Ecu Health Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Ecu Health Medical Center, Greenville, NC in 2024, from traditional Medicare claims. Back to the Ecu Health Medical Center profile, with quality ratings, finances and negotiated rates.
8,313
Medicare inpatient discharges
In 211 published DRGs
2.10
Case mix index
IPPS FY 2027
30%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
6,662
Medicare outpatient services
In 50 service groups
Inpatient stays by major diagnostic category
Circulatory system2,329 discharges in 50 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 471 | $32,435 | $9,404 | $11,677 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 166 | $79,743 | $22,689 | $28,707 | 3.24 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 123 | $21,577 | $5,362 | $7,768 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 102 | $51,930 | $11,347 | $18,695 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 90 | $144,877 | $34,076 | $52,156 | 4.88 |
| Syncope and collapseMS-DRG 312, medical | 74 | $29,364 | $6,337 | $10,571 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 72 | $34,434 | $8,400 | $12,396 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 68 | $58,190 | $15,466 | $20,948 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 65 | $72,182 | $12,722 | $25,986 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 60 | $43,717 | $7,877 | $15,738 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 56 | $37,931 | $6,564 | $13,655 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 51 | $63,193 | $16,485 | $22,749 | 2.09 |
| Hypertension without MCCMS-DRG 305, medical | 50 | $23,574 | $5,221 | $8,487 | 0.75 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 43 | $79,225 | $25,667 | $28,521 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 39 | $75,948 | $18,507 | $27,341 | 2.55 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 36 | $101,781 | $25,787 | $36,641 | 4.04 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 36 | $152,749 | $32,824 | $54,989 | 4.16 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 33 | $111,185 | $22,037 | $40,027 | 2.87 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 32 | $55,500 | $14,139 | $19,980 | 1.97 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 30 | $204,496 | $51,009 | $73,619 | 7.71 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 30 | $73,229 | $23,308 | $26,362 | 3.18 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 30 | $114,743 | $34,254 | $41,308 | 5.88 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 29 | $71,128 | $24,028 | $25,606 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 29 | $55,013 | $16,460 | $19,805 | 2.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 28 | $172,485 | $44,564 | $62,095 | 6.25 |
| Chest painMS-DRG 313, medical | 27 | $23,404 | $5,178 | $8,425 | 0.72 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 26 | $44,189 | $13,129 | $15,908 | 1.83 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 26 | $93,969 | $25,118 | $33,829 | 3.46 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 26 | $28,924 | $7,155 | $10,413 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 25 | $176,206 | $46,846 | $63,434 | 7.80 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 25 | $116,653 | $27,755 | $41,995 | 4.14 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 24 | $144,279 | $37,103 | $51,940 | 5.20 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 22 | $105,097 | $35,490 | $37,835 | 5.04 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 22 | $77,617 | $21,478 | $27,942 | 3.27 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 22 | $25,550 | $6,785 | $9,198 | 1.07 |
| Atherosclerosis without MCCMS-DRG 303, medical | 22 | $25,587 | $4,661 | $9,211 | 0.66 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 21 | $46,418 | $12,392 | $16,711 | 1.58 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 21 | $16,084 | $3,240 | $5,790 | 0.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 19 | $125,945 | $37,574 | $45,340 | 5.06 |
| Heart failure and shock with CCMS-DRG 292, medical | 19 | $26,345 | $7,741 | $9,484 | 0.86 |
| Hypertension with MCCMS-DRG 304, medical | 17 | $23,734 | $8,328 | $8,544 | 1.15 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 17 | $114,746 | $22,137 | $41,309 | 2.97 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 16 | $107,749 | $30,725 | $38,790 | 4.81 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $109,625 | $28,500 | $39,465 | 3.90 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 15 | $134,052 | $42,225 | $48,259 | 6.21 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 13 | $43,995 | $4,686 | $15,838 | 0.72 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 12 | $42,768 | $17,846 | $15,396 | 2.81 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 12 | $190,212 | $51,722 | $68,476 | 7.04 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 221, surgical | 11 | $179,555 | $42,808 | $64,640 | 4.65 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 11 | $48,542 | $12,626 | $17,475 | 1.74 |
Nervous system933 discharges in 28 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 162 | $60,283 | $14,454 | $21,702 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 107 | $38,579 | $7,275 | $13,888 | 1.02 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 58 | $34,597 | $9,848 | $12,455 | 1.36 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 44 | $40,867 | $9,692 | $14,712 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 43 | $139,938 | $38,987 | $50,378 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 42 | $77,981 | $14,979 | $28,073 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 40 | $130,406 | $32,267 | $46,946 | 4.42 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 38 | $47,607 | $16,443 | $17,139 | 2.28 |
| Seizures without MCCMS-DRG 101, medical | 36 | $31,199 | $6,196 | $11,232 | 0.91 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 32 | $46,078 | $10,469 | $16,588 | 1.47 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 28 | $32,733 | $5,515 | $11,784 | 0.80 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 24 | $71,484 | $16,275 | $25,734 | 2.23 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 24 | $32,190 | $7,834 | $11,588 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 23 | $47,781 | $12,451 | $17,201 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 20 | $29,022 | $8,113 | $10,448 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $50,183 | $14,843 | $18,066 | 2.39 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 19 | $55,286 | $13,524 | $19,903 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 19 | $34,046 | $7,548 | $12,257 | 1.06 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 19 | $46,500 | $10,834 | $16,740 | 1.51 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 18 | $27,126 | $4,181 | $9,765 | 0.69 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 18 | $47,587 | $9,131 | $17,131 | 1.32 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 17 | $31,704 | $8,053 | $11,414 | 1.14 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 17 | $135,957 | $29,380 | $48,945 | 3.85 |
| Extracranial procedures with CCMS-DRG 038, surgical | 16 | $48,000 | $11,585 | $17,280 | 1.60 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 15 | $113,577 | $24,086 | $40,888 | 3.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $87,672 | $22,337 | $31,562 | 2.95 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $80,563 | $14,292 | $29,003 | 2.43 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $53,634 | $14,875 | $19,308 | 2.27 |
Infectious and parasitic diseases881 discharges in 9 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 | 585 | $54,036 | $14,329 | $19,453 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 92 | $26,968 | $7,115 | $9,709 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 90 | $121,828 | $37,251 | $43,858 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 40 | $191,164 | $55,258 | $68,819 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 27 | $41,257 | $13,373 | $14,853 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 13 | $43,215 | $12,822 | $15,558 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $27,842 | $7,653 | $10,023 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 11 | $49,784 | $15,819 | $17,922 | 2.14 |
| Other infectious and parasitic diseases diagnoses with MCCMS-DRG 867, medical | 11 | $44,446 | $15,895 | $16,001 | 2.09 |
Respiratory system857 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 114 | $44,877 | $11,469 | $16,156 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 86 | $29,512 | $7,753 | $10,624 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 73 | $23,450 | $5,931 | $8,442 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 67 | $37,999 | $8,931 | $13,680 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 64 | $29,972 | $9,363 | $10,790 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 48 | $24,916 | $7,097 | $8,970 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 46 | $21,247 | $6,105 | $7,649 | 0.85 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 46 | $76,977 | $19,653 | $27,712 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 43 | $50,033 | $9,409 | $18,012 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 40 | $60,442 | $15,857 | $21,759 | 2.55 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 31 | $26,027 | $5,531 | $9,370 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 27 | $24,689 | $7,451 | $8,888 | 1.05 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 24 | $23,212 | $6,566 | $8,356 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 21 | $58,748 | $12,116 | $21,149 | 1.88 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 21 | $96,067 | $31,249 | $34,584 | 4.06 |
| Major chest procedures with MCCMS-DRG 163, surgical | 19 | $122,781 | $37,197 | $44,201 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 19 | $77,124 | $16,336 | $27,765 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 15 | $44,729 | $11,748 | $16,102 | 1.55 |
| Major chest trauma with MCCMS-DRG 183, medical | 14 | $27,557 | $11,404 | $9,921 | 1.57 |
| Pneumothorax with CCMS-DRG 200, medical | 14 | $32,445 | $7,696 | $11,680 | 1.08 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $146,544 | $50,106 | $52,756 | 6.91 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 11 | $22,273 | $5,796 | $8,018 | 0.91 |
Digestive system720 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 110 | $26,561 | $7,174 | $9,562 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 84 | $24,316 | $5,670 | $8,754 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 74 | $52,350 | $12,596 | $18,846 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 62 | $68,774 | $15,784 | $24,759 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 61 | $38,522 | $10,156 | $13,868 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 38 | $28,662 | $6,533 | $10,318 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 36 | $20,477 | $5,745 | $7,372 | 0.80 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 31 | $50,429 | $12,109 | $18,154 | 1.67 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 31 | $51,691 | $12,399 | $18,609 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 27 | $97,530 | $28,538 | $35,111 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $29,617 | $7,593 | $10,662 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 19 | $49,253 | $10,295 | $17,731 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $56,973 | $11,244 | $20,510 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 18 | $38,485 | $8,930 | $13,855 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 18 | $17,986 | $4,153 | $6,475 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 17 | $153,702 | $42,097 | $55,333 | 5.08 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 14 | $128,688 | $31,614 | $46,328 | 4.28 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 14 | $51,058 | $14,400 | $18,381 | 1.95 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 12 | $71,269 | $17,444 | $25,657 | 2.50 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $90,473 | $20,697 | $32,570 | 2.11 |
Kidney and urinary tract697 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 124 | $37,233 | $11,414 | $13,404 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 110 | $31,338 | $8,336 | $11,282 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 76 | $21,992 | $5,457 | $7,917 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 68 | $28,235 | $7,205 | $10,165 | 1.02 |
| Renal failure with CCMS-DRG 683, medical | 64 | $23,301 | $6,389 | $8,388 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 58 | $33,438 | $10,642 | $12,038 | 1.50 |
| Kidney transplantMS-DRG 652, surgical | 51 | $164,915 | $20,696 | $59,369 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 29 | $37,186 | $9,417 | $13,387 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 24 | $83,288 | $22,798 | $29,984 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 22 | $58,525 | $10,741 | $21,069 | 1.84 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 17 | $199,754 | $30,079 | $71,912 | 4.50 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 17 | $75,745 | $28,504 | $27,268 | 3.70 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 13 | $37,874 | $9,802 | $13,635 | 1.48 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 13 | $67,693 | $18,340 | $24,370 | 2.38 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 11 | $31,468 | $6,368 | $11,328 | 1.05 |
Musculoskeletal system and connective tissue620 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 107 | $62,946 | $14,561 | $22,660 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 78 | $29,008 | $6,857 | $10,443 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 61 | $56,177 | $13,228 | $20,224 | 1.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 42 | $72,217 | $16,251 | $25,998 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 40 | $68,818 | $14,858 | $24,774 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 33 | $83,819 | $20,609 | $30,175 | 2.95 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 32 | $111,371 | $24,981 | $40,094 | 3.49 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 29 | $95,245 | $19,311 | $34,288 | 2.67 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 26 | $74,239 | $21,040 | $26,726 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 26 | $56,577 | $11,347 | $20,368 | 1.70 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 21 | $44,389 | $10,784 | $15,980 | 1.59 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 19 | $86,107 | $18,949 | $30,998 | 2.96 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 18 | $33,478 | $8,017 | $12,052 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 18 | $34,985 | $5,529 | $12,595 | 0.90 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $24,256 | $5,642 | $8,732 | 0.79 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 15 | $39,182 | $5,237 | $14,105 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $32,753 | $7,231 | $11,791 | 1.00 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 13 | $46,747 | $17,524 | $16,829 | 2.38 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 11 | $48,213 | $13,502 | $17,357 | 1.74 |
Endocrine, nutritional and metabolic408 discharges in 8 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 | $34,389 | $9,818 | $12,380 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 90 | $27,808 | $5,627 | $10,011 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 71 | $24,342 | $6,577 | $8,763 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 56 | $38,016 | $10,165 | $13,686 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 30 | $40,793 | $13,611 | $14,685 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 13 | $26,158 | $7,996 | $9,417 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $41,938 | $10,780 | $15,098 | 1.65 |
| Other endocrine, nutritional and metabolic o.r. procedures with MCCMS-DRG 628, surgical | 11 | $88,888 | $26,430 | $32,000 | 4.01 |
Liver, gallbladder and pancreas226 discharges in 12 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 | $57,803 | $11,668 | $20,809 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 30 | $36,310 | $7,759 | $13,072 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 25 | $60,115 | $14,750 | $21,642 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 24 | $44,623 | $10,704 | $16,064 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 17 | $84,854 | $17,664 | $30,547 | 2.32 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 17 | $47,152 | $12,440 | $16,975 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $29,323 | $6,016 | $10,556 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 16 | $51,881 | $12,820 | $18,677 | 1.83 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $44,053 | $12,377 | $15,859 | 1.67 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 11 | $92,394 | $19,317 | $33,262 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 11 | $47,723 | $8,530 | $17,180 | 1.31 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $38,059 | $7,971 | $13,701 | 1.03 |
Blood and immune system132 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 | 49 | $26,698 | $6,767 | $9,611 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 32 | $45,128 | $16,457 | $16,246 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 30 | $35,252 | $9,605 | $12,691 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 21 | $46,272 | $9,244 | $16,658 | 1.20 |
Injuries, poisonings and toxic effects of drugs105 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 29 | $40,521 | $10,078 | $14,588 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 29 | $42,440 | $14,330 | $15,278 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 19 | $85,078 | $25,961 | $30,628 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 15 | $78,914 | $18,700 | $28,409 | 2.00 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $38,254 | $7,587 | $13,771 | 1.03 |
Skin, subcutaneous tissue and breast93 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 68 | $25,032 | $5,919 | $9,012 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 13 | $27,071 | $10,211 | $9,746 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 12 | $37,830 | $6,534 | $13,619 | 0.91 |
Other81 discharges in 3 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 | 44 | $123,871 | $36,970 | $44,594 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 23 | $75,937 | $23,966 | $27,337 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $68,635 | $15,873 | $24,709 | 2.49 |
Factors influencing health status65 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 28 | $15,671 | $4,566 | $5,642 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 26 | $29,562 | $5,626 | $10,642 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 11 | $33,556 | $8,825 | $12,080 | 1.25 |
Multiple significant trauma45 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 20 | $166,328 | $41,995 | $59,878 | 3.88 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 14 | $46,295 | $9,692 | $16,666 | 1.50 |
| Other o.r. procedures for multiple significant trauma with CCMS-DRG 958, surgical | 11 | $138,510 | $37,602 | $49,864 | 4.04 |
Mental diseases and disorders42 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 | 28 | $33,606 | $11,805 | $12,098 | 1.76 |
| PsychosesMS-DRG 885, medical | 14 | $46,203 | $7,466 | $16,633 | 1.37 |
Transplants, ECMO and tracheostomy (pre-MDC)41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 24 | $354,688 | $138,472 | $127,688 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 17 | $236,461 | $89,639 | $85,126 | 14.70 |
Blood cancers and poorly differentiated neoplasms24 discharges in 2 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 | 13 | $42,405 | $5,990 | $15,266 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 11 | $95,497 | $24,124 | $34,379 | 3.13 |
Alcohol and drug use14 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 | 14 | $20,631 | $6,494 | $7,427 | 0.86 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 985 | 923 | $17,158 | $1,871 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 469 | 467 | $21,149 | $1,998 | $2,208 |
| Level 1 Intraocular ProceduresAPC 5491 | 424 | 236 | $10,023 | $1,596 | $1,752 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 354 | 337 | $43,039 | $9,731 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 331 | 305 | $10,360 | $1,093 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 294 | 210 | $9,436 | $1,318 | $1,516 |
| Level 2 Upper GI ProceduresAPC 5302 | 273 | 245 | $8,088 | $1,308 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 255 | 248 | $20,485 | $3,951 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 206 | 196 | $19,875 | $3,553 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 200 | 196 | $12,322 | $2,198 | $2,405 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 194 | 194 | $39,680 | $7,208 | $8,164 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 173 | 169 | $102,364 | $18,873 | $21,117 |
| Level 4 Urology and Related ServicesAPC 5374 | 164 | 132 | $13,028 | $2,417 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 153 | 137 | $5,031 | $1,321 | $1,407 |
| Level 4 Vascular ProceduresAPC 5184 | 145 | 114 | $20,821 | $3,448 | $3,946 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 144 | 142 | $27,346 | $4,787 | $5,339 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 140 | 129 | $15,786 | $2,364 | $2,636 |
| Level 3 Endovascular ProceduresAPC 5193 | 124 | 118 | $44,865 | $7,899 | $8,874 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 113 | 111 | $29,159 | $7,649 | $8,569 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 93 | 82 | $84,256 | $22,591 | $26,719 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 82 | 79 | $8,148 | $1,101 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 76 | 75 | $59,041 | $14,167 | $15,763 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 75 | 70 | $18,544 | $1,919 | $2,141 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 66 | 66 | $37,236 | $5,797 | $6,514 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 65 | 63 | $16,901 | $2,175 | $2,373 |
| Level 4 Airway EndoscopyAPC 5154 | 62 | 61 | $10,662 | $2,596 | $2,833 |
| Level 5 Airway EndoscopyAPC 5155 | 61 | 60 | $18,507 | $4,745 | $5,183 |
| Level 2 Endovascular ProceduresAPC 5192 | 60 | 60 | $31,093 | $3,633 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 60 | 55 | $8,382 | $1,905 | $2,176 |
| Level 4 Gynecologic ProceduresAPC 5414 | 57 | 57 | $14,074 | $2,126 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 55 | 52 | $9,641 | $1,090 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 55 | 54 | $68,762 | $26,567 | $29,375 |
| Level 3 Upper GI ProceduresAPC 5303 | 55 | 54 | $18,736 | $2,603 | $2,888 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 53 | 51 | $30,781 | $4,521 | $4,982 |
| Complex GI ProceduresAPC 5331 | 52 | 42 | $24,174 | $3,572 | $4,263 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 45 | 45 | $22,436 | $5,168 | $5,682 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 43 | 39 | $24,066 | $2,643 | $2,930 |
| Level 3 Airway EndoscopyAPC 5153 | 42 | 32 | $6,257 | $1,173 | $1,264 |
| Level 7 Radiation TherapyAPC 5627 | 42 | 35 | $77,586 | $5,399 | $6,121 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 41 | 40 | $48,370 | $15,288 | $17,052 |
| Level 5 Gynecologic ProceduresAPC 5415 | 40 | 40 | $20,515 | $3,319 | $3,792 |
| Level 4 Endovascular ProceduresAPC 5194 | 35 | 30 | $57,946 | $12,432 | $14,606 |
| Level 5 ENT ProceduresAPC 5165 | 33 | 31 | $29,889 | $3,937 | $4,436 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 33 | 27 | $22,063 | $4,454 | $4,524 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 33 | 32 | $76,989 | $17,360 | $18,465 |
| Level 2 Urology and Related ServicesAPC 5372 | 28 | 23 | $4,252 | $457 | $502 |
| Level 6 Urology and Related ServicesAPC 5376 | 26 | 25 | $30,612 | $6,387 | $7,291 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 23 | 23 | $56,243 | $18,797 | $21,011 |
| Level 8 Urology and Related ServicesAPC 5378 | 15 | 14 | $71,080 | $15,883 | $17,428 |
| Level 2 Intraocular ProceduresAPC 5492 | 15 | 14 | $25,418 | $2,819 | $3,116 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.