Emory University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Emory University Hospital, Atlanta, GA in 2024, from traditional Medicare claims. Back to the Emory University Hospital profile, with quality ratings, finances and negotiated rates.
4,271
Medicare inpatient discharges
In 146 published DRGs
2.95
Case mix index
IPPS FY 2027
32%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
4,365
Medicare outpatient services
In 51 service groups
Inpatient stays by major diagnostic category
Circulatory system795 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 191 | $55,739 | $11,234 | $16,610 | 1.28 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 76 | $77,253 | $15,865 | $23,021 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 45 | $358,050 | $82,024 | $106,699 | 7.71 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 40 | $111,466 | $26,615 | $33,217 | 2.16 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 36 | $59,052 | $24,298 | $17,597 | 3.24 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 36 | $31,677 | $7,664 | $9,440 | 0.97 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 33 | $26,869 | $6,050 | $8,007 | 0.74 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 32 | $126,950 | $28,893 | $37,831 | 3.35 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 32 | $295,651 | $55,280 | $88,104 | 5.06 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 29 | $55,283 | $10,658 | $16,474 | 1.20 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 22 | $73,865 | $15,379 | $22,012 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 20 | $104,855 | $24,867 | $31,247 | 2.87 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 20 | $58,834 | $15,241 | $17,533 | 1.82 |
| Syncope and collapseMS-DRG 312, medical | 19 | $29,424 | $6,999 | $8,768 | 0.86 |
| Other vascular procedures with CCMS-DRG 253, surgical | 17 | $129,960 | $21,056 | $38,728 | 2.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 17 | $46,915 | $8,372 | $13,981 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 16 | $30,398 | $9,052 | $9,059 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 15 | $60,005 | $9,382 | $17,882 | 1.15 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 14 | $233,206 | $48,822 | $69,495 | 5.88 |
| Heart failure and shock with CCMS-DRG 292, medical | 14 | $23,750 | $7,358 | $7,078 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 14 | $23,586 | $4,562 | $7,029 | 0.55 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 12 | $99,649 | $34,866 | $29,695 | 4.16 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 12 | $78,921 | $23,535 | $23,518 | 2.97 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 11 | $189,089 | $32,323 | $56,348 | 4.04 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 11 | $222,691 | $56,974 | $66,362 | 6.25 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 11 | $121,884 | $26,158 | $36,321 | 3.46 |
Kidney and urinary tract557 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 | 93 | $72,243 | $15,620 | $21,529 | 1.65 |
| Kidney transplantMS-DRG 652, surgical | 83 | $173,380 | $23,090 | $51,667 | 3.00 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 80 | $38,104 | $8,733 | $11,355 | 1.02 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 43 | $233,571 | $42,069 | $69,604 | 4.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 40 | $38,097 | $9,634 | $11,353 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 37 | $40,905 | $7,330 | $12,190 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 34 | $51,849 | $12,536 | $15,451 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 31 | $28,670 | $6,959 | $8,544 | 0.81 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 25 | $115,715 | $31,337 | $34,483 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 21 | $125,981 | $22,544 | $37,542 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 20 | $93,329 | $15,438 | $27,812 | 1.84 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 13 | $214,604 | $29,732 | $63,952 | 3.46 |
| Major bladder procedures with CCMS-DRG 654, surgical | 13 | $130,232 | $22,858 | $38,809 | 2.74 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 13 | $65,435 | $12,312 | $19,500 | 1.48 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 11 | $88,401 | $18,392 | $26,344 | 2.38 |
Nervous system516 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 74 | $88,849 | $17,230 | $26,477 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 47 | $51,498 | $8,945 | $15,346 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 45 | $169,080 | $36,520 | $50,386 | 4.42 |
| Seizures without MCCMS-DRG 101, medical | 36 | $34,037 | $7,225 | $10,143 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 30 | $196,419 | $44,118 | $58,533 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 30 | $144,669 | $23,149 | $43,111 | 1.98 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 26 | $121,902 | $19,571 | $36,327 | 2.43 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 26 | $41,366 | $8,234 | $12,327 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 25 | $134,081 | $28,116 | $39,956 | 3.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 25 | $125,458 | $30,345 | $37,386 | 2.39 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 22 | $92,969 | $15,515 | $27,705 | 1.79 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 21 | $49,448 | $10,522 | $14,735 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 21 | $30,652 | $8,608 | $9,134 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 19 | $38,761 | $14,077 | $11,551 | 1.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 18 | $114,869 | $19,094 | $34,231 | 2.95 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 18 | $57,332 | $12,133 | $17,085 | 1.47 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 18 | $62,366 | $14,542 | $18,585 | 1.51 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 15 | $29,607 | $9,145 | $8,823 | 1.06 |
Respiratory system418 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 92 | $74,433 | $15,158 | $22,181 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 42 | $50,801 | $10,803 | $15,139 | 1.33 |
| Major chest procedures with CCMS-DRG 164, surgical | 34 | $94,055 | $18,853 | $28,028 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 34 | $55,969 | $10,655 | $16,679 | 1.40 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 34 | $91,771 | $13,222 | $27,348 | 1.81 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 33 | $68,950 | $10,157 | $20,547 | 1.23 |
| Major chest procedures with MCCMS-DRG 163, surgical | 25 | $229,730 | $45,570 | $68,459 | 4.71 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 25 | $58,747 | $9,144 | $17,507 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 21 | $63,395 | $10,081 | $18,892 | 1.10 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 19 | $34,778 | $6,461 | $10,364 | 0.82 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 18 | $32,939 | $6,507 | $9,816 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 16 | $118,649 | $19,578 | $35,358 | 1.74 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $113,484 | $24,713 | $33,818 | 2.70 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 11 | $65,311 | $14,078 | $19,463 | 1.88 |
Digestive system377 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 46 | $44,221 | $10,795 | $13,178 | 1.28 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 46 | $25,777 | $6,481 | $7,682 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 43 | $71,535 | $14,180 | $21,317 | 1.79 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 40 | $38,283 | $8,061 | $11,408 | 0.94 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 35 | $45,385 | $8,720 | $13,525 | 0.98 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 32 | $113,122 | $21,317 | $33,710 | 2.37 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 29 | $42,313 | $13,543 | $12,609 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 27 | $331,000 | $62,312 | $98,638 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 22 | $27,984 | $6,379 | $8,339 | 0.80 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 18 | $103,734 | $19,159 | $30,913 | 2.50 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 15 | $262,284 | $58,103 | $78,161 | 5.08 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 12 | $31,197 | $8,948 | $9,297 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 12 | $20,052 | $4,293 | $5,975 | 0.56 |
Infectious and parasitic diseases351 discharges in 6 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 | 232 | $86,861 | $17,055 | $25,885 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 43 | $34,374 | $7,426 | $10,243 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 36 | $212,335 | $45,761 | $63,276 | 5.00 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 15 | $266,751 | $44,942 | $79,492 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 13 | $83,988 | $15,894 | $25,029 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 12 | $276,241 | $57,480 | $82,320 | 6.96 |
Musculoskeletal system and connective tissue335 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 66 | $98,603 | $28,438 | $29,384 | 3.66 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 40 | $149,955 | $45,476 | $44,686 | 6.12 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 30 | $87,868 | $22,921 | $26,185 | 2.96 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 27 | $78,304 | $24,747 | $23,335 | 2.48 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 25 | $70,957 | $19,574 | $21,145 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 24 | $41,258 | $7,699 | $12,295 | 0.97 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 21 | $93,878 | $37,986 | $27,976 | 4.61 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 18 | $75,042 | $15,920 | $22,363 | 1.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 16 | $83,180 | $28,937 | $24,788 | 3.49 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 15 | $131,698 | $45,064 | $39,246 | 6.08 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 15 | $48,065 | $12,368 | $14,323 | 1.49 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 14 | $75,893 | $20,901 | $22,616 | 2.49 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 13 | $64,621 | $15,503 | $19,257 | 2.04 |
| Connective tissue disorders with CCMS-DRG 546, medical | 11 | $45,828 | $9,938 | $13,657 | 1.20 |
Blood cancers and poorly differentiated neoplasms190 discharges in 7 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 | 41 | $55,576 | $12,067 | $16,562 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 39 | $178,474 | $30,261 | $53,185 | 3.13 |
| Acute leukemia with MCCMS-DRG 834, medical | 27 | $213,194 | $54,401 | $63,532 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 26 | $61,988 | $18,463 | $18,472 | 2.00 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 25 | $73,562 | $21,086 | $21,921 | 2.44 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 20 | $60,088 | $12,311 | $17,906 | 1.57 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 12 | $111,825 | $42,583 | $33,324 | 4.84 |
Transplants, ECMO and tracheostomy (pre-MDC)183 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 48 | $181,657 | $52,573 | $54,134 | 6.18 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 41 | $1,307,854 | $311,002 | $389,740 | 21.32 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 37 | $1,868,068 | $508,736 | $556,684 | 36.84 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 30 | $1,197,078 | $276,617 | $356,729 | 27.10 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 16 | $533,293 | $94,090 | $158,921 | 10.35 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $508,167 | $110,896 | $151,434 | 14.70 |
Endocrine, nutritional and metabolic142 discharges in 5 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 | 69 | $50,541 | $11,259 | $15,061 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 35 | $29,575 | $5,601 | $8,813 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 14 | $64,541 | $11,863 | $19,233 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 13 | $37,992 | $12,713 | $11,322 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 11 | $33,144 | $8,464 | $9,877 | 1.06 |
Liver, gallbladder and pancreas126 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 31 | $61,028 | $15,018 | $18,186 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 21 | $106,967 | $20,549 | $31,876 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 21 | $100,394 | $16,362 | $29,917 | 1.83 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 19 | $42,072 | $8,641 | $12,538 | 0.95 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 18 | $285,252 | $53,769 | $85,005 | 5.51 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 16 | $87,208 | $21,003 | $25,988 | 2.89 |
Blood and immune system84 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 20 | $66,167 | $12,350 | $19,718 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 18 | $82,140 | $23,147 | $24,478 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 16 | $110,355 | $17,670 | $32,886 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 15 | $65,612 | $16,240 | $19,552 | 1.20 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 15 | $31,779 | $8,473 | $9,470 | 0.90 |
Injuries, poisonings and toxic effects of drugs83 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 | 36 | $113,400 | $24,337 | $33,793 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 18 | $194,116 | $40,295 | $57,847 | 3.72 |
| Complications of treatment with CCMS-DRG 920, medical | 17 | $27,815 | $6,853 | $8,289 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $60,981 | $16,900 | $18,172 | 2.00 |
Skin, subcutaneous tissue and breast36 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 24 | $29,687 | $6,792 | $8,847 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $35,674 | $12,295 | $10,631 | 1.49 |
Other28 discharges in 1 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 | 28 | $183,326 | $42,694 | $54,631 | 4.74 |
Mental diseases and disorders26 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 15 | $18,252 | $6,734 | $5,439 | 0.95 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 11 | $38,282 | $14,691 | $11,408 | 1.76 |
Factors influencing health status24 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 | 13 | $32,612 | $6,679 | $9,718 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 11 | $61,860 | $10,591 | $18,434 | 1.25 |
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 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 595 | 517 | $19,021 | $2,071 | $2,141 |
| Comprehensive Observation ServicesAPC 8011 | 577 | 559 | $14,325 | $1,992 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 454 | 433 | $37,977 | $10,362 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 215 | 181 | $19,980 | $2,299 | $2,405 |
| Level 1 Endovascular ProceduresAPC 5191 | 215 | 204 | $18,220 | $2,112 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 161 | 153 | $8,048 | $1,183 | $1,220 |
| Level 4 Urology and Related ServicesAPC 5374 | 146 | 123 | $18,586 | $2,577 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 142 | 122 | $10,788 | $1,396 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 128 | 126 | $48,291 | $20,352 | $21,117 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 94 | 93 | $33,626 | $4,239 | $4,358 |
| Level 3 Urology and Related ServicesAPC 5373 | 90 | 58 | $12,507 | $1,506 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 85 | 78 | $24,664 | $3,736 | $3,918 |
| Level 4 Airway EndoscopyAPC 5154 | 81 | 66 | $21,638 | $2,769 | $2,833 |
| Level 3 Endovascular ProceduresAPC 5193 | 79 | 67 | $40,433 | $8,569 | $8,874 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 76 | 76 | $49,627 | $15,625 | $15,763 |
| Level 4 Vascular ProceduresAPC 5184 | 75 | 72 | $36,520 | $4,063 | $3,946 |
| Level 4 Endovascular ProceduresAPC 5194 | 73 | 67 | $46,940 | $14,007 | $14,606 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 62 | 61 | $61,757 | $7,913 | $8,164 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 60 | 49 | $21,366 | $2,515 | $2,636 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 59 | 59 | $21,380 | $8,128 | $8,569 |
| Level 1 Nerve ProceduresAPC 5431 | 57 | 56 | $16,215 | $1,428 | $1,407 |
| Level 1 Intraocular ProceduresAPC 5491 | 50 | 38 | $14,313 | $1,688 | $1,752 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 49 | 48 | $51,144 | $18,620 | $18,465 |
| Level 2 Endovascular ProceduresAPC 5192 | 48 | 44 | $27,298 | $4,138 | $4,338 |
| Level 5 ENT ProceduresAPC 5165 | 47 | 47 | $37,572 | $4,238 | $4,436 |
| Complex GI ProceduresAPC 5331 | 47 | 31 | $19,804 | $3,605 | $4,263 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 44 | 44 | $35,871 | $5,084 | $5,339 |
| Level 5 Airway EndoscopyAPC 5155 | 41 | 40 | $33,881 | $5,061 | $5,183 |
| Level 2 Intraocular ProceduresAPC 5492 | 40 | 36 | $28,974 | $3,006 | $3,116 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 38 | 38 | $34,452 | $16,401 | $17,052 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 34 | 33 | $37,635 | $9,835 | $11,550 |
| Level 7 Radiation TherapyAPC 5627 | 33 | 24 | $64,891 | $5,758 | $6,121 |
| Level 4 Gynecologic ProceduresAPC 5414 | 31 | 30 | $20,434 | $2,312 | $2,389 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 29 | 29 | $51,785 | $27,815 | $29,375 |
| Level 2 Vascular ProceduresAPC 5182 | 27 | 26 | $7,025 | $1,181 | $1,204 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 26 | 26 | $15,888 | $6,279 | $6,514 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 24 | 23 | $32,558 | $5,057 | $4,524 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 23 | 23 | $58,256 | $25,923 | $26,719 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 22 | 22 | $40,842 | $4,822 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 21 | 20 | $8,195 | $1,195 | $1,264 |
| Level 8 Urology and Related ServicesAPC 5378 | 19 | 18 | $66,574 | $17,045 | $17,428 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 17 | 17 | $8,069 | $1,188 | $1,196 |
| Level 3 Upper GI ProceduresAPC 5303 | 17 | 17 | $17,264 | $2,832 | $2,888 |
| Level 6 Urology and Related ServicesAPC 5376 | 17 | 16 | $49,838 | $6,508 | $7,291 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 16 | 16 | $17,425 | $5,522 | $5,682 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 16 | 12 | $17,698 | $1,728 | $1,780 |
| Implantation of Drug Infusion DeviceAPC 5471 | 15 | 15 | $56,337 | $14,884 | $14,829 |
| Level 5 Gynecologic ProceduresAPC 5415 | 13 | 13 | $37,880 | $3,678 | $3,792 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 13 | 12 | $32,632 | $2,516 | $2,547 |
| Level 3 Intraocular ProceduresAPC 5493 | 13 | 11 | $35,645 | $3,865 | $4,004 |
| Level 2 Urology and Related ServicesAPC 5372 | 11 | $8,689 | $505 | $502 |
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.