 | $39,063 | $17,534 | $19,688 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 75 | $27,168 | $11,678 | $13,693 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 66 | $42,759 | $17,895 | $21,551 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 64 | $23,103 | $8,203 | $11,644 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 59 | $32,289 | $13,464 | $16,274 | 1.17 |
| Kidney transplantMS-DRG 652, surgical | 16 | $191,007 | $33,645 | $96,267 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 16 | $40,430 | $13,980 | $20,377 | 1.35 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 15 | $40,537 | $20,074 | $20,431 | 1.84 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $98,861 | $49,829 | $49,826 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $70,668 | $27,983 | $35,617 | 2.59 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 14 | $44,476 | $24,460 | $22,416 | 2.38 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 11 | $29,713 | $16,072 | $14,976 | 1.48 |
| Kidney and urinary tract neoplasms with MCCMS-DRG 686, medical | 11 | $58,713 | $24,115 | $29,591 | 1.84 |
Liver, gallbladder and pancreas427 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 58 | $50,940 | $21,120 | $25,674 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 48 | $54,155 | $22,226 | $27,294 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 46 | $63,341 | $32,055 | $31,924 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 44 | $30,346 | $11,650 | $15,294 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 33 | $28,378 | $9,497 | $14,303 | 0.95 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 31 | $104,406 | $32,144 | $52,621 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 29 | $54,455 | $20,549 | $27,445 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 28 | $47,569 | $18,148 | $23,975 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 28 | $31,409 | $9,056 | $15,830 | 0.86 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 22 | $121,824 | $71,450 | $61,399 | 5.51 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 20 | $35,695 | $11,679 | $17,990 | 1.10 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 15 | $30,767 | $10,746 | $15,507 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 14 | $41,304 | $18,941 | $20,817 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $34,734 | $13,891 | $17,506 | 1.31 |
Endocrine, nutritional and metabolic274 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 | 76 | $35,590 | $14,071 | $17,937 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 53 | $20,120 | $7,812 | $10,140 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 39 | $42,841 | $15,734 | $21,592 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 36 | $21,623 | $8,755 | $10,898 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 35 | $24,938 | $10,834 | $12,569 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 24 | $42,514 | $14,780 | $21,427 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 11 | $44,213 | $18,548 | $22,283 | 1.98 |
Blood cancers and poorly differentiated neoplasms175 discharges in 6 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 | 51 | $32,293 | $14,718 | $16,276 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 47 | $124,300 | $49,882 | $62,647 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 29 | $52,489 | $17,431 | $26,455 | 1.57 |
| Acute leukemia with MCCMS-DRG 834, medical | 19 | $210,468 | $96,307 | $106,076 | 5.60 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 15 | $213,852 | $89,980 | $107,781 | 4.50 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 14 | $45,812 | $26,250 | $23,089 | 2.44 |
Injuries, poisonings and toxic effects of drugs147 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 53 | $46,622 | $20,568 | $23,497 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 34 | $27,236 | $11,352 | $13,727 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 22 | $65,664 | $20,815 | $33,095 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 20 | $46,096 | $24,232 | $23,232 | 2.00 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 18 | $88,936 | $43,945 | $44,824 | 3.72 |
Blood and immune system141 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 50 | $48,181 | $21,008 | $24,283 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 33 | $26,933 | $9,710 | $13,574 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 30 | $57,476 | $20,879 | $28,968 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 15 | $38,958 | $12,694 | $19,635 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 13 | $66,098 | $31,483 | $33,313 | 2.19 |
Skin, subcutaneous tissue and breast118 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 52 | $18,596 | $8,796 | $9,372 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 21 | $28,833 | $15,271 | $14,532 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 18 | $24,511 | $9,655 | $12,353 | 0.89 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 15 | $36,437 | $16,231 | $18,364 | 1.75 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 12 | $24,418 | $9,400 | $12,306 | 0.91 |
Other101 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 | 49 | $156,530 | $66,862 | $78,891 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 20 | $115,751 | $47,273 | $58,338 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 19 | $79,045 | $32,245 | $39,839 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 13 | $47,936 | $16,159 | $24,160 | 1.70 |
Mental diseases and disorders93 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 52 | $36,120 | $15,632 | $18,204 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 25 | $28,628 | $17,020 | $14,429 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 16 | $26,681 | $10,465 | $13,447 | 0.95 |
Transplants, ECMO and tracheostomy (pre-MDC)76 discharges in 3 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 | 44 | $681,738 | $328,480 | $343,596 | 21.32 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 21 | $397,615 | $138,563 | $200,398 | 10.35 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $337,587 | $163,975 | $170,144 | 14.70 |
Female reproductive system42 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy, female reproductive system with CCMS-DRG 755, medical | 17 | $37,983 | $11,698 | $19,144 | 1.08 |
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 13 | $63,130 | $20,435 | $31,817 | 1.85 |
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 12 | $47,029 | $21,564 | $23,702 | 1.97 |
Ear, nose, mouth and throat28 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Ear, nose, mouth and throat malignancy with MCCMS-DRG 146, medical | 16 | $100,933 | $42,900 | $50,870 | 2.11 |
| Major head and neck procedures with CCMS-DRG 141, surgical | 12 | $43,793 | $21,083 | $22,072 | 2.07 |
Factors influencing health status23 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 | 23 | $20,186 | $8,487 | $10,174 | 0.80 |
Multiple significant trauma17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with CCMS-DRG 964, medical | 17 | $23,015 | $14,603 | $11,600 | 1.50 |
Eye14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of the eye without MCCMS-DRG 125, medical | 14 | $18,677 | $8,066 | $9,413 | 0.80 |
Alcohol and drug use11 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 | 11 | $21,709 | $8,879 | $10,941 | 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 Urology and Related ServicesAPC 5372 | 1,289 | 670 | $3,149 | $580 | $502 |
| Level 2 Upper GI ProceduresAPC 5302 | 945 | 766 | $7,318 | $1,622 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 930 | 838 | $13,061 | $2,309 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 642 | 592 | $7,718 | $1,379 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 519 | 426 | $7,101 | $1,735 | $1,516 |
| Level 1 Endovascular ProceduresAPC 5191 | 422 | 420 | $12,192 | $2,508 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 401 | 395 | $134,011 | $23,537 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 381 | 323 | $12,076 | $2,685 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 244 | 220 | $39,885 | $10,083 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 218 | 210 | $17,146 | $4,892 | $4,358 |
| Level 5 Airway EndoscopyAPC 5155 | 201 | 189 | $21,662 | $5,856 | $5,183 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 199 | 173 | $16,362 | $2,382 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 196 | 179 | $16,189 | $4,394 | $3,918 |
| Level 3 Airway EndoscopyAPC 5153 | 163 | 135 | $7,971 | $1,451 | $1,264 |
| Level 1 Intraocular ProceduresAPC 5491 | 160 | 129 | $7,284 | $1,993 | $1,752 |
| Level 4 Vascular ProceduresAPC 5184 | 156 | 134 | $33,871 | $4,239 | $3,946 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 155 | 109 | $16,941 | $2,883 | $2,636 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 146 | 145 | $30,450 | $9,822 | $8,569 |
| Level 2 Endovascular ProceduresAPC 5192 | 140 | 116 | $21,830 | $4,852 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 138 | 126 | $8,989 | $2,374 | $2,176 |
| Level 4 Airway EndoscopyAPC 5154 | 133 | 122 | $15,405 | $3,192 | $2,833 |
| Complex GI ProceduresAPC 5331 | 127 | 89 | $20,248 | $4,838 | $4,263 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 127 | 127 | $27,893 | $9,411 | $8,164 |
| Level 4 Urology and Related ServicesAPC 5374 | 120 | 114 | $11,796 | $2,957 | $2,629 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 115 | 113 | $21,301 | $6,015 | $5,339 |
| Level 2 Vascular ProceduresAPC 5182 | 111 | 109 | $5,096 | $1,359 | $1,204 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 111 | 111 | $37,594 | $7,483 | $6,514 |
| Level 4 Gynecologic ProceduresAPC 5414 | 103 | 102 | $9,084 | $2,674 | $2,389 |
| Level 3 Upper GI ProceduresAPC 5303 | 98 | 95 | $13,257 | $3,277 | $2,888 |
| Level 4 Endovascular ProceduresAPC 5194 | 83 | 77 | $55,111 | $16,845 | $14,606 |
| Level 1 Nerve ProceduresAPC 5431 | 81 | 74 | $9,104 | $1,632 | $1,407 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 71 | 69 | $19,156 | $5,580 | $4,982 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 67 | 63 | $15,690 | $3,262 | $2,930 |
| Level 5 ENT ProceduresAPC 5165 | 67 | 66 | $17,951 | $5,011 | $4,436 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 63 | 62 | $10,010 | $2,770 | $2,373 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 51 | 51 | $27,580 | $12,478 | $10,772 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 37 | 37 | $57,933 | $32,682 | $29,375 |
| Level 2 Intraocular ProceduresAPC 5492 | 33 | 29 | $17,602 | $3,479 | $3,116 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 28 | 27 | $8,536 | $1,375 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 25 | 24 | $34,821 | $18,334 | $15,763 |
| Level 5 Gynecologic ProceduresAPC 5415 | 24 | 23 | $16,973 | $4,079 | $3,792 |
| Level 4 ENT ProceduresAPC 5164 | 23 | 22 | $9,729 | $2,755 | $2,217 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 20 | 19 | $59,988 | $21,799 | $18,465 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 19 | 19 | $46,463 | $19,242 | $17,052 |
| Level 7 Radiation TherapyAPC 5627 | 19 | 17 | $22,113 | $6,730 | $6,121 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 17 | 16 | $6,957 | $1,995 | $1,780 |
| Level 6 Urology and Related ServicesAPC 5376 | 16 | 16 | $22,303 | $8,254 | $7,291 |
| Level 3 ENT ProceduresAPC 5163 | 13 | 11 | $12,391 | $1,305 | $1,106 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 12 | 12 | $18,596 | $7,776 | $7,546 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 12 | 12 | $42,704 | $23,612 | $21,011 |
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.