Cambridge Health Alliance Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Cambridge Health Alliance, Cambridge, MA in 2024, from traditional Medicare claims. Back to the Cambridge Health Alliance profile, with quality ratings, finances and negotiated rates.
605
Medicare inpatient discharges
In 20 published DRGs
1.49
Case mix index
IPPS FY 2027
7%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
596
Medicare outpatient services
In 18 service groups
Inpatient stays by major diagnostic category
Respiratory system164 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 53 | $23,171 | $18,610 | $17,888 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 51 | $18,202 | $16,656 | $14,052 | 1.10 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 40 | $28,791 | $21,242 | $22,227 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 20 | $24,063 | $18,641 | $18,576 | 1.23 |
Infectious and parasitic diseases121 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 | 109 | $31,295 | $24,755 | $24,160 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 12 | $18,884 | $15,968 | $14,578 | 1.03 |
Circulatory system120 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 85 | $26,435 | $19,694 | $20,408 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 24 | $36,427 | $25,468 | $28,122 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 11 | $16,056 | $13,651 | $12,395 | 0.86 |
Kidney and urinary tract64 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 19 | $32,335 | $24,404 | $24,963 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 16 | $15,111 | $14,267 | $11,666 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 16 | $15,549 | $13,729 | $12,004 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 13 | $23,284 | $22,506 | $17,975 | 1.65 |
Musculoskeletal system and connective tissue41 discharges in 2 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 | 21 | $20,965 | $25,200 | $16,185 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 20 | $30,802 | $26,435 | $23,779 | 2.07 |
Endocrine, nutritional and metabolic39 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 28 | $15,438 | $13,617 | $11,918 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 11 | $19,207 | $18,330 | $14,828 | 1.32 |
Alcohol and drug use23 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 | 23 | $13,461 | $14,033 | $10,392 | 0.86 |
Digestive system22 discharges in 1 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 | 22 | $19,821 | $13,472 | $15,302 | 0.79 |
Skin, subcutaneous tissue and breast11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 11 | $16,202 | $14,585 | $12,508 | 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 1 Intraocular ProceduresAPC 5491 | 113 | 84 | $4,987 | $1,974 | $1,752 |
| Level 2 Urology and Related ServicesAPC 5372 | 84 | 78 | $2,405 | $582 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 56 | 51 | $3,049 | $1,387 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 39 | 38 | $4,931 | $1,695 | $1,516 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 35 | 34 | $4,423 | $1,375 | $1,196 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 34 | 31 | $15,824 | $12,108 | $10,772 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 33 | 32 | $6,123 | $2,770 | $2,373 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 28 | 28 | $10,867 | $6,122 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 27 | 27 | $10,242 | $4,937 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 25 | 25 | $6,130 | $1,604 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 25 | 24 | $11,753 | $2,342 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 17 | 16 | $8,034 | $2,429 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 17 | 17 | $8,251 | $4,428 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 15 | 12 | $8,344 | $2,983 | $2,629 |
| Level 4 Gynecologic ProceduresAPC 5414 | 14 | 12 | $6,076 | $2,675 | $2,389 |
| Level 2 Endovascular ProceduresAPC 5192 | 12 | $15,086 | $4,891 | $4,338 | |
| Level 3 Vascular ProceduresAPC 5183 | 11 | 11 | $13,107 | $2,727 | $2,405 |
| Level 1 Nerve ProceduresAPC 5431 | 11 | $4,531 | $1,652 | $1,407 |
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.