Carle Health Proctor Hospital Medicare inpatient and outpatient services

Every DRG and outpatient service group CMS publishes for Carle Health Proctor Hospital, Peoria, IL in 2024, from traditional Medicare claims. Back to the Carle Health Proctor Hospital profile, with quality ratings, finances and negotiated rates.

538
Medicare inpatient discharges
In 19 published DRGs
1.68
Case mix index
IPPS FY 2027
41%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
2,159
Medicare outpatient services
In 17 service groups

Inpatient stays by major diagnostic category

Musculoskeletal system and connective tissue222 discharges in 8 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	69	$82,871	$12,401	$20,303	2.07
Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical	30	$95,430	$11,856	$23,380	1.88
Hip and femur procedures except major joint with MCCMS-DRG 480, surgical	30	$118,047	$17,242	$28,921	2.95
Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical	24	$83,720	$12,980	$20,511	2.11
Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical	19	$136,855	$15,934	$33,529	2.48
Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical	18	$95,185	$15,343	$23,320	2.40
Revision of hip or knee replacement with CCMS-DRG 467, surgical	17	$134,331	$20,920	$32,911	3.49
Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical	15	$102,722	$17,383	$25,167	2.99

Infectious and parasitic diseases125 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	101	$54,117	$11,520	$13,259	1.98
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	24	$37,210	$5,519	$9,116	1.03

Respiratory system63 discharges in 3 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Respiratory infections and inflammations with MCCMS-DRG 177, medical	24	$55,036	$9,880	$13,484	1.70
Pulmonary edema and respiratory failureMS-DRG 189, medical	20	$66,347	$9,055	$16,255	1.23
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	19	$62,399	$7,715	$15,288	1.33

Circulatory system60 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	60	$44,493	$7,668	$10,901	1.28

Kidney and urinary tract33 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Renal failure with CCMS-DRG 683, medical	18	$29,996	$4,716	$7,349	0.90
Renal failure with MCCMS-DRG 682, medical	15	$54,663	$8,877	$13,392	1.50

Alcohol and drug use13 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	13	$24,845	$2,576	$6,087	0.86

Endocrine, nutritional and metabolic11 discharges in 1 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	11	$50,748	$7,731	$12,433	1.32

Blood and immune system11 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Red blood cell disorders without MCCMS-DRG 812, medical	11	$37,035	$4,869	$9,074	0.90

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 5 Musculoskeletal ProceduresAPC 5115	662	621	$66,182	$10,391	$10,772
Level 1 Intraocular ProceduresAPC 5491	566	328	$21,354	$1,707	$1,752
Level 1 Nerve ProceduresAPC 5431	173	150	$18,775	$1,395	$1,407
Level 3 Musculoskeletal ProceduresAPC 5113	127	125	$32,061	$2,344	$2,373
Level 4 Musculoskeletal ProceduresAPC 5114	126	126	$51,594	$5,184	$5,339
Level 2 Intraocular ProceduresAPC 5492	105	97	$33,908	$2,964	$3,116
Level 6 Musculoskeletal ProceduresAPC 5116	104	100	$98,343	$15,553	$15,763
Comprehensive Observation ServicesAPC 8011	63	61	$22,826	$2,015	$2,090
Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503	42	41	$25,034	$1,680	$1,780
Level 2 Musculoskeletal ProceduresAPC 5112	36	34	$20,229	$1,139	$1,196
Level 3 Intraocular ProceduresAPC 5493	36	29	$33,541	$3,738	$4,004
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	28	28	$17,843	$1,151	$1,220
Level 5 Gynecologic ProceduresAPC 5415	24	23	$43,150	$3,205	$3,792
Level 3 Vascular ProceduresAPC 5183	22	22	$17,884	$2,347	$2,405
Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073	16	15	$28,993	$1,961	$2,141
Level 3 Urology and Related ServicesAPC 5373	16	13	$15,988	$1,393	$1,516
Level 5 Urology and Related ServicesAPC 5375	13	13	$36,051	$3,810	$3,918

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.