Duke University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Duke University Hospital, Durham, NC in 2024, from traditional Medicare claims. Back to the Duke University Hospital profile, with quality ratings, finances and negotiated rates.
9,300
Medicare inpatient discharges
In 251 published DRGs
2.49
Case mix index
IPPS FY 2027
39%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
14,568
Medicare outpatient services
In 61 service groups
Inpatient stays by major diagnostic category
Circulatory system2,142 discharges in 47 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 316 | $42,399 | $11,641 | $11,999 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 165 | $262,179 | $44,011 | $74,197 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 134 | $98,496 | $24,556 | $27,874 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 87 | $25,277 | $6,902 | $7,153 | 0.74 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 82 | $124,474 | $31,850 | $35,226 | 4.04 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 74 | $47,223 | $9,125 | $13,364 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 73 | $67,410 | $18,306 | $19,077 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 68 | $90,947 | $14,977 | $25,738 | 1.82 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 66 | $228,126 | $47,550 | $64,560 | 5.06 |
| Syncope and collapseMS-DRG 312, medical | 65 | $29,573 | $7,933 | $8,369 | 0.86 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 62 | $246,148 | $51,132 | $69,660 | 5.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 61 | $34,143 | $10,627 | $9,662 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 59 | $133,132 | $23,229 | $37,676 | 2.87 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 51 | $159,639 | $28,694 | $45,178 | 3.24 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 48 | $281,421 | $75,058 | $79,642 | 7.71 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 44 | $131,958 | $32,849 | $37,344 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 39 | $82,826 | $22,615 | $23,440 | 2.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 39 | $49,107 | $9,083 | $13,897 | 0.97 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 37 | $56,660 | $14,779 | $16,035 | 1.59 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 34 | $33,253 | $8,424 | $9,411 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 34 | $16,560 | $4,997 | $4,686 | 0.55 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 30 | $313,424 | $62,611 | $88,699 | 6.25 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 28 | $298,143 | $77,641 | $84,374 | 9.71 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 28 | $138,422 | $34,426 | $39,173 | 3.27 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 28 | $182,726 | $39,970 | $51,711 | 3.90 |
| Heart failure and shock with CCMS-DRG 292, medical | 27 | $29,811 | $7,612 | $8,437 | 0.86 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 26 | $115,445 | $19,546 | $32,671 | 2.28 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 25 | $30,204 | $8,872 | $8,548 | 1.07 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 23 | $129,043 | $29,272 | $36,519 | 3.46 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 22 | $191,352 | $46,989 | $54,152 | 5.88 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 21 | $171,153 | $28,619 | $48,436 | 3.18 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 21 | $73,292 | $14,706 | $20,742 | 1.74 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 20 | $176,453 | $43,748 | $49,936 | 5.20 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 20 | $42,579 | $12,840 | $12,050 | 1.58 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 19 | $169,678 | $28,998 | $48,019 | 3.46 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 19 | $213,675 | $39,670 | $60,470 | 4.16 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 17 | $281,442 | $48,078 | $79,648 | 4.78 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 217, surgical | 16 | $212,964 | $48,633 | $60,269 | 6.37 |
| Cardiac pacemaker revision except device replacement with MCCMS-DRG 260, surgical | 15 | $169,397 | $36,259 | $47,939 | 3.32 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 14 | $178,265 | $35,872 | $50,449 | 4.81 |
| Hypertension without MCCMS-DRG 305, medical | 14 | $24,863 | $6,574 | $7,036 | 0.75 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 13 | $110,550 | $24,647 | $31,286 | 2.81 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $75,805 | $13,705 | $21,453 | 1.83 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 12 | $245,441 | $67,028 | $69,460 | 7.80 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 11 | $223,704 | $45,969 | $63,308 | 5.04 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 11 | $241,948 | $62,812 | $68,471 | 6.85 |
| Chest painMS-DRG 313, medical | 11 | $28,413 | $6,820 | $8,041 | 0.72 |
Respiratory system1,093 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 126 | $58,620 | $15,017 | $16,589 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 90 | $49,346 | $11,252 | $13,965 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 90 | $42,747 | $11,388 | $12,097 | 1.33 |
| Major chest procedures with CCMS-DRG 164, surgical | 83 | $79,012 | $21,582 | $22,361 | 2.55 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 68 | $67,623 | $17,110 | $19,137 | 1.81 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 59 | $34,829 | $7,489 | $9,857 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 53 | $60,770 | $15,261 | $17,198 | 1.88 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 52 | $45,219 | $8,948 | $12,797 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 42 | $46,550 | $11,681 | $13,174 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 42 | $33,587 | $10,174 | $9,505 | 1.10 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 39 | $97,163 | $12,936 | $27,497 | 0.91 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 34 | $65,296 | $14,943 | $18,479 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 32 | $151,213 | $38,432 | $42,793 | 4.71 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 32 | $69,804 | $16,306 | $19,754 | 1.90 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 28 | $99,077 | $24,435 | $28,039 | 2.70 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 23 | $56,259 | $15,504 | $15,921 | 1.82 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 23 | $29,809 | $7,682 | $8,436 | 0.82 |
| Major chest trauma with MCCMS-DRG 183, medical | 23 | $69,949 | $14,296 | $19,795 | 1.57 |
| Major chest trauma with CCMS-DRG 184, medical | 23 | $49,051 | $8,594 | $13,881 | 1.05 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 20 | $36,968 | $9,245 | $10,462 | 1.10 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 19 | $92,285 | $31,175 | $26,117 | 4.06 |
| Pneumothorax with CCMS-DRG 200, medical | 18 | $51,052 | $9,459 | $14,448 | 1.08 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 17 | $22,801 | $7,589 | $6,453 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 17 | $25,811 | $8,253 | $7,304 | 0.96 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 16 | $220,741 | $61,437 | $62,470 | 6.91 |
| Other respiratory system o.r. procedures without cc/mccMS-DRG 168, surgical | 12 | $45,797 | $11,851 | $12,960 | 1.36 |
| Respiratory signs and symptomsMS-DRG 204, medical | 12 | $27,901 | $5,673 | $7,896 | 0.82 |
Musculoskeletal system and connective tissue1,039 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 128 | $55,756 | $16,181 | $15,779 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 82 | $79,111 | $17,365 | $22,388 | 2.07 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 66 | $129,935 | $30,516 | $36,771 | 3.66 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 52 | $202,129 | $44,017 | $57,203 | 4.61 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 49 | $90,725 | $20,010 | $25,675 | 2.67 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 48 | $113,017 | $32,132 | $31,984 | 3.49 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 45 | $236,625 | $55,964 | $66,965 | 6.12 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 42 | $88,751 | $25,296 | $25,116 | 2.96 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 39 | $69,451 | $20,726 | $19,655 | 2.46 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 38 | $73,992 | $18,957 | $20,940 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 32 | $36,716 | $7,891 | $10,390 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 30 | $97,204 | $25,817 | $27,509 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 30 | $36,832 | $9,588 | $10,423 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 27 | $88,380 | $26,015 | $25,011 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 26 | $62,209 | $14,760 | $17,605 | 1.70 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 25 | $241,445 | $48,943 | $68,329 | 6.08 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 24 | $122,287 | $23,072 | $34,607 | 2.40 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 23 | $99,094 | $23,286 | $28,044 | 2.48 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 21 | $32,744 | $12,604 | $9,267 | 1.49 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 21 | $32,311 | $7,208 | $9,144 | 0.82 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 19 | $60,737 | $17,715 | $17,189 | 2.04 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 17 | $81,771 | $17,083 | $23,141 | 1.82 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 17 | $136,339 | $33,393 | $38,584 | 2.49 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 17 | $24,436 | $8,064 | $6,916 | 0.90 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 16 | $119,904 | $41,815 | $33,933 | 5.66 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 15 | $67,805 | $26,534 | $19,189 | 3.00 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 15 | $87,705 | $23,085 | $24,821 | 1.97 |
| Connective tissue disorders with CCMS-DRG 546, medical | 15 | $34,188 | $10,762 | $9,675 | 1.20 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 13 | $151,104 | $30,405 | $42,762 | 3.33 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 13 | $21,701 | $6,903 | $6,141 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 12 | $85,911 | $16,672 | $24,313 | 1.87 |
| Amputation for musculoskeletal system and connective tissue disorders with MCCMS-DRG 474, surgical | 11 | $170,778 | $38,786 | $48,330 | 4.30 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 11 | $57,852 | $10,285 | $16,372 | 1.43 |
Nervous system869 discharges in 23 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 | 98 | $44,424 | $8,453 | $12,572 | 1.02 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 95 | $67,991 | $20,856 | $19,241 | 2.43 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 88 | $114,445 | $36,850 | $32,388 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 83 | $85,069 | $20,025 | $24,075 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 69 | $29,855 | $12,150 | $8,449 | 1.36 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 47 | $67,246 | $24,284 | $19,031 | 2.95 |
| Seizures without MCCMS-DRG 101, medical | 40 | $34,971 | $7,295 | $9,897 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 38 | $196,540 | $51,282 | $55,621 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 37 | $72,353 | $16,959 | $20,476 | 1.98 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 36 | $51,522 | $13,083 | $14,581 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 32 | $70,975 | $16,583 | $20,086 | 1.79 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 31 | $35,498 | $9,098 | $10,046 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 30 | $61,880 | $16,502 | $17,512 | 1.79 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 19 | $61,957 | $14,491 | $17,534 | 1.62 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 19 | $44,254 | $8,871 | $12,524 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 15 | $169,241 | $33,395 | $47,895 | 3.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 15 | $92,501 | $16,566 | $26,178 | 2.39 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $40,582 | $8,537 | $11,485 | 1.06 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 14 | $48,993 | $10,045 | $13,865 | 1.14 |
| Nervous system neoplasms without MCCMS-DRG 055, medical | 13 | $60,555 | $11,399 | $17,137 | 1.07 |
| Headaches without MCCMS-DRG 103, medical | 13 | $20,810 | $5,554 | $5,889 | 0.84 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 11 | $33,066 | $6,111 | $9,358 | 0.69 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 11 | $46,443 | $6,075 | $13,143 | 0.80 |
Digestive system855 discharges in 21 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 | 123 | $27,522 | $7,051 | $7,789 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 108 | $32,842 | $8,996 | $9,294 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 69 | $42,724 | $11,013 | $12,091 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 60 | $65,945 | $19,879 | $18,662 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 56 | $78,224 | $16,893 | $22,137 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 52 | $66,607 | $15,491 | $18,850 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 47 | $165,782 | $39,396 | $46,916 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 45 | $31,263 | $8,677 | $8,847 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 44 | $25,093 | $7,428 | $7,101 | 0.80 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 40 | $50,352 | $13,699 | $14,250 | 1.67 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 24 | $72,940 | $20,178 | $20,642 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 21 | $52,112 | $12,817 | $14,748 | 1.60 |
| Digestive malignancy with CCMS-DRG 375, medical | 21 | $38,562 | $11,326 | $10,913 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 21 | $37,276 | $12,847 | $10,549 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 20 | $138,967 | $47,238 | $39,328 | 5.08 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 20 | $18,785 | $5,001 | $5,316 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 19 | $162,127 | $35,334 | $45,882 | 4.28 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 18 | $54,072 | $14,950 | $15,302 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 18 | $32,428 | $8,738 | $9,177 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $62,105 | $19,146 | $17,576 | 2.10 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 11 | $67,955 | $19,648 | $19,231 | 2.20 |
Kidney and urinary tract766 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 109 | $24,489 | $7,403 | $6,930 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 98 | $32,831 | $8,850 | $9,291 | 1.02 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 91 | $45,551 | $14,225 | $12,891 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 73 | $25,943 | $7,616 | $7,342 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 68 | $45,962 | $12,937 | $13,007 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 54 | $33,533 | $10,286 | $9,490 | 1.17 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 52 | $48,696 | $11,822 | $13,781 | 1.35 |
| Kidney transplantMS-DRG 652, surgical | 33 | $211,606 | $28,681 | $59,885 | 3.00 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 25 | $60,996 | $15,613 | $17,262 | 1.84 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 24 | $118,826 | $35,600 | $33,628 | 3.70 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 22 | $48,489 | $13,011 | $13,722 | 1.48 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $123,751 | $24,028 | $35,022 | 2.59 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 18 | $46,341 | $9,517 | $13,115 | 1.05 |
| Major bladder procedures with CCMS-DRG 654, surgical | 17 | $101,188 | $24,521 | $28,636 | 2.74 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 15 | $116,918 | $25,390 | $33,088 | 2.38 |
| Urinary stones without MCCMS-DRG 694, medical | 13 | $33,161 | $6,966 | $9,384 | 0.78 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 12 | $270,999 | $36,123 | $76,693 | 4.50 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 12 | $116,648 | $32,576 | $33,011 | 3.14 |
| Transurethral procedures with CCMS-DRG 669, surgical | 11 | $35,524 | $13,699 | $10,053 | 1.53 |
Infectious and parasitic diseases683 discharges in 11 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 | 347 | $67,361 | $17,386 | $19,063 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 87 | $36,578 | $9,074 | $10,352 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 76 | $190,929 | $44,504 | $54,033 | 5.00 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 30 | $49,974 | $18,746 | $14,143 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 26 | $147,455 | $37,288 | $41,730 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 24 | $59,002 | $16,452 | $16,698 | 1.84 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 24 | $38,241 | $6,892 | $10,822 | 0.88 |
| Viral illness without MCCMS-DRG 866, medical | 22 | $23,347 | $8,139 | $6,607 | 0.92 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 21 | $24,431 | $9,022 | $6,914 | 1.01 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 15 | $66,929 | $16,363 | $18,941 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 11 | $232,653 | $69,711 | $65,841 | 6.96 |
Liver, gallbladder and pancreas377 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 50 | $35,148 | $7,920 | $9,947 | 0.95 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 43 | $89,220 | $20,437 | $25,249 | 1.92 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 39 | $75,880 | $25,409 | $21,474 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 35 | $38,589 | $9,891 | $10,921 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 33 | $57,999 | $15,715 | $16,414 | 1.76 |
| Pancreas, liver and shunt procedures without cc/mccMS-DRG 407, surgical | 25 | $53,623 | $16,810 | $15,175 | 2.15 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 25 | $62,643 | $14,679 | $17,728 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 25 | $70,256 | $15,554 | $19,882 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 21 | $36,301 | $7,209 | $10,273 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 20 | $39,436 | $14,828 | $11,160 | 1.83 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 18 | $31,954 | $9,725 | $9,043 | 1.03 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 17 | $160,783 | $50,880 | $45,501 | 5.51 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 14 | $30,312 | $10,126 | $8,578 | 1.10 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 12 | $44,439 | $11,639 | $12,576 | 1.31 |
Endocrine, nutritional and metabolic286 discharges in 9 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 | 75 | $26,461 | $7,356 | $7,489 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 72 | $51,382 | $11,626 | $14,541 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 40 | $27,272 | $7,383 | $7,718 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 25 | $32,158 | $9,101 | $9,101 | 1.06 |
| Adrenal and pituitary procedures without cc/mccMS-DRG 615, surgical | 18 | $42,866 | $12,986 | $12,131 | 1.47 |
| Diabetes with MCCMS-DRG 637, medical | 17 | $34,601 | $11,846 | $9,792 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 15 | $46,803 | $14,331 | $13,245 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $66,212 | $15,842 | $18,738 | 1.98 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 11 | $60,236 | $19,917 | $17,047 | 2.25 |
Blood cancers and poorly differentiated neoplasms285 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 106 | $58,061 | $11,994 | $16,431 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 37 | $194,025 | $34,917 | $54,909 | 3.13 |
| Acute leukemia with MCCMS-DRG 834, medical | 28 | $323,241 | $75,888 | $91,477 | 5.60 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 21 | $106,000 | $13,309 | $29,998 | 1.57 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 20 | $196,898 | $33,389 | $55,722 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 14 | $359,737 | $76,749 | $101,805 | 4.84 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 13 | $62,954 | $20,628 | $17,816 | 2.32 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 13 | $74,580 | $21,051 | $21,106 | 2.00 |
| Lymphoma and leukemia with major o.r. procedures without cc/mccMS-DRG 822, surgical | 11 | $38,458 | $10,891 | $10,884 | 1.24 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 11 | $167,975 | $46,294 | $47,537 | 4.50 |
| Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mcMS-DRG 843, medical | 11 | $56,512 | $17,107 | $15,993 | 1.86 |
Blood and immune system213 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 | 68 | $30,919 | $7,586 | $8,750 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 49 | $69,057 | $13,655 | $19,543 | 1.20 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 49 | $49,844 | $12,997 | $14,106 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 33 | $68,485 | $15,362 | $19,381 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 14 | $94,724 | $21,444 | $26,807 | 2.19 |
Injuries, poisonings and toxic effects of drugs168 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 45 | $74,721 | $17,337 | $21,146 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 37 | $36,503 | $8,901 | $10,330 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 31 | $162,145 | $39,625 | $45,887 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 27 | $50,824 | $16,130 | $14,383 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $41,112 | $13,746 | $11,635 | 1.60 |
| Other o.r. procedures for injuries without cc/mccMS-DRG 909, surgical | 13 | $65,202 | $12,256 | $18,452 | 1.36 |
Other155 discharges in 8 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 | $165,846 | $39,563 | $46,934 | 4.74 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 19 | $313,093 | $82,659 | $88,605 | |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 19 | $239,445 | $52,811 | $67,763 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 18 | $126,772 | $34,783 | $35,876 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $85,269 | $20,683 | $24,131 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $139,454 | $34,755 | $39,466 | 3.38 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 13 | $140,499 | $37,164 | $39,761 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 13 | $92,073 | $27,417 | $26,057 |
Transplants, ECMO and tracheostomy (pre-MDC)125 discharges in 5 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 | 40 | $911,161 | $236,470 | $257,858 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 35 | $1,034,932 | $280,216 | $292,886 | 27.10 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 21 | $448,897 | $95,532 | $127,038 | 10.35 |
| Lung transplantMS-DRG 007, surgical | 17 | $611,496 | $111,271 | $173,053 | 12.27 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 12 | $141,730 | $35,495 | $40,110 | 4.00 |
Skin, subcutaneous tissue and breast97 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 67 | $21,443 | $8,003 | $6,068 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 19 | $46,975 | $13,214 | $13,294 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 11 | $34,101 | $7,307 | $9,651 | 0.91 |
Factors influencing health status54 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 35 | $25,753 | $7,319 | $7,288 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 19 | $72,569 | $14,416 | $20,537 | 1.25 |
Multiple significant trauma25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with CCMS-DRG 964, medical | 14 | $57,224 | $13,277 | $16,194 | 1.50 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 11 | $146,585 | $28,702 | $41,484 | 3.88 |
Eye25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Neurological eye disordersMS-DRG 123, medical | 13 | $42,782 | $6,958 | $12,107 | 0.80 |
| Other disorders of the eye without MCCMS-DRG 125, medical | 12 | $29,642 | $7,209 | $8,389 | 0.80 |
Male reproductive system16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major male pelvic procedures without cc/mccMS-DRG 708, surgical | 16 | $41,900 | $11,241 | $11,858 | 1.46 |
Mental diseases and disorders16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 16 | $29,058 | $14,126 | $8,224 | 1.76 |
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 | $31,733 | $7,660 | $8,980 | 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 |
|---|---|---|---|---|---|
| Level 2 Urology and Related ServicesAPC 5372 | 1,492 | 724 | $3,222 | $484 | $502 |
| Level 1 Intraocular ProceduresAPC 5491 | 1,160 | 808 | $14,837 | $1,651 | $1,752 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 879 | 806 | $8,020 | $1,126 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 633 | 606 | $16,085 | $1,923 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 624 | 620 | $20,292 | $2,036 | $2,208 |
| Level 2 Upper GI ProceduresAPC 5302 | 603 | 531 | $12,818 | $1,335 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 582 | 507 | $9,018 | $1,439 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 568 | 493 | $20,390 | $2,025 | $2,141 |
| Level 2 Intraocular ProceduresAPC 5492 | 526 | 468 | $20,735 | $2,911 | $3,116 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 518 | 501 | $51,180 | $10,046 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 479 | 348 | $18,583 | $2,187 | $2,405 |
| Level 4 Airway EndoscopyAPC 5154 | 470 | 342 | $20,717 | $2,559 | $2,833 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 360 | 355 | $129,769 | $19,462 | $21,117 |
| Level 3 Endovascular ProceduresAPC 5193 | 312 | 285 | $54,727 | $8,098 | $8,874 |
| Level 4 Urology and Related ServicesAPC 5374 | 293 | 236 | $17,271 | $2,445 | $2,629 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 284 | 266 | $14,732 | $1,654 | $1,780 |
| Level 5 Urology and Related ServicesAPC 5375 | 282 | 269 | $23,949 | $3,626 | $3,918 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 263 | 252 | $41,941 | $7,574 | $8,164 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 261 | 254 | $35,343 | $5,022 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 238 | 237 | $25,233 | $4,077 | $4,358 |
| Level 4 Vascular ProceduresAPC 5184 | 233 | 182 | $26,043 | $3,114 | $3,946 |
| Level 3 Airway EndoscopyAPC 5153 | 207 | 159 | $8,158 | $1,184 | $1,264 |
| Level 5 ENT ProceduresAPC 5165 | 192 | 192 | $23,649 | $4,133 | $4,436 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 178 | 150 | $16,742 | $2,387 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 174 | 148 | $10,046 | $1,377 | $1,407 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 167 | 167 | $99,812 | $14,961 | $15,763 |
| Level 5 Airway EndoscopyAPC 5155 | 156 | 154 | $47,991 | $4,887 | $5,183 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 153 | 138 | $21,368 | $2,721 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 150 | 150 | $28,307 | $4,561 | $4,982 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 145 | 136 | $18,098 | $2,270 | $2,373 |
| Level 3 Lower GI ProceduresAPC 5313 | 143 | 138 | $15,030 | $2,042 | $2,176 |
| Complex GI ProceduresAPC 5331 | 109 | 75 | $28,003 | $3,494 | $4,263 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 108 | 107 | $161,572 | $26,052 | $26,719 |
| Level 3 Intraocular ProceduresAPC 5493 | 98 | 83 | $26,815 | $3,756 | $4,004 |
| Level 6 Urology and Related ServicesAPC 5376 | 94 | 91 | $43,490 | $6,566 | $7,291 |
| Level 2 Endovascular ProceduresAPC 5192 | 90 | 80 | $32,174 | $4,016 | $4,338 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 87 | 87 | $62,240 | $7,989 | $8,569 |
| Level 4 Endovascular ProceduresAPC 5194 | 82 | 79 | $83,630 | $13,980 | $14,606 |
| Level 5 Gynecologic ProceduresAPC 5415 | 82 | 56 | $20,478 | $3,444 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 77 | 66 | $21,212 | $2,609 | $2,888 |
| Level 7 Radiation TherapyAPC 5627 | 77 | 66 | $22,998 | $5,378 | $6,121 |
| Level 4 Gynecologic ProceduresAPC 5414 | 74 | 69 | $15,644 | $2,184 | $2,389 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 73 | 65 | $25,736 | $2,779 | $2,969 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 68 | 44 | $35,941 | $4,090 | $4,524 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 67 | 66 | $203,250 | $27,311 | $29,375 |
| Level 6 Gynecologic ProceduresAPC 5416 | 67 | 63 | $25,418 | $5,345 | $5,836 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 62 | 62 | $42,018 | $6,068 | $6,514 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 61 | 60 | $10,921 | $1,117 | $1,196 |
| Level 4 ENT ProceduresAPC 5164 | 57 | 33 | $11,316 | $1,258 | $2,217 |
| Level 2 Vascular ProceduresAPC 5182 | 56 | 56 | $4,690 | $1,151 | $1,204 |
| Level 8 Urology and Related ServicesAPC 5378 | 56 | 56 | $100,768 | $15,436 | $17,428 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 53 | 50 | $51,300 | $10,632 | $11,550 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 51 | 50 | $114,145 | $15,905 | $17,052 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 36 | 36 | $132,626 | $18,052 | $18,465 |
| Cochlear Implant ProcedureAPC 5166 | 31 | 31 | $164,817 | $28,526 | $29,489 |
| Level 3 ENT ProceduresAPC 5163 | 29 | 25 | $10,165 | $1,058 | $1,106 |
| Level 2 Nerve ProceduresAPC 5432 | 27 | 21 | $32,647 | $3,897 | $4,674 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 26 | 26 | $144,759 | $24,510 | $26,955 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 17 | 17 | $155,159 | $19,576 | $21,011 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 16 | 16 | $16,710 | $2,445 | $2,547 |
| Level 7 Urology and Related ServicesAPC 5377 | 12 | 12 | $57,253 | $9,932 | $10,388 |
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.