Caldwell Memorial Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Caldwell Memorial Hospital, Lenoir, NC in 2024, from traditional Medicare claims. Back to the Caldwell Memorial Hospital profile, with quality ratings, finances and negotiated rates.
379
Medicare inpatient discharges
In 19 published DRGs
1.57
Case mix index
IPPS FY 2027
11%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
1,144
Medicare outpatient services
In 22 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases93 discharges in 2 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 | 80 | $33,104 | $11,185 | $11,950 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 13 | $22,512 | $6,286 | $8,127 | 1.03 |
Respiratory system62 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 32 | $28,678 | $8,193 | $10,353 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 15 | $26,528 | $9,853 | $9,576 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 15 | $28,921 | $8,102 | $10,441 | 1.23 |
Kidney and urinary tract53 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 15 | $23,362 | $5,085 | $8,434 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 14 | $30,452 | $7,472 | $10,993 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 12 | $28,741 | $9,684 | $10,376 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 12 | $16,280 | $4,987 | $5,877 | 0.90 |
Endocrine, nutritional and metabolic48 discharges in 3 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 | 22 | $25,671 | $8,310 | $9,267 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 15 | $21,031 | $5,213 | $7,592 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 11 | $13,352 | $6,306 | $4,820 | 0.90 |
Musculoskeletal system and connective tissue42 discharges in 3 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 | 16 | $47,970 | $11,668 | $17,317 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 15 | $49,433 | $13,308 | $17,845 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 11 | $56,026 | $13,348 | $20,225 | 2.07 |
Circulatory system38 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 26 | $27,931 | $8,063 | $10,083 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 12 | $29,513 | $8,926 | $10,654 | 1.59 |
Mental diseases and disorders29 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 29 | $46,922 | $7,929 | $16,939 | 1.37 |
Skin, subcutaneous tissue and breast14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 14 | $22,193 | $5,530 | $8,012 | 0.88 |
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 Endovascular ProceduresAPC 5192 | 219 | 149 | $15,271 | $3,890 | $4,338 |
| Level 3 Vascular ProceduresAPC 5183 | 119 | 102 | $16,010 | $2,210 | $2,405 |
| Level 2 Urology and Related ServicesAPC 5372 | 107 | 59 | $1,225 | $473 | $502 |
| Level 3 Endovascular ProceduresAPC 5193 | 69 | 57 | $40,330 | $7,819 | $8,874 |
| Level 1 Endovascular ProceduresAPC 5191 | 68 | 68 | $16,460 | $1,919 | $2,208 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 60 | 59 | $31,397 | $4,878 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 59 | 52 | $16,809 | $1,993 | $2,373 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 56 | 54 | $6,268 | $1,059 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 54 | 51 | $44,602 | $9,625 | $10,772 |
| Comprehensive Observation ServicesAPC 8011 | 52 | 51 | $16,468 | $1,898 | $2,090 |
| Level 4 Vascular ProceduresAPC 5184 | 43 | 33 | $24,460 | $3,810 | $3,946 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 35 | 34 | $7,024 | $1,114 | $1,196 |
| Level 1 Nerve ProceduresAPC 5431 | 30 | 23 | $11,283 | $1,339 | $1,407 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 29 | 22 | $19,236 | $3,725 | $4,358 |
| Level 3 Urology and Related ServicesAPC 5373 | 29 | 26 | $5,504 | $1,412 | $1,516 |
| Level 4 Endovascular ProceduresAPC 5194 | 28 | 20 | $59,904 | $13,598 | $14,606 |
| Level 5 Urology and Related ServicesAPC 5375 | 23 | 16 | $21,443 | $3,588 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 16 | 14 | $12,471 | $2,417 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 13 | 13 | $13,293 | $1,319 | $1,445 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 12 | 12 | $53,522 | $14,552 | $15,763 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $28,946 | $4,745 | $5,183 |
| Level 4 Airway EndoscopyAPC 5154 | 11 | $20,225 | $2,596 | $2,833 |
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.