Boston Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Boston Medical Center, Boston, MA in 2024, from traditional Medicare claims. Back to the Boston Medical Center profile, with quality ratings, finances and negotiated rates.
1,982
Medicare inpatient discharges
In 78 published DRGs
2.16
Case mix index
IPPS FY 2027
18%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
3,473
Medicare outpatient services
In 45 service groups
Inpatient stays by major diagnostic category
Circulatory system405 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 152 | $38,089 | $19,671 | $16,721 | 1.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 40 | $83,863 | $32,616 | $36,816 | 2.16 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 31 | $47,956 | $23,687 | $21,053 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 27 | $71,972 | $46,288 | $31,596 | 3.35 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 26 | $50,417 | $30,052 | $22,133 | 2.09 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $57,244 | $30,528 | $25,130 | 2.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 22 | $31,971 | $12,824 | $14,035 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 20 | $38,543 | $14,060 | $16,920 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 19 | $59,672 | $24,088 | $26,196 | 1.82 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 13 | $45,445 | $16,758 | $19,950 | 1.07 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 11 | $106,193 | $65,861 | $46,619 | 4.81 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $29,518 | $14,137 | $12,958 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 11 | $37,992 | $19,047 | $16,678 | 1.20 |
Nervous system277 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 56 | $88,710 | $31,479 | $38,944 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 34 | $44,833 | $15,215 | $19,682 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 31 | $71,503 | $21,018 | $31,390 | 1.36 |
| Seizures without MCCMS-DRG 101, medical | 31 | $34,921 | $13,846 | $15,330 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 28 | $180,338 | $78,387 | $79,168 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 27 | $54,927 | $28,914 | $24,113 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 18 | $271,797 | $94,987 | $119,319 | 4.42 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 16 | $141,056 | $47,023 | $61,923 | 2.28 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 12 | $107,704 | $31,380 | $47,282 | 2.39 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 12 | $52,339 | $22,705 | $22,977 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 12 | $27,292 | $15,721 | $11,981 | 1.03 |
Infectious and parasitic diseases259 discharges in 4 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 | 160 | $71,542 | $30,290 | $31,407 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 46 | $180,648 | $76,096 | $79,305 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 28 | $27,285 | $16,657 | $11,978 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 25 | $293,738 | $116,850 | $128,951 | 6.96 |
Respiratory system219 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 48 | $47,665 | $25,178 | $20,925 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $30,800 | $17,643 | $13,521 | 1.10 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 32 | $36,715 | $20,683 | $16,118 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 21 | $38,957 | $19,308 | $17,102 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 20 | $32,523 | $15,070 | $14,277 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 20 | $21,078 | $14,142 | $9,253 | 0.85 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 15 | $65,680 | $21,528 | $28,833 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 13 | $91,187 | $30,186 | $40,031 | 1.74 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 13 | $23,402 | $13,927 | $10,273 | 0.82 |
Kidney and urinary tract179 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 39 | $55,788 | $25,090 | $24,491 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 31 | $22,364 | $14,427 | $9,818 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 30 | $49,872 | $22,731 | $21,894 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 19 | $39,163 | $17,148 | $17,193 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 19 | $19,725 | $13,371 | $8,659 | 0.81 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $131,488 | $52,085 | $57,723 | 3.70 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 15 | $30,236 | $17,210 | $13,273 | 1.02 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 11 | $100,422 | $35,048 | $44,085 | 2.38 |
Musculoskeletal system and connective tissue178 discharges in 11 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 | 29 | $68,648 | $29,397 | $30,136 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 23 | $37,620 | $15,272 | $16,515 | 0.97 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 17 | $74,681 | $31,761 | $32,785 | 2.40 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 16 | $51,677 | $24,402 | $22,686 | 1.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 16 | $33,724 | $16,871 | $14,805 | 1.09 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $71,352 | $40,850 | $31,323 | 2.96 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 13 | $189,502 | $56,210 | $83,191 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 13 | $134,141 | $49,116 | $58,888 | 3.46 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 13 | $78,354 | $28,079 | $34,397 | 2.11 |
| Medical back problems with MCCMS-DRG 551, medical | 12 | $48,827 | $22,137 | $21,435 | 1.70 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 11 | $78,668 | $24,824 | $34,535 | 1.82 |
Digestive system109 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 35 | $27,912 | $15,744 | $12,253 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 29 | $23,765 | $13,694 | $10,433 | 0.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 16 | $28,784 | $19,917 | $12,636 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 15 | $22,996 | $13,533 | $10,095 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 14 | $73,753 | $29,331 | $32,378 | 1.79 |
Mental diseases and disorders91 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 66 | $78,853 | $23,375 | $34,617 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 14 | $64,003 | $23,850 | $28,097 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 11 | $34,144 | $15,398 | $14,989 | 0.95 |
Endocrine, nutritional and metabolic90 discharges in 4 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 | 39 | $30,881 | $20,365 | $13,557 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 21 | $23,434 | $13,079 | $10,288 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 16 | $69,903 | $22,663 | $30,688 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 14 | $31,000 | $14,808 | $13,609 | 0.90 |
Alcohol and drug use44 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 | 28 | $35,419 | $14,453 | $15,549 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 16 | $41,044 | $24,433 | $18,018 | 1.78 |
Blood and immune system33 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 22 | $49,440 | $17,794 | $21,704 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 11 | $31,551 | $21,470 | $13,851 | 1.40 |
Other32 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 21 | $168,350 | $72,765 | $73,906 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $82,321 | $36,240 | $36,139 | 2.49 |
Skin, subcutaneous tissue and breast22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 22 | $20,736 | $13,487 | $9,103 | 0.88 |
Injuries, poisonings and toxic effects of drugs22 discharges in 1 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 | 22 | $86,978 | $32,241 | $38,183 | 1.60 |
Transplants, ECMO and tracheostomy (pre-MDC)11 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 | 11 | $748,951 | $328,752 | $328,789 | 21.32 |
Ear, nose, mouth and throat11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Dental and oral diseases with CCMS-DRG 158, medical | 11 | $32,014 | $14,843 | $14,054 | 0.94 |
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 | 928 | 696 | $14,523 | $2,329 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 384 | 235 | $2,367 | $573 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 201 | 190 | $7,281 | $1,365 | $1,220 |
| Level 1 Intraocular ProceduresAPC 5491 | 183 | 147 | $8,519 | $1,983 | $1,752 |
| Level 4 ENT ProceduresAPC 5164 | 151 | 73 | $4,088 | $1,402 | $2,217 |
| Level 3 Urology and Related ServicesAPC 5373 | 125 | 115 | $6,322 | $1,712 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 107 | 105 | $13,842 | $2,386 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 80 | 75 | $11,566 | $2,693 | $2,405 |
| Level 5 ENT ProceduresAPC 5165 | 64 | 61 | $19,590 | $4,972 | $4,436 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 59 | 49 | $9,197 | $2,300 | $2,373 |
| Level 1 Endovascular ProceduresAPC 5191 | 57 | 56 | $13,426 | $2,513 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 57 | 55 | $73,111 | $23,804 | $21,117 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 56 | 53 | $20,864 | $4,848 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 56 | 52 | $17,836 | $4,349 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 54 | 51 | $42,997 | $12,247 | $10,772 |
| Level 3 Endovascular ProceduresAPC 5193 | 54 | 50 | $41,700 | $10,163 | $8,874 |
| Level 4 Urology and Related ServicesAPC 5374 | 54 | 49 | $10,566 | $2,982 | $2,629 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 52 | 51 | $23,287 | $6,004 | $5,339 |
| Level 2 Intraocular ProceduresAPC 5492 | 50 | 48 | $13,327 | $3,479 | $3,116 |
| Level 2 Upper GI ProceduresAPC 5302 | 49 | 43 | $6,896 | $1,632 | $1,445 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 45 | 43 | $7,600 | $1,375 | $1,196 |
| Level 4 Airway EndoscopyAPC 5154 | 43 | 41 | $15,218 | $3,204 | $2,833 |
| Level 2 Endovascular ProceduresAPC 5192 | 43 | 36 | $19,371 | $4,887 | $4,338 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 37 | $11,118 | $3,260 | $2,930 |
| Level 3 Airway EndoscopyAPC 5153 | 41 | 26 | $4,579 | $1,452 | $1,264 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 35 | 35 | $35,578 | $9,411 | $8,164 |
| Level 3 ENT ProceduresAPC 5163 | 34 | 26 | $4,449 | $1,189 | $1,106 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 31 | 26 | $9,403 | $2,960 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 30 | 24 | $5,052 | $1,652 | $1,407 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 28 | 28 | $29,153 | $7,472 | $6,514 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 27 | 27 | $24,853 | $9,822 | $8,569 |
| Level 2 Vascular ProceduresAPC 5182 | 26 | 23 | $5,776 | $1,369 | $1,204 |
| Level 4 Gynecologic ProceduresAPC 5414 | 26 | 26 | $9,254 | $2,675 | $2,389 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 26 | 24 | $11,072 | $1,923 | $1,780 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 21 | 21 | $27,495 | $5,580 | $4,982 |
| Level 4 Vascular ProceduresAPC 5184 | 21 | 19 | $22,325 | $4,254 | $3,946 |
| Level 8 Urology and Related ServicesAPC 5378 | 20 | 18 | $37,150 | $19,972 | $17,428 |
| Level 3 Lower GI ProceduresAPC 5313 | 19 | 19 | $5,802 | $2,408 | $2,176 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 17 | 17 | $89,718 | $33,589 | $29,375 |
| Level 4 Endovascular ProceduresAPC 5194 | 16 | 15 | $57,617 | $17,156 | $14,606 |
| Level 3 Intraocular ProceduresAPC 5493 | 15 | 14 | $15,725 | $4,472 | $4,004 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 12 | 12 | $54,575 | $16,806 | $15,763 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 12 | 11 | $66,478 | $21,799 | $18,465 |
| Level 5 Airway EndoscopyAPC 5155 | 11 | 11 | $24,969 | $5,857 | $5,183 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 11 | $54,847 | $19,242 | $17,052 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.