Corewell Health Royal Oak Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Corewell Health Royal Oak, Royal Oak, MI in 2024, from traditional Medicare claims. Back to the Corewell Health Royal Oak profile, with quality ratings, finances and negotiated rates.
8,747
Medicare inpatient discharges
In 217 published DRGs
2.05
Case mix index
IPPS FY 2027
26%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
7,312
Medicare outpatient services
In 53 service groups
Inpatient stays by major diagnostic category
Circulatory system2,217 discharges in 44 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 559 | $41,752 | $9,415 | $9,018 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 109 | $28,296 | $6,036 | $6,112 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 103 | $26,268 | $4,990 | $5,674 | 0.74 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 101 | $218,514 | $36,834 | $47,199 | 4.88 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 85 | $41,719 | $8,864 | $9,011 | 1.20 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 76 | $56,055 | $11,716 | $12,108 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 74 | $85,814 | $16,279 | $18,536 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 72 | $47,014 | $6,897 | $10,155 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 70 | $73,712 | $15,213 | $15,922 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 62 | $97,164 | $11,828 | $20,987 | 1.82 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 57 | $113,630 | $24,756 | $24,544 | 3.24 |
| Chest painMS-DRG 313, medical | 52 | $24,321 | $4,770 | $5,253 | 0.72 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 50 | $153,077 | $19,939 | $33,065 | 2.87 |
| Hypertension without MCCMS-DRG 305, medical | 47 | $34,042 | $4,657 | $7,353 | 0.75 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 45 | $31,583 | $7,999 | $6,822 | 1.07 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 44 | $316,548 | $54,549 | $68,374 | 6.25 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 44 | $45,763 | $12,186 | $9,885 | 1.58 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 42 | $138,513 | $27,382 | $29,919 | 3.35 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 39 | $25,102 | $3,037 | $5,422 | 0.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 38 | $285,164 | $54,851 | $61,595 | 7.71 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 34 | $42,405 | $6,224 | $9,159 | 0.91 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 28 | $154,907 | $28,510 | $33,460 | 4.04 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 26 | $197,455 | $43,314 | $42,650 | 5.88 |
| Hypertension with MCCMS-DRG 304, medical | 24 | $41,311 | $8,515 | $8,923 | 1.15 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 24 | $33,139 | $6,166 | $7,158 | 0.97 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 23 | $217,082 | $40,279 | $46,890 | 5.24 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 22 | $92,499 | $16,747 | $19,980 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 22 | $114,727 | $19,193 | $24,781 | 2.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 21 | $125,152 | $27,403 | $27,033 | 3.46 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $236,768 | $40,336 | $51,142 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 19 | $125,491 | $25,563 | $27,106 | 3.46 |
| Atherosclerosis without MCCMS-DRG 303, medical | 19 | $25,549 | $3,358 | $5,519 | 0.66 |
| Heart failure and shock with CCMS-DRG 292, medical | 17 | $33,311 | $5,983 | $7,195 | 0.86 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 15 | $89,698 | $13,676 | $19,375 | 1.83 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 15 | $156,107 | $30,669 | $33,719 | 4.16 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 15 | $24,558 | $4,508 | $5,304 | 0.71 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 14 | $258,761 | $62,324 | $55,892 | 7.80 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 14 | $217,162 | $35,270 | $46,907 | 3.90 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 14 | $169,349 | $21,423 | $36,579 | 2.97 |
| Other heart assist system implantMS-DRG 215, surgical | 13 | $491,992 | $74,284 | $106,270 | 10.21 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 13 | $112,189 | $16,328 | $24,233 | 1.97 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 12 | $162,113 | $27,091 | $35,016 | 3.18 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 12 | $33,352 | $3,975 | $7,204 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 11 | $485,789 | $88,173 | $104,930 | 9.71 |
Digestive system993 discharges in 22 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 | 194 | $28,592 | $5,149 | $6,176 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 121 | $38,846 | $6,722 | $8,391 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 89 | $96,425 | $16,934 | $20,828 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 74 | $61,957 | $13,430 | $13,383 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 73 | $34,691 | $6,482 | $7,493 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 59 | $45,655 | $9,560 | $9,861 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 52 | $215,095 | $37,582 | $46,461 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 48 | $54,348 | $12,022 | $11,739 | 1.62 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 36 | $28,843 | $5,425 | $6,230 | 0.80 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 32 | $61,493 | $10,851 | $13,283 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $39,328 | $7,237 | $8,495 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 23 | $104,222 | $13,788 | $22,512 | 2.10 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 21 | $240,877 | $43,405 | $52,029 | 5.08 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 21 | $121,275 | $17,487 | $26,195 | 2.50 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 21 | $56,547 | $9,568 | $12,214 | 1.36 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $20,953 | $3,374 | $4,526 | 0.56 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 18 | $75,870 | $10,355 | $16,388 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 16 | $93,720 | $14,167 | $20,243 | 1.75 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 14 | $66,178 | $11,938 | $14,294 | 1.72 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 13 | $200,681 | $36,969 | $43,347 | 4.28 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 13 | $43,560 | $10,038 | $9,409 | 1.45 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $78,819 | $14,232 | $17,025 | 2.11 |
Respiratory system933 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 157 | $60,571 | $12,217 | $13,083 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 147 | $42,151 | $9,187 | $9,105 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 93 | $41,288 | $7,975 | $8,918 | 1.10 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 74 | $29,516 | $6,501 | $6,375 | 0.96 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 55 | $26,531 | $6,621 | $5,731 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 54 | $57,753 | $9,183 | $12,475 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 50 | $25,812 | $5,730 | $5,575 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 41 | $77,804 | $10,531 | $16,806 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 38 | $106,043 | $17,497 | $22,905 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 31 | $32,854 | $6,152 | $7,096 | 0.85 |
| Major chest trauma with CCMS-DRG 184, medical | 29 | $44,958 | $7,494 | $9,711 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 28 | $70,521 | $12,741 | $15,232 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 24 | $130,692 | $22,151 | $28,230 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 21 | $30,513 | $5,557 | $6,591 | 0.82 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 18 | $52,730 | $13,427 | $11,390 | 1.90 |
| Major chest procedures with MCCMS-DRG 163, surgical | 16 | $195,280 | $33,935 | $42,180 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 16 | $77,173 | $12,952 | $16,669 | 1.88 |
| Respiratory signs and symptomsMS-DRG 204, medical | 14 | $34,636 | $5,566 | $7,481 | 0.82 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 14 | $49,774 | $14,802 | $10,751 | 1.81 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 13 | $145,539 | $26,910 | $31,436 | 4.06 |
Musculoskeletal system and connective tissue930 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 89 | $32,613 | $6,348 | $7,044 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 82 | $84,692 | $15,488 | $18,293 | 2.07 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 67 | $111,838 | $25,028 | $24,157 | 3.66 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 57 | $72,463 | $13,281 | $15,652 | 1.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 42 | $97,895 | $17,092 | $21,145 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 34 | $128,672 | $22,393 | $27,793 | 2.95 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 33 | $94,988 | $17,382 | $20,517 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 33 | $85,639 | $15,803 | $18,498 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 33 | $30,196 | $6,124 | $6,522 | 0.90 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 32 | $102,550 | $22,922 | $22,151 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 28 | $83,023 | $22,769 | $17,933 | 2.96 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 27 | $77,602 | $18,184 | $16,762 | 2.67 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 27 | $24,098 | $5,658 | $5,205 | 0.82 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 25 | $204,936 | $40,531 | $44,266 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 22 | $77,320 | $15,526 | $16,701 | 2.04 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 21 | $162,192 | $35,506 | $35,033 | 4.61 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 21 | $68,639 | $13,855 | $14,826 | 1.82 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 20 | $117,574 | $24,073 | $25,396 | 3.33 |
| Medical back problems with MCCMS-DRG 551, medical | 20 | $47,685 | $12,509 | $10,300 | 1.70 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 19 | $78,562 | $14,202 | $16,969 | 1.97 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 19 | $32,361 | $5,291 | $6,990 | 0.79 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 19 | $38,088 | $5,634 | $8,227 | 0.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 18 | $33,992 | $6,784 | $7,342 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 17 | $144,726 | $21,757 | $31,261 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 16 | $35,745 | $11,256 | $7,721 | 1.52 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 15 | $110,157 | $15,910 | $23,794 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 15 | $59,574 | $9,758 | $12,868 | 1.49 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 15 | $35,089 | $6,207 | $7,579 | 1.00 |
| Spinal fusion except cervical with MCCMS-DRG 459, surgical | 14 | $182,874 | $42,629 | $39,501 | 6.63 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 13 | $142,229 | $47,544 | $30,721 | 6.08 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 13 | $81,793 | $18,474 | $17,667 | 2.46 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 13 | $61,928 | $11,657 | $13,376 | 1.59 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $38,372 | $5,580 | $8,288 | 0.88 |
Kidney and urinary tract824 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 139 | $26,598 | $5,577 | $5,745 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 127 | $37,907 | $8,485 | $8,188 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 120 | $29,893 | $6,376 | $6,457 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 107 | $53,895 | $12,548 | $11,641 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 93 | $42,490 | $11,167 | $9,178 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 73 | $31,918 | $6,989 | $6,894 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 27 | $47,928 | $9,206 | $10,352 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 26 | $44,776 | $6,967 | $9,672 | 1.05 |
| Kidney transplantMS-DRG 652, surgical | 24 | $262,761 | $20,431 | $56,756 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 23 | $138,809 | $28,641 | $29,983 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 22 | $69,607 | $20,268 | $15,035 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 18 | $84,637 | $11,558 | $18,282 | 1.84 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 14 | $78,732 | $18,476 | $17,006 | 2.38 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 11 | $71,996 | $8,890 | $15,551 | 1.48 |
Infectious and parasitic diseases748 discharges in 10 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 | 435 | $71,937 | $14,685 | $15,538 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 113 | $35,833 | $6,594 | $7,740 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 84 | $203,136 | $38,603 | $43,877 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 30 | $222,083 | $56,352 | $47,970 | 6.96 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 19 | $32,867 | $6,905 | $7,099 | 1.01 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 17 | $73,645 | $14,100 | $15,907 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 15 | $68,741 | $13,327 | $14,848 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 13 | $58,931 | $12,640 | $12,729 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $167,271 | $25,771 | $36,131 | 4.43 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 11 | $54,456 | $7,745 | $11,763 | 0.88 |
Nervous system717 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 83 | $72,532 | $14,229 | $15,667 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 82 | $46,840 | $6,683 | $10,117 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 56 | $31,570 | $5,210 | $6,819 | 0.80 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 50 | $34,339 | $7,641 | $7,417 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 49 | $178,942 | $31,801 | $38,651 | 4.42 |
| Seizures without MCCMS-DRG 101, medical | 49 | $40,148 | $6,860 | $8,672 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 39 | $30,149 | $8,882 | $6,512 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 35 | $113,638 | $16,617 | $24,546 | 1.98 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 34 | $55,393 | $16,332 | $11,965 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 32 | $34,387 | $6,705 | $7,428 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 27 | $56,228 | $10,165 | $12,145 | 1.47 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 19 | $32,998 | $3,801 | $7,128 | 0.69 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 18 | $171,072 | $42,530 | $36,951 | 5.67 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $61,720 | $12,729 | $13,332 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 16 | $48,226 | $9,212 | $10,417 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 15 | $28,637 | $5,381 | $6,186 | 0.84 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 14 | $31,908 | $8,074 | $6,892 | 1.06 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 13 | $53,867 | $12,333 | $11,635 | 1.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $135,864 | $22,357 | $29,347 | 2.95 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 12 | $112,979 | $19,900 | $24,403 | 2.28 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $140,679 | $17,276 | $30,387 | 2.43 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 11 | $53,396 | $5,068 | $11,533 | 1.14 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 11 | $75,704 | $15,291 | $16,352 | 2.23 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $53,743 | $17,466 | $11,608 | 2.27 |
Endocrine, nutritional and metabolic324 discharges in 6 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 | 125 | $43,912 | $9,579 | $9,485 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 92 | $24,347 | $5,522 | $5,259 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 36 | $25,918 | $6,364 | $5,598 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 34 | $55,433 | $10,283 | $11,973 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 21 | $27,921 | $7,362 | $6,031 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $47,421 | $11,722 | $10,243 | 1.65 |
Liver, gallbladder and pancreas277 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 31 | $70,657 | $16,177 | $15,262 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 31 | $49,857 | $7,593 | $10,769 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 30 | $68,663 | $12,270 | $14,831 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 21 | $38,186 | $5,504 | $8,248 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 21 | $107,348 | $13,554 | $23,187 | 1.83 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 20 | $320,318 | $50,137 | $69,189 | 5.51 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 20 | $78,197 | $12,118 | $16,891 | 1.63 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 20 | $60,202 | $12,858 | $13,004 | 1.67 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 20 | $65,900 | $11,916 | $14,234 | 1.63 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 18 | $137,778 | $20,042 | $29,760 | 2.89 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 17 | $37,808 | $7,220 | $8,166 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 15 | $41,268 | $7,262 | $8,914 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 13 | $52,472 | $8,828 | $11,334 | 1.31 |
Skin, subcutaneous tissue and breast160 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 95 | $23,475 | $6,082 | $5,071 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 33 | $38,833 | $10,801 | $8,388 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 20 | $32,767 | $6,332 | $7,078 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 12 | $118,095 | $14,475 | $25,509 | 1.75 |
Blood and immune system135 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 49 | $33,672 | $6,254 | $7,273 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 32 | $47,478 | $10,074 | $10,255 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 23 | $68,393 | $13,385 | $14,773 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 17 | $37,375 | $8,807 | $8,073 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 14 | $84,290 | $17,291 | $18,207 | 2.19 |
Other125 discharges in 6 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 | 43 | $182,555 | $35,632 | $39,432 | 4.74 |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 19 | $97,282 | $23,825 | $21,013 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 17 | $162,602 | $32,284 | $35,122 | |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 16 | $117,554 | $33,593 | $25,392 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $101,666 | $19,223 | $21,960 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $165,934 | $27,273 | $35,842 | 3.38 |
Mental diseases and disorders97 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 54 | $31,674 | $12,518 | $6,842 | 1.76 |
| PsychosesMS-DRG 885, medical | 30 | $27,678 | $10,683 | $5,978 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 13 | $23,092 | $6,677 | $4,988 | 0.95 |
Injuries, poisonings and toxic effects of drugs61 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 21 | $140,236 | $25,777 | $30,291 | 3.72 |
| Complications of treatment with MCCMS-DRG 919, medical | 21 | $64,627 | $12,414 | $13,959 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 19 | $43,002 | $6,819 | $9,288 | 1.03 |
Ear, nose, mouth and throat54 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 42 | $29,448 | $4,760 | $6,361 | 0.74 |
| Dental and oral diseases with CCMS-DRG 158, medical | 12 | $40,112 | $6,636 | $8,664 | 0.94 |
Blood cancers and poorly differentiated neoplasms46 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 20 | $114,432 | $23,842 | $24,717 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 13 | $90,678 | $12,590 | $19,586 | 1.57 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 13 | $38,557 | $9,763 | $8,328 | 1.21 |
Factors influencing health status32 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 | 32 | $27,773 | $5,564 | $5,999 | 0.80 |
Eye30 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Neurological eye disordersMS-DRG 123, medical | 16 | $51,620 | $5,280 | $11,150 | 0.80 |
| Other disorders of the eye without MCCMS-DRG 125, medical | 14 | $29,565 | $5,324 | $6,386 | 0.80 |
Alcohol and drug use29 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 | 29 | $36,903 | $6,231 | $7,971 | 0.86 |
Transplants, ECMO and tracheostomy (pre-MDC)15 discharges in 1 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 | 15 | $614,895 | $127,163 | $132,817 | 21.32 |
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 | 1,076 | 984 | $22,028 | $1,895 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 563 | 550 | $56,868 | $10,011 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 560 | 531 | $9,327 | $1,142 | $1,220 |
| Level 2 Intraocular ProceduresAPC 5492 | 334 | 304 | $25,117 | $2,875 | $3,116 |
| Level 1 Endovascular ProceduresAPC 5191 | 333 | 331 | $19,071 | $2,067 | $2,208 |
| Level 3 Urology and Related ServicesAPC 5373 | 324 | 170 | $12,232 | $1,412 | $1,516 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 276 | 270 | $35,904 | $3,981 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 261 | 206 | $20,609 | $2,455 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 244 | 236 | $20,176 | $2,217 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 239 | 215 | $26,004 | $3,658 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 224 | 214 | $19,080 | $1,963 | $2,141 |
| Level 3 Endovascular ProceduresAPC 5193 | 171 | 156 | $70,269 | $7,896 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 171 | 168 | $182,192 | $19,254 | $21,117 |
| Level 2 Upper GI ProceduresAPC 5302 | 168 | 151 | $11,356 | $1,326 | $1,445 |
| Level 1 Intraocular ProceduresAPC 5491 | 163 | 122 | $19,023 | $1,553 | $1,752 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 154 | 149 | $43,405 | $4,981 | $5,339 |
| Level 5 ENT ProceduresAPC 5165 | 123 | 123 | $31,444 | $3,989 | $4,436 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 113 | 113 | $86,752 | $14,808 | $15,763 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 108 | 90 | $25,809 | $2,426 | $2,636 |
| Level 2 Urology and Related ServicesAPC 5372 | 106 | 100 | $4,937 | $470 | $502 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 98 | 98 | $46,436 | $7,876 | $8,569 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 97 | 92 | $25,507 | $2,177 | $2,373 |
| Level 2 Vascular ProceduresAPC 5182 | 89 | 83 | $9,922 | $1,131 | $1,204 |
| Level 2 Endovascular ProceduresAPC 5192 | 75 | 72 | $31,091 | $3,862 | $4,338 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 75 | 74 | $16,398 | $1,655 | $1,780 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 73 | 73 | $59,244 | $7,534 | $8,164 |
| Level 1 Nerve ProceduresAPC 5431 | 70 | 63 | $14,477 | $1,368 | $1,407 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 68 | 65 | $23,955 | $2,704 | $2,930 |
| Level 4 Gynecologic ProceduresAPC 5414 | 66 | 62 | $19,623 | $2,154 | $2,389 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 63 | 62 | $41,741 | $4,631 | $4,982 |
| Level 3 Intraocular ProceduresAPC 5493 | 61 | 53 | $27,135 | $3,710 | $4,004 |
| Level 4 Airway EndoscopyAPC 5154 | 58 | 56 | $20,866 | $2,568 | $2,833 |
| Level 4 Vascular ProceduresAPC 5184 | 58 | 53 | $36,510 | $3,829 | $3,946 |
| Level 3 Lower GI ProceduresAPC 5313 | 58 | 51 | $17,243 | $1,936 | $2,176 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 57 | 56 | $12,014 | $1,112 | $1,196 |
| Level 3 Airway EndoscopyAPC 5153 | 57 | 47 | $11,344 | $1,205 | $1,264 |
| Complex GI ProceduresAPC 5331 | 56 | 38 | $19,765 | $3,681 | $4,263 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 44 | 43 | $48,580 | $6,033 | $6,514 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 39 | 39 | $207,974 | $26,187 | $29,375 |
| Level 3 Upper GI ProceduresAPC 5303 | 38 | 37 | $19,964 | $2,637 | $2,888 |
| Level 5 Gynecologic ProceduresAPC 5415 | 37 | 37 | $27,671 | $3,526 | $3,792 |
| Level 5 Airway EndoscopyAPC 5155 | 36 | 36 | $40,264 | $4,857 | $5,183 |
| Level 4 Endovascular ProceduresAPC 5194 | 34 | 33 | $104,546 | $13,965 | $14,606 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 33 | 32 | $90,265 | $17,818 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 32 | 32 | $72,853 | $5,357 | $6,121 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 24 | 24 | $42,993 | $4,844 | $4,524 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 19 | 16 | $33,924 | $2,459 | $2,969 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 18 | 17 | $72,634 | $6,768 | $7,546 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 13 | $25,528 | $2,274 | $2,217 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 14 | 14 | $99,682 | $15,696 | $17,052 |
| Level 6 Urology and Related ServicesAPC 5376 | 14 | 14 | $35,798 | $6,562 | $7,291 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 13 | 13 | $128,774 | $17,829 | $21,011 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 13 | 13 | $138,819 | $25,963 | $26,719 |
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.