Cape Cod Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Cape Cod Hospital, Hyannis, MA in 2024, from traditional Medicare claims. Back to the Cape Cod Hospital profile, with quality ratings, finances and negotiated rates.
7,999
Medicare inpatient discharges
In 170 published DRGs
1.76
Case mix index
IPPS FY 2027
19%
Surgical stays
72%
Stays with complications
In DRGs with a CC or MCC
5,765
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,811 discharges in 36 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 469 | $23,594 | $12,146 | $9,721 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 124 | $36,719 | $14,931 | $15,128 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 90 | $112,941 | $48,782 | $46,532 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 86 | $48,015 | $31,152 | $19,782 | 3.24 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 86 | $91,729 | $17,100 | $37,792 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 84 | $20,027 | $6,354 | $8,251 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 78 | $23,630 | $7,525 | $9,735 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 65 | $28,349 | $10,771 | $11,680 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 54 | $30,876 | $8,207 | $12,721 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 50 | $16,429 | $4,195 | $6,769 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 40 | $114,889 | $26,878 | $47,334 | 2.87 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 39 | $29,615 | $5,874 | $12,201 | 0.72 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 38 | $140,897 | $61,390 | $58,049 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 35 | $56,441 | $21,327 | $23,254 | 2.16 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 34 | $165,933 | $53,337 | $68,364 | 5.06 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 33 | $40,300 | $9,869 | $16,604 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 33 | $35,582 | $20,200 | $14,660 | 2.09 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 31 | $100,322 | $33,553 | $41,333 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 29 | $79,719 | $22,044 | $32,844 | 2.28 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 28 | $66,818 | $17,292 | $27,529 | 1.83 |
| Hypertension without MCCMS-DRG 305, medical | 27 | $20,779 | $6,401 | $8,561 | 0.75 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 26 | $26,800 | $15,332 | $11,041 | 1.58 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 25 | $163,239 | $80,054 | $67,255 | 7.80 |
| Chest painMS-DRG 313, medical | 23 | $30,163 | $6,106 | $12,427 | 0.72 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 21 | $35,636 | $19,602 | $14,682 | 1.97 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 19 | $22,556 | $9,748 | $9,293 | 1.07 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 18 | $113,596 | $36,254 | $46,802 | 3.46 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 18 | $135,064 | $30,134 | $55,646 | 2.97 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 16 | $81,838 | $33,664 | $33,717 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 16 | $90,790 | $25,186 | $37,406 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 14 | $143,768 | $77,799 | $59,233 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 14 | $67,596 | $41,333 | $27,850 | 4.16 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 14 | $224,495 | $71,580 | $92,492 | 7.04 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $18,060 | $9,266 | $7,441 | 0.97 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $18,329 | $7,663 | $7,552 | 0.86 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $41,043 | $9,678 | $16,910 | 1.15 |
Infectious and parasitic diseases1,510 discharges in 8 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 | 1,060 | $33,090 | $18,834 | $13,633 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 221 | $20,066 | $9,180 | $8,267 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 126 | $67,692 | $49,218 | $27,889 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 45 | $34,122 | $19,037 | $14,058 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 19 | $29,250 | $18,421 | $12,051 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 14 | $59,139 | $44,430 | $24,365 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 14 | $24,413 | $8,669 | $10,058 | 1.01 |
| Other infectious and parasitic diseases diagnoses with CCMS-DRG 868, medical | 11 | $19,777 | $9,667 | $8,148 | 1.09 |
Respiratory system991 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 207 | $23,858 | $12,607 | $9,829 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 196 | $26,627 | $15,482 | $10,970 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 174 | $24,380 | $11,393 | $10,044 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 67 | $20,669 | $10,307 | $8,515 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 52 | $28,921 | $13,323 | $11,916 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 50 | $20,402 | $7,096 | $8,406 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 36 | $20,393 | $8,818 | $8,402 | 0.99 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 30 | $19,239 | $7,050 | $7,927 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 24 | $21,649 | $9,057 | $8,919 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 22 | $29,591 | $16,758 | $12,191 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 22 | $54,167 | $26,744 | $22,317 | 2.70 |
| Major chest trauma with MCCMS-DRG 183, medical | 21 | $31,226 | $15,011 | $12,865 | 1.57 |
| Major chest procedures with MCCMS-DRG 163, surgical | 19 | $60,695 | $44,635 | $25,006 | 4.71 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $20,918 | $7,661 | $8,618 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 17 | $19,076 | $7,979 | $7,859 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 14 | $38,973 | $16,544 | $16,057 | 1.88 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $33,332 | $15,220 | $13,733 | 1.81 |
| Major chest procedures with CCMS-DRG 164, surgical | 11 | $58,786 | $22,778 | $24,220 | 2.55 |
Digestive system858 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 174 | $24,218 | $8,768 | $9,978 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 152 | $18,661 | $6,742 | $7,688 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 101 | $37,324 | $17,595 | $15,377 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 61 | $24,891 | $11,837 | $10,255 | 1.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 51 | $12,941 | $4,204 | $5,332 | 0.56 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 49 | $15,160 | $6,730 | $6,246 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 45 | $19,319 | $8,334 | $7,960 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 43 | $57,747 | $23,093 | $23,792 | 2.37 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 31 | $21,033 | $9,588 | $8,666 | 1.04 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 29 | $73,704 | $45,694 | $30,366 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 24 | $34,779 | $16,258 | $14,329 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 23 | $27,645 | $17,052 | $11,390 | 1.75 |
| Digestive malignancy with MCCMS-DRG 374, medical | 16 | $38,810 | $16,452 | $15,990 | 2.10 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 14 | $123,839 | $43,001 | $51,022 | 4.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 12 | $40,130 | $15,714 | $16,533 | 1.67 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $110,177 | $46,684 | $45,393 | 5.08 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 11 | $18,755 | $5,201 | $7,727 | 0.63 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 11 | $18,966 | $8,908 | $7,814 | 0.97 |
Nervous system641 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 110 | $27,785 | $8,966 | $11,447 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 109 | $36,582 | $19,320 | $15,072 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 47 | $25,089 | $6,839 | $10,336 | 0.80 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 35 | $34,693 | $17,537 | $14,294 | 1.81 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 34 | $24,957 | $9,375 | $10,282 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 32 | $33,741 | $19,535 | $13,901 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 29 | $23,935 | $5,551 | $9,861 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 27 | $27,263 | $12,608 | $11,232 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 24 | $65,255 | $44,672 | $26,885 | 4.42 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 24 | $26,983 | $17,562 | $11,117 | 1.79 |
| Seizures without MCCMS-DRG 101, medical | 22 | $16,624 | $8,160 | $6,849 | 0.91 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 21 | $31,229 | $21,813 | $12,866 | 2.27 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 18 | $35,448 | $10,363 | $14,604 | 1.14 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 18 | $24,658 | $9,120 | $10,159 | 1.06 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 17 | $37,251 | $22,881 | $15,348 | 2.30 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 17 | $27,811 | $24,301 | $11,458 | 2.39 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 17 | $32,382 | $17,424 | $13,341 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $24,486 | $11,847 | $10,088 | 1.47 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 13 | $26,599 | $8,494 | $10,959 | 1.03 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 11 | $26,737 | $12,658 | $11,016 | 1.32 |
Musculoskeletal system and connective tissue630 discharges in 25 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 | 82 | $40,600 | $19,972 | $16,727 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 77 | $50,281 | $28,940 | $20,716 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 51 | $22,557 | $8,478 | $9,294 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 47 | $44,942 | $20,413 | $18,516 | 2.11 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 35 | $54,167 | $28,356 | $22,317 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 31 | $25,833 | $15,980 | $10,643 | 1.70 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 29 | $40,148 | $17,802 | $16,541 | 1.88 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 27 | $21,500 | $7,655 | $8,858 | 0.90 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 24 | $56,013 | $45,725 | $23,077 | 4.61 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 22 | $65,900 | $61,159 | $27,151 | 6.12 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 20 | $24,470 | $14,932 | $10,081 | 1.56 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 18 | $23,784 | $9,242 | $9,799 | 1.09 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 16 | $21,454 | $12,610 | $8,839 | 1.30 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 15 | $26,657 | $14,327 | $10,983 | 1.52 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $55,501 | $35,974 | $22,866 | 3.66 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 14 | $27,672 | $14,399 | $11,401 | 1.56 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 13 | $37,076 | $20,133 | $15,275 | 2.46 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $20,626 | $7,017 | $8,498 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $21,910 | $9,168 | $9,027 | 1.00 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 12 | $42,707 | $31,419 | $17,595 | 3.16 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 12 | $41,076 | $18,785 | $16,923 | 1.97 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 12 | $16,680 | $6,861 | $6,872 | 0.79 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 11 | $47,135 | $28,995 | $19,419 | 2.96 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 11 | $28,212 | $14,812 | $11,623 | 1.59 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $16,334 | $7,557 | $6,730 | 0.88 |
Kidney and urinary tract598 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 153 | $20,775 | $10,770 | $8,559 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 105 | $27,099 | $14,337 | $11,165 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 100 | $18,585 | $7,051 | $7,657 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 98 | $18,196 | $7,746 | $7,497 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 84 | $25,988 | $16,171 | $10,707 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 22 | $23,717 | $9,629 | $9,771 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 20 | $28,609 | $12,719 | $11,787 | 1.35 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $58,649 | $37,573 | $24,163 | 3.70 |
Endocrine, nutritional and metabolic299 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 | 108 | $24,420 | $12,386 | $10,061 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 79 | $15,796 | $6,619 | $6,508 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 32 | $25,323 | $13,909 | $10,433 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 25 | $26,291 | $15,864 | $10,832 | 1.65 |
| Diabetes with CCMS-DRG 638, medical | 22 | $21,511 | $8,099 | $8,862 | 0.90 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 17 | $25,743 | $18,333 | $10,606 | 1.86 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $18,494 | $9,656 | $7,620 | 1.06 |
Liver, gallbladder and pancreas164 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 25 | $32,135 | $9,826 | $13,240 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 20 | $41,581 | $15,490 | $17,131 | 1.63 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 18 | $28,215 | $14,125 | $11,625 | 1.67 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 14 | $34,357 | $15,853 | $14,155 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 13 | $15,883 | $7,741 | $6,544 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $28,515 | $17,728 | $11,748 | 1.83 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $39,190 | $16,263 | $16,146 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 12 | $57,273 | $22,974 | $23,596 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 12 | $36,529 | $12,451 | $15,050 | 1.31 |
| Disorders of pancreas except malignancy without cc/mccMS-DRG 440, medical | 12 | $15,050 | $4,606 | $6,200 | 0.62 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 12 | $19,700 | $8,866 | $8,116 | 0.95 |
Skin, subcutaneous tissue and breast120 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 85 | $17,292 | $7,669 | $7,124 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 35 | $26,843 | $14,073 | $11,059 | 1.49 |
Blood and immune system99 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 34 | $27,906 | $14,422 | $11,497 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 29 | $27,698 | $8,021 | $11,411 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 25 | $26,252 | $13,226 | $10,816 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $27,675 | $11,041 | $11,402 | 1.20 |
Injuries, poisonings and toxic effects of drugs83 discharges in 4 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 | 46 | $29,005 | $15,293 | $11,950 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 13 | $32,535 | $18,274 | $13,404 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $22,249 | $10,099 | $9,166 | 1.03 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 11 | $23,005 | $7,595 | $9,478 | 0.86 |
Alcohol and drug use55 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 with MCCMS-DRG 896, medical | 29 | $28,069 | $17,180 | $11,564 | 1.78 |
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 26 | $19,966 | $7,824 | $8,226 | 0.86 |
Factors influencing health status45 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 30 | $13,431 | $5,351 | $5,533 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 15 | $23,157 | $7,138 | $9,541 | 0.80 |
Mental diseases and disorders39 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 27 | $25,115 | $13,371 | $10,347 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 12 | $35,551 | $16,662 | $14,647 | 1.76 |
Other35 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 | 20 | $80,231 | $47,815 | $33,055 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $65,235 | $25,174 | $26,877 | 2.49 |
Ear, nose, mouth and throat21 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 21 | $24,324 | $6,244 | $10,022 | 0.74 |
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 | 1,097 | 1,021 | $19,933 | $2,308 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 480 | 463 | $29,009 | $12,426 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 446 | 404 | $7,132 | $1,367 | $1,220 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 424 | 415 | $16,983 | $6,121 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 329 | 328 | $19,353 | $2,492 | $2,208 |
| Level 1 Nerve ProceduresAPC 5431 | 273 | 252 | $13,659 | $1,651 | $1,407 |
| Level 5 Urology and Related ServicesAPC 5375 | 266 | 250 | $15,492 | $4,393 | $3,918 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 243 | 236 | $18,763 | $4,896 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 230 | 208 | $11,433 | $2,983 | $2,629 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 196 | 183 | $12,332 | $2,945 | $2,636 |
| Level 3 Urology and Related ServicesAPC 5373 | 159 | 99 | $9,958 | $1,719 | $1,516 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 138 | 134 | $10,000 | $2,770 | $2,373 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 131 | 127 | $16,330 | $2,393 | $2,141 |
| Level 3 Endovascular ProceduresAPC 5193 | 131 | 112 | $73,359 | $10,008 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 117 | 116 | $102,258 | $23,804 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 107 | 107 | $17,179 | $2,727 | $2,405 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 90 | 85 | $16,700 | $3,262 | $2,930 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 81 | 81 | $31,993 | $18,334 | $15,763 |
| Level 4 Airway EndoscopyAPC 5154 | 68 | 66 | $13,202 | $3,204 | $2,833 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 66 | 66 | $38,795 | $9,268 | $8,164 |
| Level 4 Endovascular ProceduresAPC 5194 | 63 | 56 | $115,890 | $17,152 | $14,606 |
| Level 2 Upper GI ProceduresAPC 5302 | 62 | 54 | $7,910 | $1,616 | $1,445 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 59 | 56 | $30,039 | $5,484 | $4,982 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 58 | 58 | $46,389 | $9,817 | $8,569 |
| Level 4 Vascular ProceduresAPC 5184 | 55 | 46 | $29,909 | $4,275 | $3,946 |
| Level 8 Urology and Related ServicesAPC 5378 | 39 | 35 | $34,031 | $19,976 | $17,428 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 34 | 33 | $7,932 | $1,375 | $1,196 |
| Level 6 Urology and Related ServicesAPC 5376 | 31 | 29 | $18,222 | $7,988 | $7,291 |
| Level 4 Gynecologic ProceduresAPC 5414 | 26 | 26 | $8,841 | $2,675 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 25 | 25 | $6,223 | $1,369 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 24 | 24 | $151,933 | $33,589 | $29,375 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 23 | 23 | $31,705 | $7,488 | $6,514 |
| Level 3 Airway EndoscopyAPC 5153 | 22 | 21 | $7,013 | $1,447 | $1,264 |
| Level 7 Radiation TherapyAPC 5627 | 22 | 16 | $33,731 | $6,730 | $6,121 |
| Complex GI ProceduresAPC 5331 | 20 | 19 | $22,399 | $4,877 | $4,263 |
| Level 2 Endovascular ProceduresAPC 5192 | 19 | 19 | $39,306 | $4,762 | $4,338 |
| Level 3 Upper GI ProceduresAPC 5303 | 18 | 18 | $23,333 | $3,186 | $2,888 |
| Level 3 Lower GI ProceduresAPC 5313 | 18 | 18 | $8,649 | $2,411 | $2,176 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 15 | 15 | $83,163 | $19,237 | $17,052 |
| Level 5 Gynecologic ProceduresAPC 5415 | 14 | 14 | $20,418 | $4,256 | $3,792 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $17,656 | $5,857 | $5,183 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 12 | 12 | $51,781 | $31,598 | $26,719 |
| Level 5 ENT ProceduresAPC 5165 | 11 | 11 | $19,930 | $5,011 | $4,436 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 11 | $36,395 | $4,788 | $4,524 |
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.