Corewell Health Troy Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Corewell Health Troy, Troy, MI in 2024, from traditional Medicare claims. Back to the Corewell Health Troy profile, with quality ratings, finances and negotiated rates.
7,875
Medicare inpatient discharges
In 173 published DRGs
1.67
Case mix index
IPPS FY 2027
18%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
4,860
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,710 discharges in 31 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 557 | $39,340 | $7,606 | $8,379 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 119 | $30,641 | $4,785 | $6,527 | 0.86 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 115 | $55,606 | $9,568 | $11,844 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 105 | $27,560 | $3,914 | $5,870 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 82 | $46,563 | $7,184 | $9,918 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 73 | $96,537 | $10,367 | $20,562 | 1.82 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 50 | $21,232 | $2,439 | $4,522 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 46 | $72,136 | $12,399 | $15,365 | 2.16 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 45 | $121,434 | $20,424 | $25,865 | 3.24 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 45 | $33,397 | $4,889 | $7,114 | 0.91 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 43 | $24,386 | $6,078 | $5,194 | 1.07 |
| Hypertension without MCCMS-DRG 305, medical | 43 | $25,454 | $3,614 | $5,422 | 0.75 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 36 | $49,013 | $5,715 | $10,440 | 1.08 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 35 | $133,848 | $18,023 | $28,510 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 33 | $65,387 | $12,237 | $13,927 | 2.09 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 31 | $213,621 | $31,871 | $45,501 | 4.88 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 29 | $40,532 | $8,887 | $8,633 | 1.58 |
| Chest painMS-DRG 313, medical | 29 | $23,671 | $3,761 | $5,042 | 0.72 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 26 | $87,794 | $12,905 | $18,700 | 2.28 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 23 | $130,265 | $21,915 | $27,746 | 3.46 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 17 | $161,384 | $21,024 | $34,375 | 3.35 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 17 | $23,023 | $3,548 | $4,904 | 0.71 |
| Other vascular procedures with CCMS-DRG 253, surgical | 14 | $147,854 | $14,299 | $31,493 | 2.55 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $37,986 | $2,921 | $8,091 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 13 | $260,945 | $45,273 | $55,581 | 7.80 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 13 | $274,128 | $41,459 | $58,389 | 6.25 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $241,049 | $28,272 | $51,343 | 5.06 |
| Hypertension with MCCMS-DRG 304, medical | 12 | $41,086 | $6,562 | $8,751 | 1.15 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $129,790 | $21,489 | $27,645 | 3.27 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $21,398 | $4,399 | $4,558 | 0.86 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 11 | $28,781 | $4,951 | $6,130 | 0.97 |
Digestive system984 discharges in 17 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 | 280 | $27,484 | $4,009 | $5,854 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 146 | $37,055 | $5,496 | $7,893 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 86 | $43,970 | $7,766 | $9,366 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 71 | $73,500 | $10,973 | $15,656 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 62 | $27,858 | $5,064 | $5,934 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 61 | $80,245 | $13,334 | $17,092 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 53 | $25,769 | $4,178 | $5,489 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 39 | $161,527 | $26,337 | $34,405 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 32 | $60,589 | $11,987 | $12,906 | 1.62 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 29 | $75,717 | $9,382 | $16,128 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 27 | $31,455 | $6,079 | $6,700 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 23 | $50,612 | $9,105 | $10,780 | 1.45 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 18 | $20,362 | $2,676 | $4,337 | 0.56 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 17 | $19,118 | $4,848 | $4,072 | 0.97 |
| Digestive malignancy with MCCMS-DRG 374, medical | 14 | $62,767 | $10,641 | $13,369 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 13 | $51,979 | $10,278 | $11,071 | 1.75 |
| Digestive malignancy with CCMS-DRG 375, medical | 13 | $39,300 | $6,800 | $8,371 | 1.20 |
Respiratory system982 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 199 | $50,502 | $9,928 | $10,757 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 196 | $40,130 | $7,499 | $8,548 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 106 | $39,923 | $6,460 | $8,504 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 73 | $23,188 | $4,130 | $4,939 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 63 | $40,738 | $7,159 | $8,677 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 53 | $28,277 | $5,642 | $6,023 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 52 | $28,805 | $4,918 | $6,135 | 0.96 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 48 | $28,985 | $4,715 | $6,174 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 25 | $27,396 | $4,398 | $5,835 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 22 | $55,330 | $8,134 | $11,785 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 21 | $51,387 | $9,723 | $10,945 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 20 | $63,760 | $17,576 | $13,581 | 2.70 |
| Respiratory signs and symptomsMS-DRG 204, medical | 19 | $28,503 | $4,307 | $6,071 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 18 | $37,212 | $5,819 | $7,926 | 1.05 |
| Major chest procedures with MCCMS-DRG 163, surgical | 17 | $185,481 | $26,906 | $39,507 | 4.71 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 13 | $18,639 | $4,251 | $3,970 | 0.76 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 13 | $21,701 | $2,807 | $4,622 | 0.63 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 12 | $26,034 | $6,593 | $5,545 | 1.10 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $68,013 | $10,844 | $14,487 | 1.81 |
Kidney and urinary tract904 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 200 | $23,789 | $4,359 | $5,067 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 136 | $30,391 | $6,729 | $6,473 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 131 | $27,121 | $4,786 | $5,777 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 121 | $52,271 | $9,907 | $11,134 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 106 | $45,918 | $9,022 | $9,780 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 74 | $26,742 | $5,799 | $5,696 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 42 | $52,399 | $7,916 | $11,161 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 28 | $73,016 | $15,134 | $15,552 | 2.59 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 16 | $36,440 | $5,949 | $7,762 | 1.05 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $92,872 | $24,921 | $19,782 | 3.70 |
| Urinary stones without MCCMS-DRG 694, medical | 13 | $34,766 | $3,725 | $7,405 | 0.78 |
| Transurethral procedures with CCMS-DRG 669, surgical | 11 | $61,619 | $9,109 | $13,125 | 1.53 |
| Renal failure without cc/mccMS-DRG 684, medical | 11 | $20,081 | $3,010 | $4,277 | 0.61 |
Musculoskeletal system and connective tissue879 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 126 | $31,846 | $5,196 | $6,783 | 0.97 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 105 | $101,779 | $21,041 | $21,679 | 3.66 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 88 | $91,523 | $12,615 | $19,494 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 58 | $90,995 | $12,927 | $19,382 | 2.11 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 52 | $66,295 | $11,500 | $14,121 | 1.88 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 41 | $32,015 | $4,955 | $6,819 | 0.90 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 37 | $116,708 | $19,066 | $24,859 | 3.49 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 36 | $24,112 | $4,553 | $5,136 | 0.82 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 31 | $89,804 | $16,310 | $19,128 | 2.96 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 26 | $32,147 | $3,998 | $6,847 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 26 | $46,953 | $9,184 | $10,001 | 1.70 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 24 | $72,235 | $11,635 | $15,386 | 2.04 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 21 | $100,101 | $14,376 | $21,322 | 2.67 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 21 | $86,580 | $13,971 | $18,442 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 17 | $149,621 | $19,226 | $31,869 | 2.95 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 17 | $99,978 | $15,638 | $21,295 | 2.48 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $62,391 | $11,291 | $13,289 | 1.97 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 16 | $73,968 | $8,377 | $15,755 | 1.49 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 16 | $104,358 | $18,494 | $22,228 | 2.99 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 16 | $29,688 | $5,861 | $6,324 | 1.09 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 16 | $20,039 | $4,390 | $4,268 | 0.82 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 15 | $140,245 | $36,712 | $29,872 | 6.08 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 13 | $60,078 | $11,289 | $12,797 | 1.82 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 11 | $134,390 | $32,300 | $28,625 | 6.12 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $19,769 | $4,379 | $4,211 | 0.88 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 11 | $25,672 | $6,326 | $5,468 | 1.13 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 11 | $26,185 | $8,082 | $5,577 | 1.52 |
Infectious and parasitic diseases760 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 | 507 | $68,519 | $11,839 | $14,595 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 108 | $32,371 | $5,600 | $6,895 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 75 | $155,838 | $27,603 | $33,194 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 25 | $87,077 | $11,506 | $18,547 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 18 | $218,300 | $41,499 | $46,498 | 6.96 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 16 | $24,134 | $5,220 | $5,141 | 1.01 |
| Viral illness without MCCMS-DRG 866, medical | 11 | $24,896 | $5,320 | $5,303 | 0.92 |
Nervous system507 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 85 | $61,828 | $11,034 | $13,169 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 79 | $44,738 | $5,321 | $9,529 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 48 | $27,950 | $4,118 | $5,953 | 0.80 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 47 | $32,898 | $7,917 | $7,007 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $27,578 | $6,061 | $5,874 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 23 | $47,028 | $12,275 | $10,017 | 1.98 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 22 | $60,474 | $14,021 | $12,881 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 21 | $29,866 | $5,992 | $6,361 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 19 | $27,058 | $4,926 | $5,763 | 0.91 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 18 | $128,721 | $27,136 | $27,418 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 18 | $57,649 | $10,135 | $12,279 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 17 | $30,316 | $3,156 | $6,457 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 14 | $49,843 | $7,807 | $10,617 | 1.36 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $53,901 | $8,144 | $11,481 | 1.47 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 12 | $74,274 | $10,461 | $15,820 | 1.87 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 11 | $60,691 | $6,188 | $12,927 | 1.14 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $37,671 | $8,699 | $8,024 | 1.51 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $71,371 | $11,750 | $15,202 | 2.27 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 11 | $55,707 | $6,272 | $11,866 | 1.32 |
Endocrine, nutritional and metabolic311 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 | 90 | $24,962 | $4,314 | $5,317 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 86 | $41,269 | $7,992 | $8,790 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 59 | $25,304 | $5,001 | $5,390 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 29 | $49,941 | $8,573 | $10,638 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 19 | $29,244 | $5,969 | $6,229 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $51,748 | $8,742 | $11,022 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $48,713 | $12,082 | $10,376 | 1.98 |
Skin, subcutaneous tissue and breast217 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 135 | $21,924 | $4,725 | $4,670 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 52 | $40,685 | $8,955 | $8,666 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 15 | $46,911 | $8,329 | $9,992 | 1.75 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 15 | $30,503 | $5,576 | $6,497 | 0.91 |
Liver, gallbladder and pancreas188 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 32 | $74,377 | $9,511 | $15,842 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $35,121 | $6,455 | $7,481 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 18 | $60,695 | $7,014 | $12,928 | 1.31 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $58,758 | $10,440 | $12,516 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 18 | $33,402 | $4,489 | $7,115 | 0.86 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 16 | $36,425 | $5,997 | $7,758 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 16 | $56,845 | $10,614 | $12,108 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 14 | $50,065 | $10,955 | $10,664 | 1.92 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 13 | $94,699 | $13,671 | $20,171 | 2.32 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $77,948 | $9,927 | $16,603 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $29,869 | $5,302 | $6,362 | 0.95 |
Blood and immune system137 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 71 | $32,004 | $5,114 | $6,817 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 35 | $48,563 | $8,585 | $10,344 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 16 | $59,589 | $9,700 | $12,692 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 15 | $35,790 | $6,831 | $7,623 | 1.20 |
Mental diseases and disorders80 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 | 57 | $34,790 | $9,753 | $7,410 | 1.76 |
| PsychosesMS-DRG 885, medical | 23 | $33,552 | $8,329 | $7,147 | 1.37 |
Other80 discharges in 5 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 | $190,170 | $27,122 | $40,506 | 4.74 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 19 | $113,150 | $24,664 | $24,101 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $113,984 | $13,608 | $24,279 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 13 | $225,484 | $44,713 | $48,028 | 1.70 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 12 | $180,678 | $20,438 | $38,484 | 3.38 |
Injuries, poisonings and toxic effects of drugs46 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 21 | $29,896 | $5,714 | $6,368 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 14 | $76,899 | $11,551 | $16,380 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 11 | $99,001 | $20,940 | $21,087 | 3.72 |
Alcohol and drug use33 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 without MCCMS-DRG 897, medical | 19 | $37,341 | $4,758 | $7,954 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 14 | $58,835 | $8,851 | $12,532 | 1.78 |
Ear, nose, mouth and throat29 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 29 | $27,500 | $3,908 | $5,858 | 0.74 |
Factors influencing health status28 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 | 28 | $23,337 | $4,362 | $4,971 | 0.80 |
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 | 1,046 | 940 | $21,547 | $1,910 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 359 | 351 | $9,547 | $1,128 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 300 | 289 | $53,752 | $10,015 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 251 | 250 | $19,708 | $2,072 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 207 | 206 | $38,609 | $4,024 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 207 | 185 | $22,118 | $2,442 | $2,629 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 187 | 181 | $17,344 | $1,986 | $2,141 |
| Level 3 Urology and Related ServicesAPC 5373 | 150 | 86 | $13,266 | $1,374 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 149 | 132 | $24,448 | $3,637 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 145 | 144 | $20,797 | $2,215 | $2,405 |
| Level 1 Nerve ProceduresAPC 5431 | 130 | 117 | $14,717 | $1,347 | $1,407 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 123 | 122 | $41,343 | $4,913 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 114 | 104 | $67,444 | $8,056 | $8,874 |
| Level 1 Intraocular ProceduresAPC 5491 | 108 | 74 | $15,803 | $1,609 | $1,752 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 95 | 93 | $25,127 | $2,706 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 94 | 89 | $8,573 | $1,111 | $1,204 |
| Level 2 Upper GI ProceduresAPC 5302 | 90 | 76 | $8,599 | $1,347 | $1,445 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 84 | 83 | $40,088 | $4,520 | $4,982 |
| Level 4 Gynecologic ProceduresAPC 5414 | 81 | 81 | $21,046 | $2,220 | $2,389 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 80 | 80 | $23,188 | $2,253 | $2,373 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 79 | 72 | $24,151 | $2,426 | $2,636 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 75 | 75 | $59,959 | $7,538 | $8,164 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 68 | 66 | $72,182 | $14,510 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 62 | 62 | $7,525 | $1,204 | $1,264 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 57 | 57 | $43,087 | $7,778 | $8,569 |
| Level 4 Airway EndoscopyAPC 5154 | 54 | 54 | $23,440 | $2,659 | $2,833 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 45 | 42 | $13,376 | $1,094 | $1,196 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 39 | 39 | $164,043 | $19,482 | $21,117 |
| Level 2 Endovascular ProceduresAPC 5192 | 38 | 35 | $34,369 | $3,898 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 30 | 30 | $13,977 | $1,994 | $2,176 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 29 | 29 | $47,985 | $6,311 | $7,546 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 28 | 27 | $18,515 | $1,649 | $1,780 |
| Level 4 Vascular ProceduresAPC 5184 | 27 | 27 | $37,914 | $3,758 | $3,946 |
| Level 4 Endovascular ProceduresAPC 5194 | 27 | 25 | $101,944 | $12,923 | $14,606 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 27 | 27 | $194,920 | $27,595 | $29,375 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 25 | 25 | $49,402 | $5,803 | $6,514 |
| Level 5 Airway EndoscopyAPC 5155 | 24 | 24 | $36,290 | $4,658 | $5,183 |
| Level 5 Gynecologic ProceduresAPC 5415 | 23 | 23 | $29,100 | $3,378 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 22 | 20 | $15,998 | $2,720 | $2,888 |
| Level 3 ENT ProceduresAPC 5163 | 21 | 21 | $12,493 | $1,083 | $1,106 |
| Level 5 ENT ProceduresAPC 5165 | 20 | 20 | $35,298 | $4,155 | $4,436 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $18,642 | $2,286 | $2,217 |
| Level 2 Urology and Related ServicesAPC 5372 | 14 | 13 | $9,135 | $485 | $502 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 12 | 11 | $125,456 | $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.