Duke Raleigh Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Duke Raleigh Hospital, Raleigh, NC in 2024, from traditional Medicare claims. Back to the Duke Raleigh Hospital profile, with quality ratings, finances and negotiated rates.
530
Medicare inpatient discharges
In 23 published DRGs
2.01
Case mix index
IPPS FY 2026
35%
Surgical stays
54%
Stays with complications
In DRGs with a CC or MCC
2,107
Medicare outpatient services
In 36 service groups
Inpatient stays by major diagnostic category
Musculoskeletal system and connective tissue176 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 42 | $155,700 | $31,396 | $51,848 | 4.61 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 31 | $97,328 | $23,803 | $32,410 | 3.66 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 27 | $224,269 | $49,357 | $74,682 | 6.12 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 24 | $51,893 | $15,888 | $17,280 | 2.46 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 20 | $58,644 | $12,875 | $19,528 | 1.88 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 17 | $78,333 | $15,810 | $26,085 | 2.48 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $73,644 | $19,973 | $24,523 | 2.96 |
Infectious and parasitic diseases97 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 | 73 | $43,009 | $12,561 | $14,322 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 24 | $32,670 | $6,772 | $10,879 | 1.03 |
Circulatory system92 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 52 | $29,056 | $9,083 | $9,676 | 1.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 17 | $49,387 | $14,309 | $16,446 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 12 | $17,974 | $5,741 | $5,985 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 11 | $18,364 | $5,660 | $6,115 | 0.86 |
Digestive system58 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 25 | $22,638 | $6,789 | $7,539 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 22 | $23,586 | $5,709 | $7,854 | 0.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 11 | $48,749 | $10,274 | $16,234 | 1.67 |
Respiratory system41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 22 | $34,357 | $8,673 | $11,441 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 19 | $36,068 | $11,801 | $12,011 | 1.70 |
Kidney and urinary tract37 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 14 | $22,465 | $6,047 | $7,481 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 12 | $32,296 | $10,432 | $10,755 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 11 | $35,627 | $10,487 | $11,864 | 1.50 |
Blood and immune system16 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 | 16 | $21,363 | $5,972 | $7,114 | 0.90 |
Skin, subcutaneous tissue and breast13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 13 | $16,455 | $6,381 | $5,479 | 0.88 |
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 1 Intraocular ProceduresAPC 5491 | 407 | 259 | $11,670 | $1,662 | $1,752 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 133 | 127 | $7,795 | $995 | $1,220 |
| Level 2 Urology and Related ServicesAPC 5372 | 119 | 56 | $2,325 | $479 | $502 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 111 | 110 | $60,571 | $9,926 | $10,772 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 102 | 102 | $68,200 | $14,962 | $15,763 |
| Comprehensive Observation ServicesAPC 8011 | 93 | 92 | $12,814 | $1,884 | $2,090 |
| Level 2 Intraocular ProceduresAPC 5492 | 84 | 72 | $16,160 | $2,882 | $3,116 |
| Level 5 Urology and Related ServicesAPC 5375 | 77 | 73 | $26,887 | $3,707 | $3,918 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 74 | 74 | $26,008 | $5,059 | $5,339 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 72 | 72 | $12,272 | $1,654 | $1,780 |
| Level 4 Vascular ProceduresAPC 5184 | 71 | 34 | $19,385 | $1,832 | $3,946 |
| Level 2 Upper GI ProceduresAPC 5302 | 69 | 66 | $11,598 | $1,345 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 65 | 65 | $22,000 | $2,044 | $2,208 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 61 | 58 | $18,655 | $1,918 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 49 | 49 | $136,214 | $19,696 | $21,117 |
| Level 1 Nerve ProceduresAPC 5431 | 48 | 41 | $10,662 | $1,356 | $1,407 |
| Level 3 Urology and Related ServicesAPC 5373 | 45 | 39 | $10,090 | $1,450 | $1,516 |
| Level 4 Urology and Related ServicesAPC 5374 | 43 | 38 | $15,460 | $2,438 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 36 | 36 | $21,417 | $4,018 | $4,358 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 35 | 35 | $14,619 | $2,330 | $2,636 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 34 | 34 | $17,596 | $2,181 | $2,373 |
| Level 4 Airway EndoscopyAPC 5154 | 34 | 34 | $21,734 | $2,598 | $2,833 |
| Level 8 Urology and Related ServicesAPC 5378 | 30 | 30 | $93,137 | $15,099 | $17,428 |
| Level 5 ENT ProceduresAPC 5165 | 24 | 24 | $20,892 | $4,016 | $4,436 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 22 | 22 | $38,769 | $7,623 | $8,164 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 19 | 19 | $25,870 | $4,677 | $4,982 |
| Level 3 Vascular ProceduresAPC 5183 | 19 | 18 | $13,544 | $2,278 | $2,405 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 17 | 17 | $21,147 | $2,734 | $2,930 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 17 | 17 | $8,887 | $1,017 | $1,196 |
| Level 3 Lower GI ProceduresAPC 5313 | 17 | 16 | $14,546 | $2,016 | $2,176 |
| Level 3 Airway EndoscopyAPC 5153 | 16 | 16 | $12,453 | $1,214 | $1,264 |
| Level 3 Endovascular ProceduresAPC 5193 | 15 | 14 | $49,161 | $7,714 | $8,874 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 14 | 14 | $163,175 | $26,227 | $26,719 |
| Level 2 Vascular ProceduresAPC 5182 | 12 | 12 | $6,257 | $1,053 | $1,204 |
| Level 7 Radiation TherapyAPC 5627 | 12 | 12 | $21,831 | $5,586 | $6,121 |
| Level 4 Gynecologic ProceduresAPC 5414 | 11 | 11 | $15,409 | $2,243 | $2,389 |
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.