Elkhart General Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Elkhart General Hospital, Elkhart, IN in 2024, from traditional Medicare claims. Back to the Elkhart General Hospital profile, with quality ratings, finances and negotiated rates.
1,724
Medicare inpatient discharges
In 64 published DRGs
1.81
Case mix index
IPPS FY 2027
17%
Surgical stays
59%
Stays with complications
In DRGs with a CC or MCC
1,542
Medicare outpatient services
In 31 service groups
Inpatient stays by major diagnostic category
Circulatory system508 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 95 | $36,714 | $8,477 | $8,187 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 41 | $27,872 | $4,670 | $6,215 | 0.74 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 36 | $157,262 | $21,356 | $35,069 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 36 | $41,343 | $6,535 | $9,219 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 34 | $166,201 | $33,478 | $37,063 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 34 | $47,225 | $10,892 | $10,531 | 1.59 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 27 | $192,098 | $33,150 | $42,838 | 5.24 |
| Syncope and collapseMS-DRG 312, medical | 24 | $29,265 | $5,922 | $6,526 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $92,235 | $11,920 | $20,568 | 1.82 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 22 | $143,461 | $28,204 | $31,992 | 4.04 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 22 | $43,745 | $8,191 | $9,755 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $38,473 | $5,645 | $8,580 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 16 | $20,608 | $2,982 | $4,596 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 14 | $58,175 | $14,596 | $12,973 | 2.16 |
| Hypertension without MCCMS-DRG 305, medical | 14 | $21,915 | $4,773 | $4,887 | 0.75 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 14 | $134,818 | $19,628 | $30,064 | 2.87 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $126,576 | $34,978 | $28,226 | 5.06 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 11 | $228,771 | $44,010 | $51,016 | 6.25 |
| Chest painMS-DRG 313, medical | 11 | $23,651 | $4,727 | $5,274 | 0.72 |
Respiratory system336 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 93 | $52,202 | $8,055 | $11,641 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 48 | $28,174 | $5,154 | $6,283 | 0.82 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 45 | $50,555 | $10,883 | $11,274 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 41 | $48,296 | $8,736 | $10,770 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 22 | $36,651 | $7,202 | $8,173 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 22 | $29,310 | $5,587 | $6,536 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 18 | $26,091 | $4,511 | $5,818 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 17 | $33,497 | $5,885 | $7,470 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 17 | $25,634 | $6,205 | $5,716 | 0.96 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 13 | $47,529 | $9,051 | $10,599 | 1.40 |
Infectious and parasitic diseases178 discharges in 3 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 | 131 | $65,959 | $13,364 | $14,709 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 31 | $33,103 | $6,305 | $7,382 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 16 | $141,613 | $32,116 | $31,580 | 5.00 |
Nervous system175 discharges in 9 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 | 49 | $30,014 | $6,520 | $6,693 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 27 | $55,071 | $12,987 | $12,281 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 22 | $24,287 | $4,876 | $5,416 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 17 | $31,265 | $5,877 | $6,972 | 0.91 |
| Extracranial procedures with CCMS-DRG 038, surgical | 13 | $39,639 | $10,857 | $8,840 | 1.60 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $36,196 | $6,662 | $8,072 | 1.06 |
| Seizures with MCCMS-DRG 100, medical | 12 | $58,653 | $13,597 | $13,080 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 11 | $21,615 | $3,529 | $4,820 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 11 | $28,875 | $9,067 | $6,439 | 1.36 |
Kidney and urinary tract160 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 65 | $25,160 | $5,050 | $5,611 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 32 | $34,379 | $7,482 | $7,666 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 28 | $42,343 | $9,826 | $9,443 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 23 | $30,513 | $5,986 | $6,804 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 12 | $39,121 | $10,641 | $8,724 | 1.65 |
Digestive system119 discharges in 5 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 | 43 | $22,990 | $4,756 | $5,127 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 30 | $47,378 | $6,538 | $10,565 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 20 | $46,820 | $11,996 | $10,441 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 15 | $44,344 | $8,019 | $9,889 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 11 | $74,605 | $16,424 | $16,637 | 2.37 |
Musculoskeletal system and connective tissue96 discharges in 6 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 | 23 | $76,163 | $12,949 | $16,984 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 21 | $82,017 | $14,299 | $18,290 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 17 | $26,045 | $5,963 | $5,808 | 0.97 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 12 | $115,886 | $18,697 | $25,843 | 2.67 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 12 | $24,820 | $5,598 | $5,535 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 11 | $97,342 | $18,754 | $21,707 | 2.99 |
Endocrine, nutritional and metabolic54 discharges in 2 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 | 28 | $21,625 | $5,033 | $4,822 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 26 | $31,541 | $8,411 | $7,034 | 1.32 |
Skin, subcutaneous tissue and breast53 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 42 | $25,936 | $5,265 | $5,784 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 11 | $36,694 | $9,691 | $8,183 | 1.49 |
Blood and immune system17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 17 | $23,546 | $6,018 | $5,251 | 0.90 |
Factors influencing health status16 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 | 16 | $25,873 | $5,541 | $5,770 | 0.80 |
Liver, gallbladder and pancreas12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 12 | $27,209 | $5,130 | $6,068 | 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 | 333 | 311 | $13,218 | $1,987 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 205 | 192 | $8,750 | $1,183 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 174 | 172 | $18,705 | $2,150 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 79 | 78 | $74,355 | $10,505 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 69 | 69 | $24,781 | $3,999 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 63 | 57 | $67,612 | $8,516 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 48 | 46 | $158,834 | $20,243 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 44 | 44 | $15,213 | $2,292 | $2,405 |
| Level 5 Airway EndoscopyAPC 5155 | 41 | 41 | $38,973 | $5,036 | $5,183 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 39 | 39 | $11,378 | $2,037 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 39 | 38 | $45,342 | $5,264 | $5,339 |
| Level 4 Endovascular ProceduresAPC 5194 | 34 | 33 | $120,036 | $14,519 | $14,606 |
| Level 3 Urology and Related ServicesAPC 5373 | 34 | 12 | $7,802 | $1,499 | $1,516 |
| Level 4 Airway EndoscopyAPC 5154 | 30 | 30 | $20,430 | $2,755 | $2,833 |
| Level 5 Urology and Related ServicesAPC 5375 | 29 | 26 | $22,042 | $3,800 | $3,918 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 28 | 25 | $14,542 | $2,381 | $2,373 |
| Level 2 Upper GI ProceduresAPC 5302 | 27 | 25 | $10,169 | $1,406 | $1,445 |
| Level 2 Vascular ProceduresAPC 5182 | 26 | 25 | $25,167 | $1,178 | $1,204 |
| Level 4 Urology and Related ServicesAPC 5374 | 20 | 18 | $15,496 | $2,565 | $2,629 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 19 | 18 | $103,023 | $13,904 | $15,763 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 19 | 19 | $45,765 | $6,229 | $6,514 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 19 | 19 | $46,459 | $8,221 | $8,569 |
| Level 5 ENT ProceduresAPC 5165 | 17 | 17 | $29,256 | $4,309 | $4,436 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 16 | 16 | $176,355 | $26,959 | $26,719 |
| Level 3 Lower GI ProceduresAPC 5313 | 15 | 15 | $7,182 | $2,152 | $2,176 |
| Level 3 Airway EndoscopyAPC 5153 | 14 | 13 | $12,981 | $1,249 | $1,264 |
| Level 2 Endovascular ProceduresAPC 5192 | 13 | 13 | $35,571 | $4,203 | $4,338 |
| Level 1 Nerve ProceduresAPC 5431 | 13 | 11 | $6,572 | $1,421 | $1,407 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 12 | 12 | $28,528 | $4,798 | $4,982 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 12 | 12 | $15,036 | $2,322 | $2,636 |
| Level 4 ENT ProceduresAPC 5164 | 11 | 11 | $15,516 | $2,153 | $2,217 |
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.