Eisenhower Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Eisenhower Medical Center, Rancho Mirage, CA in 2024, from traditional Medicare claims. Back to the Eisenhower Medical Center profile, with quality ratings, finances and negotiated rates.
6,751
Medicare inpatient discharges
In 157 published DRGs
2.01
Case mix index
IPPS FY 2027
32%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
12,534
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,683 discharges in 34 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 314 | $76,104 | $12,292 | $13,014 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 173 | $111,765 | $33,386 | $19,112 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 132 | $181,540 | $66,003 | $31,043 | 6.25 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 111 | $149,203 | $51,546 | $25,514 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 98 | $91,794 | $14,898 | $15,697 | 1.59 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 96 | $133,147 | $33,148 | $22,768 | 3.18 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 77 | $60,194 | $6,677 | $10,293 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 65 | $129,029 | $17,990 | $22,064 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 53 | $79,424 | $11,642 | $13,582 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 44 | $69,280 | $8,653 | $11,847 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 40 | $146,141 | $20,277 | $24,990 | 2.16 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 38 | $115,933 | $40,262 | $19,825 | 3.90 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 36 | $195,168 | $53,904 | $33,374 | 5.04 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 35 | $132,172 | $19,597 | $22,601 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 35 | $167,324 | $29,011 | $28,612 | 2.87 |
| Hypertension without MCCMS-DRG 305, medical | 30 | $67,757 | $7,039 | $11,586 | 0.75 |
| Syncope and collapseMS-DRG 312, medical | 29 | $58,888 | $8,257 | $10,070 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 28 | $44,640 | $4,426 | $7,633 | 0.55 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 24 | $54,992 | $6,222 | $9,404 | 0.72 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 24 | $83,004 | $10,511 | $14,194 | 1.08 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 18 | $192,135 | $37,873 | $32,855 | 4.04 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 18 | $168,464 | $33,647 | $28,807 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 17 | $155,886 | $26,524 | $26,656 | 2.55 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 17 | $101,558 | $15,345 | $17,366 | 1.58 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $57,475 | $10,171 | $9,828 | 1.07 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 16 | $180,170 | $31,375 | $30,809 | 2.97 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $134,538 | $36,505 | $23,006 | 3.46 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 13 | $280,184 | $54,242 | $47,912 | 5.24 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 13 | $120,239 | $23,268 | $20,561 | 2.28 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 13 | $55,841 | $9,707 | $9,549 | 0.97 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 12 | $201,521 | $43,828 | $34,460 | 4.14 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 11 | $344,330 | $69,221 | $58,880 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $182,974 | $43,890 | $31,289 | 4.16 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $67,727 | $10,870 | $11,581 | 1.15 |
Infectious and parasitic diseases1,157 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 | 779 | $118,242 | $18,658 | $20,219 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 214 | $65,207 | $9,293 | $11,150 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 87 | $246,346 | $46,028 | $42,125 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 39 | $138,303 | $19,946 | $23,650 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $126,551 | $19,276 | $21,640 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 12 | $103,712 | $18,476 | $17,735 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 12 | $459,469 | $76,545 | $78,569 | 6.96 |
Digestive system776 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 134 | $68,682 | $9,100 | $11,745 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 91 | $60,890 | $6,904 | $10,412 | 0.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 87 | $50,254 | $7,266 | $8,593 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 76 | $185,526 | $23,793 | $31,725 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 49 | $97,814 | $17,435 | $16,726 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 42 | $232,620 | $41,960 | $39,778 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 38 | $85,921 | $9,245 | $14,692 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 33 | $59,583 | $9,614 | $10,189 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 30 | $125,606 | $16,229 | $21,479 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 26 | $66,008 | $14,442 | $11,287 | 1.45 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 25 | $38,081 | $4,646 | $6,512 | 0.56 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 24 | $83,414 | $12,583 | $14,264 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 21 | $94,514 | $16,892 | $16,162 | 1.62 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 17 | $138,867 | $25,413 | $23,746 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $108,889 | $17,486 | $18,620 | 1.75 |
| Appendix procedures with CCMS-DRG 398, surgical | 16 | $108,522 | $14,096 | $18,557 | 1.51 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 13 | $114,067 | $15,815 | $19,505 | 1.60 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 13 | $173,217 | $20,498 | $29,620 | 2.11 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 12 | $131,223 | $22,873 | $22,439 | 2.20 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $77,370 | $10,800 | $13,230 | 1.20 |
Musculoskeletal system and connective tissue690 discharges in 20 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 | 146 | $87,547 | $18,552 | $14,970 | 1.88 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 73 | $107,187 | $19,753 | $18,329 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 67 | $178,913 | $36,697 | $30,594 | 3.66 |
| Medical back problems without MCCMS-DRG 552, medical | 54 | $62,110 | $8,657 | $10,621 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 53 | $115,349 | $18,538 | $19,725 | 2.07 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 35 | $42,825 | $7,163 | $7,323 | 0.79 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 25 | $119,290 | $23,506 | $20,399 | 2.38 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 25 | $102,679 | $14,608 | $17,558 | 1.59 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 24 | $97,399 | $25,134 | $16,655 | 2.67 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 23 | $224,998 | $46,543 | $38,475 | 4.61 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 23 | $161,453 | $30,451 | $27,609 | 2.96 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 23 | $186,988 | $26,331 | $31,975 | 2.48 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 21 | $179,248 | $31,379 | $30,651 | 3.49 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 17 | $45,600 | $7,989 | $7,798 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $160,403 | $27,185 | $27,429 | 2.99 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 14 | $156,441 | $26,045 | $26,751 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 14 | $123,557 | $23,135 | $21,128 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 14 | $60,766 | $9,535 | $10,391 | 1.09 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 12 | $283,166 | $65,088 | $48,421 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 12 | $87,469 | $19,474 | $14,957 | 2.04 |
Respiratory system587 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 126 | $73,930 | $12,084 | $12,642 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 81 | $95,185 | $15,353 | $16,277 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 56 | $77,884 | $10,404 | $13,318 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 49 | $73,874 | $12,521 | $12,632 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 45 | $67,734 | $7,365 | $11,583 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 34 | $95,225 | $12,938 | $16,284 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 31 | $235,796 | $30,427 | $40,321 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 27 | $127,883 | $25,237 | $21,868 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 22 | $80,925 | $9,008 | $13,838 | 0.99 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 17 | $85,656 | $17,842 | $14,647 | 1.88 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 16 | $239,972 | $42,417 | $41,035 | 4.06 |
| Pleural effusion with MCCMS-DRG 186, medical | 16 | $86,937 | $13,577 | $14,866 | 1.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 15 | $91,589 | $18,285 | $15,662 | 1.74 |
| Pneumothorax with CCMS-DRG 200, medical | 15 | $60,566 | $10,445 | $10,357 | 1.08 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 14 | $52,381 | $7,144 | $8,957 | 0.82 |
| Major chest procedures with MCCMS-DRG 163, surgical | 12 | $238,367 | $49,504 | $40,761 | 4.71 |
| Major chest trauma with CCMS-DRG 184, medical | 11 | $55,000 | $9,932 | $9,405 | 1.05 |
Nervous system539 discharges in 18 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 | 108 | $68,485 | $9,380 | $11,711 | 1.02 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 84 | $83,722 | $18,831 | $14,316 | 1.81 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 58 | $111,087 | $19,298 | $18,996 | 2.00 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 28 | $85,144 | $24,170 | $14,560 | 2.30 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 26 | $281,090 | $42,498 | $48,066 | 4.42 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 25 | $84,044 | $12,708 | $14,371 | 1.32 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 23 | $77,207 | $13,373 | $13,202 | 1.47 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 23 | $79,956 | $9,894 | $13,672 | 1.06 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 22 | $92,913 | $17,018 | $15,888 | 1.79 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 19 | $55,720 | $9,400 | $9,528 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 18 | $72,276 | $12,407 | $12,359 | 1.36 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 18 | $54,756 | $8,271 | $9,363 | 0.89 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 17 | $105,409 | $13,851 | $18,025 | 1.36 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 16 | $52,756 | $6,241 | $9,021 | 0.69 |
| Seizures without MCCMS-DRG 101, medical | 16 | $74,855 | $8,186 | $12,800 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 14 | $105,779 | $18,146 | $18,088 | 1.98 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 13 | $80,209 | $11,482 | $13,716 | 1.14 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 11 | $145,538 | $18,524 | $24,887 | 1.79 |
Kidney and urinary tract485 discharges in 8 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 | 125 | $96,691 | $15,488 | $16,534 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 86 | $60,456 | $8,511 | $10,338 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 86 | $52,198 | $7,274 | $8,926 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 61 | $63,887 | $9,862 | $10,925 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 48 | $108,050 | $14,772 | $18,476 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 44 | $71,777 | $11,246 | $12,274 | 1.17 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 19 | $133,486 | $40,573 | $22,826 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 16 | $74,941 | $12,206 | $12,815 | 1.35 |
Endocrine, nutritional and metabolic308 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 without MCCMS-DRG 641, medical | 94 | $53,256 | $7,046 | $9,107 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 75 | $67,211 | $12,428 | $11,493 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 30 | $58,140 | $8,195 | $9,942 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 30 | $69,170 | $10,254 | $11,828 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 29 | $95,576 | $16,121 | $16,343 | 1.65 |
| Diabetes with MCCMS-DRG 637, medical | 20 | $88,627 | $14,427 | $15,155 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 16 | $94,061 | $16,431 | $16,084 | 1.98 |
| Endocrine disorders without cc/mccMS-DRG 645, medical | 14 | $63,463 | $6,220 | $10,852 | 0.76 |
Liver, gallbladder and pancreas148 discharges in 8 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 | 27 | $124,792 | $16,396 | $21,340 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 23 | $117,811 | $16,991 | $20,146 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 20 | $137,849 | $23,927 | $23,572 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 18 | $102,015 | $12,714 | $17,444 | 1.31 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 18 | $102,343 | $10,464 | $17,501 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 17 | $61,958 | $7,161 | $10,595 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 13 | $112,250 | $20,103 | $19,195 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 12 | $106,462 | $15,381 | $18,205 | 1.63 |
Blood and immune system96 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 | 39 | $55,689 | $8,659 | $9,523 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 22 | $70,821 | $14,314 | $12,110 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 19 | $75,040 | $14,477 | $12,832 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 16 | $55,296 | $12,095 | $9,456 | 1.20 |
Skin, subcutaneous tissue and breast85 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 72 | $51,675 | $7,715 | $8,836 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 13 | $92,672 | $13,595 | $15,847 | 1.49 |
Injuries, poisonings and toxic effects of drugs63 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 20 | $80,538 | $18,898 | $13,772 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 17 | $97,078 | $15,154 | $16,600 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $204,132 | $38,182 | $34,906 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $62,708 | $9,988 | $10,723 | 1.03 |
Other48 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 | 21 | $240,363 | $49,032 | $41,102 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 15 | $126,581 | $25,041 | $21,645 | 2.49 |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 12 | $148,706 | $31,501 | $25,429 |
Blood cancers and poorly differentiated neoplasms35 discharges in 1 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 | 35 | $55,480 | $12,343 | $9,487 | 1.21 |
Alcohol and drug use19 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 | 19 | $53,685 | $7,619 | $9,180 | 0.86 |
Factors influencing health status17 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 | 17 | $66,907 | $7,251 | $11,441 | 0.80 |
Male reproductive system15 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 | 15 | $116,426 | $13,512 | $19,909 | 1.46 |
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 | 1,845 | 1,675 | $35,768 | $2,670 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 1,714 | 990 | $1,168 | $666 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 883 | 678 | $9,082 | $1,987 | $1,516 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 797 | 770 | $69,986 | $14,388 | $10,772 |
| Level 1 Nerve ProceduresAPC 5431 | 771 | 693 | $12,468 | $1,874 | $1,407 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 539 | 472 | $7,424 | $1,584 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 509 | 505 | $40,794 | $2,872 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 412 | 297 | $13,465 | $3,104 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 389 | 377 | $47,357 | $7,105 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 317 | 314 | $50,524 | $5,597 | $4,358 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 304 | 287 | $9,203 | $1,569 | $1,196 |
| Level 4 Urology and Related ServicesAPC 5374 | 304 | 259 | $22,751 | $3,402 | $2,629 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 280 | 271 | $87,540 | $21,219 | $15,763 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 272 | 262 | $20,980 | $3,170 | $2,373 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 269 | 266 | $16,387 | $2,752 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 265 | 247 | $25,886 | $5,002 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 262 | 236 | $15,762 | $1,855 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 208 | 203 | $139,468 | $27,347 | $21,117 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 200 | 188 | $26,941 | $3,698 | $2,930 |
| Level 5 Airway EndoscopyAPC 5155 | 178 | 166 | $58,492 | $6,743 | $5,183 |
| Level 4 Gynecologic ProceduresAPC 5414 | 172 | 164 | $15,700 | $3,062 | $2,389 |
| Level 3 Endovascular ProceduresAPC 5193 | 169 | 160 | $76,213 | $11,798 | $8,874 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 161 | 155 | $27,641 | $3,346 | $2,636 |
| Level 3 Lower GI ProceduresAPC 5313 | 159 | 150 | $16,799 | $2,424 | $2,176 |
| Level 2 Vascular ProceduresAPC 5182 | 135 | 125 | $8,744 | $1,545 | $1,204 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 111 | 108 | $74,892 | $21,457 | $17,052 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 111 | 111 | $86,391 | $11,004 | $8,164 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 103 | 100 | $50,530 | $6,388 | $4,982 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 90 | 90 | $46,000 | $8,697 | $6,514 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 87 | 87 | $43,809 | $11,474 | $8,569 |
| Level 4 Endovascular ProceduresAPC 5194 | 65 | 55 | $91,884 | $18,037 | $14,606 |
| Level 3 Airway EndoscopyAPC 5153 | 62 | 61 | $9,338 | $1,577 | $1,264 |
| Level 4 Vascular ProceduresAPC 5184 | 50 | 45 | $39,253 | $5,275 | $3,946 |
| Level 2 Endovascular ProceduresAPC 5192 | 46 | 45 | $49,254 | $5,599 | $4,338 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 43 | 43 | $91,837 | $37,784 | $29,375 |
| Level 3 Upper GI ProceduresAPC 5303 | 42 | 39 | $28,819 | $3,757 | $2,888 |
| Level 4 Airway EndoscopyAPC 5154 | 34 | 33 | $24,333 | $3,668 | $2,833 |
| Level 5 Gynecologic ProceduresAPC 5415 | 33 | 32 | $31,693 | $4,872 | $3,792 |
| Level 6 Urology and Related ServicesAPC 5376 | 32 | 32 | $51,575 | $9,378 | $7,291 |
| Level 8 Urology and Related ServicesAPC 5378 | 26 | 23 | $99,647 | $22,211 | $17,428 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 14 | 14 | $43,676 | $9,943 | $7,546 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 13 | 12 | $16,266 | $3,333 | $2,547 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 13 | 13 | $96,683 | $36,422 | $26,719 |
| Level 5 ENT ProceduresAPC 5165 | 12 | 12 | $61,273 | $5,736 | $4,436 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 11 | 11 | $61,072 | $27,249 | $21,011 |
| Complex GI ProceduresAPC 5331 | 11 | 11 | $53,542 | $5,583 | $4,263 |
| Implantation of Drug Infusion DeviceAPC 5471 | 11 | 11 | $78,429 | $20,238 | $14,829 |
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.