Charleston Area Medical Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Charleston Area Medical Hospital, Charleston, WV in 2024, from traditional Medicare claims. Back to the Charleston Area Medical Hospital profile, with quality ratings, finances and negotiated rates.
6,561
Medicare inpatient discharges
In 154 published DRGs
2.07
Case mix index
IPPS FY 2027
27%
Surgical stays
68%
Stays with complications
In DRGs with a CC or MCC
5,578
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,809 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 281 | $59,281 | $8,726 | $15,294 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 129 | $79,566 | $11,141 | $20,528 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 101 | $120,865 | $11,478 | $31,183 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 85 | $34,374 | $4,108 | $8,868 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 85 | $168,179 | $20,388 | $43,390 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 80 | $52,396 | $6,251 | $13,518 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 74 | $301,754 | $50,228 | $77,853 | 6.25 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 73 | $185,348 | $22,784 | $47,820 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 69 | $41,686 | $5,249 | $10,755 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 67 | $46,749 | $5,574 | $12,061 | 0.91 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 63 | $55,278 | $7,506 | $14,262 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 54 | $261,929 | $34,978 | $67,578 | 4.88 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 51 | $28,837 | $3,192 | $7,440 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 50 | $94,836 | $15,448 | $24,468 | 2.16 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 49 | $223,840 | $24,608 | $57,751 | 4.04 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 40 | $272,192 | $44,757 | $70,225 | 5.06 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 39 | $196,817 | $30,599 | $50,779 | 3.90 |
| Chest painMS-DRG 313, medical | 38 | $42,549 | $4,450 | $10,978 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 32 | $309,583 | $38,226 | $79,872 | 5.20 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 32 | $38,084 | $4,287 | $9,826 | 0.72 |
| Hypertension without MCCMS-DRG 305, medical | 30 | $41,189 | $4,268 | $10,627 | 0.75 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 29 | $44,064 | $6,812 | $11,369 | 1.07 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 27 | $89,589 | $15,244 | $23,114 | 2.09 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 26 | $352,085 | $54,009 | $90,838 | 7.80 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 25 | $151,052 | $24,890 | $38,971 | 3.18 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 25 | $299,474 | $41,615 | $77,264 | 5.88 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 25 | $88,311 | $15,544 | $22,784 | 2.28 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 22 | $185,032 | $20,062 | $47,738 | 2.97 |
| Atherosclerosis without MCCMS-DRG 303, medical | 19 | $32,189 | $4,452 | $8,305 | 0.66 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $149,497 | $23,381 | $38,570 | 3.46 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 17 | $142,512 | $21,472 | $36,768 | 3.35 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 15 | $312,757 | $42,719 | $80,691 | 5.24 |
| Other vascular procedures with CCMS-DRG 253, surgical | 14 | $106,225 | $15,109 | $27,406 | 2.55 |
| Hypertension with MCCMS-DRG 304, medical | 14 | $55,368 | $7,171 | $14,285 | 1.15 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 12 | $355,416 | $48,769 | $91,697 | 7.71 |
Infectious and parasitic diseases1,221 discharges in 7 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 | 785 | $79,694 | $13,015 | $20,561 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 183 | $49,875 | $6,405 | $12,868 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 147 | $209,795 | $35,375 | $54,127 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 45 | $111,090 | $14,318 | $28,661 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 35 | $226,650 | $44,588 | $58,476 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 15 | $147,122 | $29,811 | $37,957 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 11 | $154,291 | $20,109 | $39,807 | 2.14 |
Respiratory system725 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 | 119 | $53,265 | $8,485 | $13,742 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 112 | $55,381 | $7,162 | $14,288 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 91 | $58,744 | $7,548 | $15,156 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 82 | $66,441 | $10,927 | $17,142 | 1.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 57 | $37,935 | $5,060 | $9,787 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 42 | $79,610 | $10,168 | $20,539 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 27 | $103,221 | $16,207 | $26,631 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 26 | $108,767 | $16,842 | $28,062 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 25 | $40,250 | $6,259 | $10,385 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 23 | $36,004 | $4,793 | $9,289 | 0.85 |
| Major chest procedures with MCCMS-DRG 163, surgical | 22 | $221,887 | $36,474 | $57,247 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 20 | $97,356 | $11,102 | $25,118 | 1.88 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 16 | $164,567 | $27,022 | $42,458 | 4.06 |
| Pleural effusion with MCCMS-DRG 186, medical | 14 | $97,357 | $13,186 | $25,118 | 1.55 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $44,388 | $4,957 | $11,452 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $40,226 | $4,620 | $10,378 | 0.96 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 12 | $67,227 | $11,808 | $17,345 | 1.74 |
| Major chest trauma with CCMS-DRG 184, medical | 11 | $56,366 | $5,972 | $14,543 | 1.05 |
Kidney and urinary tract639 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 124 | $41,772 | $5,504 | $10,777 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 113 | $39,719 | $5,110 | $10,247 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 96 | $79,125 | $10,648 | $20,414 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 77 | $55,140 | $9,642 | $14,226 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 73 | $51,681 | $7,075 | $13,334 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 35 | $68,388 | $7,426 | $17,644 | 1.02 |
| Kidney transplantMS-DRG 652, surgical | 30 | $359,237 | $22,704 | $92,683 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 23 | $61,598 | $8,793 | $15,892 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 22 | $117,538 | $18,302 | $30,325 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 18 | $129,473 | $27,099 | $33,404 | 3.70 |
| Renal failure without cc/mccMS-DRG 684, medical | 17 | $34,096 | $3,653 | $8,797 | 0.61 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 11 | $44,076 | $4,210 | $11,372 | 0.69 |
Nervous system601 discharges in 22 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 | 94 | $48,880 | $6,294 | $12,611 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 86 | $86,572 | $12,797 | $22,335 | 2.00 |
| Seizures without MCCMS-DRG 101, medical | 40 | $37,576 | $5,745 | $9,695 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 36 | $44,579 | $3,796 | $11,501 | 0.69 |
| Seizures with MCCMS-DRG 100, medical | 32 | $67,316 | $12,287 | $17,367 | 1.98 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 29 | $86,694 | $7,557 | $22,367 | 1.14 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 28 | $90,337 | $13,709 | $23,307 | 1.81 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $44,452 | $5,842 | $11,469 | 1.03 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 26 | $47,260 | $4,667 | $12,193 | 0.80 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 24 | $184,622 | $28,269 | $47,632 | 4.42 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 20 | $54,267 | $8,317 | $14,001 | 1.36 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 19 | $56,578 | $8,834 | $14,597 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 18 | $202,475 | $34,373 | $52,239 | 5.67 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 17 | $43,205 | $8,045 | $11,147 | 1.32 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 16 | $88,539 | $12,047 | $22,843 | 1.79 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 15 | $120,269 | $16,156 | $31,029 | 2.30 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 14 | $46,209 | $6,411 | $11,922 | 1.03 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 14 | $30,559 | $5,204 | $7,884 | 0.89 |
| Extracranial procedures with CCMS-DRG 038, surgical | 12 | $80,389 | $10,291 | $20,740 | 1.60 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 12 | $32,598 | $6,900 | $8,410 | 1.06 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 11 | $55,196 | $9,313 | $14,241 | 1.47 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 11 | $39,386 | $5,667 | $10,162 | 0.92 |
Digestive system535 discharges in 15 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 | 115 | $40,145 | $4,700 | $10,357 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 76 | $47,686 | $5,861 | $12,303 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 52 | $84,992 | $11,959 | $21,928 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 41 | $39,287 | $4,796 | $10,136 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 39 | $60,636 | $8,290 | $15,644 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 38 | $108,416 | $14,316 | $27,971 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 34 | $179,190 | $30,782 | $46,231 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 22 | $72,322 | $10,694 | $18,659 | 1.67 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 21 | $25,712 | $3,148 | $6,634 | 0.56 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 20 | $101,775 | $15,760 | $26,258 | 2.50 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 19 | $45,071 | $6,069 | $11,628 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 18 | $58,492 | $11,259 | $15,091 | 1.62 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 16 | $74,596 | $9,685 | $19,246 | 1.60 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 13 | $103,528 | $13,578 | $26,710 | 2.11 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 11 | $71,642 | $10,254 | $18,484 | 1.75 |
Musculoskeletal system and connective tissue308 discharges in 12 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 | 88 | $100,151 | $13,495 | $25,839 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 47 | $39,045 | $5,746 | $10,074 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 46 | $96,543 | $13,628 | $24,908 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 20 | $100,206 | $14,899 | $25,853 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 16 | $120,510 | $18,815 | $31,092 | 2.95 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $143,055 | $18,311 | $36,908 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $134,357 | $19,906 | $34,664 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $31,148 | $4,715 | $8,036 | 0.79 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $76,246 | $10,191 | $19,671 | 1.59 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 12 | $50,483 | $4,728 | $13,025 | 0.88 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 12 | $46,729 | $5,524 | $12,056 | 0.90 |
| Shoulder, elbow or forearm procedures, except major joint procedures with CCMS-DRG 511, surgical | 11 | $96,374 | $12,651 | $24,864 | 1.99 |
Endocrine, nutritional and metabolic212 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 without MCCMS-DRG 641, medical | 62 | $37,154 | $4,899 | $9,586 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 55 | $61,983 | $8,065 | $15,992 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 33 | $40,106 | $5,593 | $10,347 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 20 | $59,127 | $9,137 | $15,255 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $43,403 | $4,621 | $11,198 | 1.06 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 14 | $103,384 | $13,165 | $26,673 | 1.98 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $62,488 | $10,243 | $16,122 | 1.65 |
Liver, gallbladder and pancreas111 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 21 | $40,572 | $5,681 | $10,468 | 0.86 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $64,968 | $6,628 | $16,762 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 17 | $95,503 | $10,017 | $24,640 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 15 | $89,885 | $12,133 | $23,190 | 1.83 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 14 | $49,199 | $5,631 | $12,693 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 13 | $77,711 | $8,176 | $20,049 | 1.31 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 12 | $64,087 | $6,883 | $16,535 | 1.03 |
Other88 discharges in 4 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 | 46 | $221,875 | $34,984 | $57,244 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 17 | $158,110 | $21,390 | $40,792 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $162,460 | $24,060 | $41,915 | 3.38 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 11 | $58,474 | $11,440 | $15,086 | 1.70 |
Skin, subcutaneous tissue and breast84 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 57 | $33,563 | $5,549 | $8,659 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $61,579 | $11,078 | $15,887 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 13 | $34,146 | $5,351 | $8,810 | 0.91 |
Blood and immune system63 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 33 | $62,849 | $8,966 | $16,215 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 30 | $48,568 | $5,343 | $12,531 | 0.90 |
Injuries, poisonings and toxic effects of drugs59 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 18 | $49,546 | $4,873 | $12,783 | 0.86 |
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $95,131 | $13,755 | $24,544 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $35,874 | $7,036 | $9,256 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 11 | $49,650 | $9,816 | $12,810 | 1.60 |
Factors influencing health status40 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 40 | $45,225 | $4,886 | $11,668 | 0.80 |
Mental diseases and disorders30 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 18 | $52,362 | $11,332 | $13,509 | 1.76 |
| PsychosesMS-DRG 885, medical | 12 | $95,252 | $8,572 | $24,575 | 1.37 |
Transplants, ECMO and tracheostomy (pre-MDC)25 discharges in 2 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 | 13 | $602,977 | $105,467 | $155,568 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 12 | $333,593 | $92,517 | $86,067 | 14.70 |
Alcohol and drug use11 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 | 11 | $37,605 | $5,106 | $9,702 | 0.86 |
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 | 700 | 664 | $21,340 | $1,783 | $2,090 |
| Level 3 Urology and Related ServicesAPC 5373 | 476 | 415 | $10,700 | $1,285 | $1,516 |
| Level 1 Endovascular ProceduresAPC 5191 | 453 | 451 | $20,536 | $1,929 | $2,208 |
| Level 2 Urology and Related ServicesAPC 5372 | 442 | 323 | $3,156 | $425 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 430 | 397 | $8,390 | $1,064 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 223 | 184 | $30,467 | $3,424 | $3,918 |
| Level 1 Intraocular ProceduresAPC 5491 | 217 | 166 | $14,519 | $1,524 | $1,752 |
| Level 4 Urology and Related ServicesAPC 5374 | 208 | 169 | $17,354 | $2,302 | $2,629 |
| Level 3 Endovascular ProceduresAPC 5193 | 203 | 193 | $86,826 | $7,485 | $8,874 |
| Level 3 Vascular ProceduresAPC 5183 | 191 | 179 | $19,834 | $2,118 | $2,405 |
| Level 2 Upper GI ProceduresAPC 5302 | 169 | 146 | $14,524 | $1,234 | $1,445 |
| Level 2 Endovascular ProceduresAPC 5192 | 128 | 117 | $34,974 | $3,795 | $4,338 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 118 | 112 | $37,722 | $3,836 | $4,358 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 108 | 107 | $54,932 | $6,844 | $8,164 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 107 | 101 | $17,533 | $1,868 | $2,141 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 89 | 80 | $25,049 | $2,106 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 89 | 87 | $13,910 | $1,120 | $1,264 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 81 | 79 | $83,304 | $8,868 | $10,772 |
| Level 4 Endovascular ProceduresAPC 5194 | 74 | 72 | $110,389 | $12,838 | $14,606 |
| Level 2 Vascular ProceduresAPC 5182 | 72 | 67 | $5,837 | $1,063 | $1,204 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 72 | 68 | $28,359 | $2,267 | $2,636 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 71 | 71 | $35,499 | $7,411 | $8,569 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 66 | 66 | $54,628 | $4,752 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 61 | 58 | $35,214 | $2,526 | $2,833 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 61 | 61 | $111,275 | $17,842 | $21,117 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 52 | 49 | $44,168 | $4,320 | $4,982 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 52 | 52 | $147,391 | $25,152 | $29,375 |
| Level 4 Gynecologic ProceduresAPC 5414 | 51 | 51 | $14,711 | $2,108 | $2,389 |
| Level 1 Nerve ProceduresAPC 5431 | 50 | 44 | $10,036 | $1,253 | $1,407 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 45 | 43 | $10,787 | $1,027 | $1,196 |
| Level 4 Vascular ProceduresAPC 5184 | 44 | 43 | $35,780 | $3,541 | $3,946 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 39 | $24,557 | $2,387 | $2,930 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 41 | 41 | $180,554 | $24,013 | $26,719 |
| Level 4 ENT ProceduresAPC 5164 | 38 | 38 | $30,358 | $2,105 | $2,217 |
| Level 5 ENT ProceduresAPC 5165 | 34 | 28 | $33,203 | $3,710 | $4,436 |
| Level 3 Lower GI ProceduresAPC 5313 | 32 | 32 | $25,183 | $1,835 | $2,176 |
| Level 3 Upper GI ProceduresAPC 5303 | 26 | 26 | $24,653 | $2,583 | $2,888 |
| Level 6 Urology and Related ServicesAPC 5376 | 24 | 24 | $46,256 | $6,211 | $7,291 |
| Complex GI ProceduresAPC 5331 | 21 | 20 | $40,349 | $3,846 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 20 | 20 | $29,526 | $3,340 | $3,792 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 17 | 17 | $88,931 | $14,851 | $17,052 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 16 | 16 | $41,807 | $5,361 | $6,514 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 14 | 14 | $116,501 | $13,119 | $15,763 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 14 | 14 | $131,909 | $16,869 | $18,465 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $55,846 | $4,623 | $5,183 |
| Level 8 Urology and Related ServicesAPC 5378 | 12 | 12 | $84,641 | $14,223 | $17,428 |
| Level 2 Intraocular ProceduresAPC 5492 | 12 | 11 | $15,973 | $2,529 | $3,116 |
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.