Enloe Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Enloe Medical Center, Chico, CA in 2024, from traditional Medicare claims. Back to the Enloe Medical Center profile, with quality ratings, finances and negotiated rates.
6,445
Medicare inpatient discharges
In 157 published DRGs
1.91
Case mix index
IPPS FY 2027
21%
Surgical stays
75%
Stays with complications
In DRGs with a CC or MCC
7,409
Medicare outpatient services
In 45 service groups
Inpatient stays by major diagnostic category
Circulatory system1,304 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 439 | $101,149 | $11,360 | $14,464 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 71 | $221,415 | $57,709 | $31,662 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 62 | $213,484 | $19,551 | $30,528 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 59 | $79,233 | $6,056 | $11,330 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 59 | $199,632 | $14,878 | $28,547 | 1.82 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 53 | $164,117 | $13,917 | $23,469 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 49 | $104,856 | $10,552 | $14,994 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 44 | $250,393 | $24,623 | $35,806 | 2.87 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 42 | $153,910 | $9,145 | $22,009 | 1.08 |
| Syncope and collapseMS-DRG 312, medical | 40 | $88,101 | $7,345 | $12,598 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 37 | $186,550 | $44,569 | $26,677 | 4.88 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 32 | $136,820 | $7,600 | $19,565 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 29 | $134,799 | $18,804 | $19,276 | 2.09 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 28 | $64,546 | $4,053 | $9,230 | 0.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 26 | $88,286 | $8,966 | $12,625 | 1.07 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $191,388 | $30,916 | $27,369 | 3.35 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 22 | $610,346 | $47,605 | $87,279 | 5.20 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 20 | $173,279 | $20,339 | $24,779 | 2.28 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $159,312 | $14,139 | $22,782 | 1.58 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 18 | $74,638 | $8,314 | $10,673 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 17 | $800,843 | $70,979 | $114,521 | 7.80 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $233,139 | $30,216 | $33,339 | 3.46 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 17 | $140,593 | $15,870 | $20,105 | 1.83 |
| Other vascular procedures with CCMS-DRG 253, surgical | 17 | $218,510 | $22,885 | $31,247 | 2.55 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 17 | $215,331 | $31,644 | $30,792 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $110,121 | $7,412 | $15,747 | 0.86 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 12 | $356,152 | $46,967 | $50,930 | 5.06 |
| Hypertension without MCCMS-DRG 305, medical | 12 | $73,334 | $6,289 | $10,487 | 0.75 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $340,850 | $39,858 | $48,742 | 4.16 |
Respiratory system928 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 | 207 | $99,725 | $11,660 | $14,261 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 186 | $108,762 | $14,406 | $15,553 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 151 | $89,080 | $10,950 | $12,738 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 62 | $66,604 | $9,537 | $9,524 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 60 | $68,302 | $6,672 | $9,767 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 48 | $237,228 | $25,037 | $33,924 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 40 | $160,164 | $12,788 | $22,903 | 1.40 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 40 | $67,088 | $8,106 | $9,594 | 0.99 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 20 | $142,114 | $15,547 | $20,322 | 1.74 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 19 | $67,495 | $7,205 | $9,652 | 0.85 |
| Major chest procedures with MCCMS-DRG 163, surgical | 16 | $448,489 | $42,876 | $64,134 | 4.71 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 16 | $80,507 | $6,555 | $11,512 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 14 | $118,979 | $8,728 | $17,014 | 1.05 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 14 | $121,707 | $16,203 | $17,404 | 1.81 |
| Pneumothorax with MCCMS-DRG 199, medical | 12 | $148,049 | $15,614 | $21,171 | 1.77 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $61,814 | $7,986 | $8,839 | 0.96 |
| Pneumothorax with CCMS-DRG 200, medical | 11 | $100,541 | $9,038 | $14,377 | 1.08 |
Infectious and parasitic diseases885 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 | 607 | $146,101 | $17,592 | $20,892 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 112 | $73,864 | $8,558 | $10,563 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 92 | $320,642 | $45,863 | $45,852 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 23 | $149,316 | $18,158 | $21,352 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 22 | $190,279 | $39,522 | $27,210 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 18 | $102,445 | $16,825 | $14,650 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $70,745 | $8,297 | $10,117 | 1.01 |
Kidney and urinary tract630 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 115 | $76,888 | $7,932 | $10,995 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 109 | $99,965 | $14,541 | $14,295 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 104 | $102,124 | $12,979 | $14,604 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 74 | $68,794 | $10,007 | $9,838 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 70 | $64,250 | $6,600 | $9,188 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 43 | $74,035 | $8,700 | $10,587 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 37 | $115,752 | $11,506 | $16,553 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 25 | $104,395 | $7,501 | $14,929 | 1.05 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 22 | $213,300 | $34,787 | $30,502 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $188,218 | $23,705 | $26,915 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $129,350 | $16,372 | $18,497 | 1.84 |
Digestive system621 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 99 | $83,612 | $8,318 | $11,957 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 91 | $63,249 | $6,292 | $9,045 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 68 | $139,834 | $15,729 | $19,996 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 43 | $103,206 | $10,863 | $14,758 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 43 | $69,265 | $7,967 | $9,905 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 40 | $344,450 | $41,187 | $49,256 | 4.52 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 39 | $189,847 | $21,373 | $27,148 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 35 | $54,824 | $6,467 | $7,840 | 0.80 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 32 | $83,725 | $8,260 | $11,973 | 1.04 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 28 | $113,135 | $15,466 | $16,178 | 1.75 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 27 | $116,389 | $14,231 | $16,644 | 1.62 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 20 | $138,336 | $14,608 | $19,782 | 1.67 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 18 | $99,696 | $12,758 | $14,257 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 15 | $154,312 | $18,351 | $22,067 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $83,834 | $10,698 | $11,988 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 11 | $45,822 | $3,701 | $6,553 | 0.56 |
Nervous system526 discharges in 20 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 | 97 | $83,611 | $8,446 | $11,956 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 89 | $126,970 | $16,829 | $18,157 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 35 | $82,783 | $11,755 | $11,838 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 30 | $162,320 | $16,423 | $23,212 | 1.79 |
| Seizures without MCCMS-DRG 101, medical | 29 | $75,504 | $7,282 | $10,797 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 24 | $119,595 | $9,490 | $17,102 | 1.14 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 23 | $56,968 | $5,070 | $8,146 | 0.69 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 23 | $72,536 | $8,577 | $10,373 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 22 | $121,658 | $18,053 | $17,397 | 1.98 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 21 | $113,765 | $11,134 | $16,268 | 1.32 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 16 | $285,549 | $39,737 | $40,834 | 4.42 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 16 | $111,284 | $15,035 | $15,914 | 1.79 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 15 | $124,588 | $16,165 | $17,816 | 1.81 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 14 | $162,956 | $24,484 | $23,303 | 2.39 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $83,648 | $12,808 | $11,962 | 1.47 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 13 | $68,177 | $8,143 | $9,749 | 1.06 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 12 | $142,771 | $20,745 | $20,416 | 2.30 |
| Extracranial procedures with CCMS-DRG 038, surgical | 12 | $149,380 | $13,901 | $21,361 | 1.60 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 11 | $83,975 | $6,223 | $12,008 | 0.80 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $152,871 | $20,366 | $21,861 | 2.27 |
Musculoskeletal system and connective tissue506 discharges in 18 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 | 81 | $152,584 | $17,762 | $21,819 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 59 | $86,047 | $7,804 | $12,305 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 50 | $156,544 | $18,655 | $22,386 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 35 | $73,571 | $7,201 | $10,521 | 0.90 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 30 | $297,590 | $33,135 | $42,555 | 3.66 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 27 | $212,725 | $26,625 | $30,420 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 26 | $201,238 | $25,337 | $28,777 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 26 | $104,914 | $14,109 | $15,003 | 1.70 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 25 | $127,170 | $16,458 | $18,185 | 1.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 23 | $205,741 | $20,990 | $29,421 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 20 | $61,302 | $6,467 | $8,766 | 0.79 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 19 | $192,415 | $18,084 | $27,515 | 2.04 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 17 | $198,588 | $29,604 | $28,398 | 3.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 17 | $117,411 | $15,090 | $16,790 | 1.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 17 | $74,815 | $9,085 | $10,699 | 1.09 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 12 | $68,270 | $6,962 | $9,763 | 0.82 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 11 | $129,611 | $24,870 | $18,534 | 3.00 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 11 | $55,329 | $6,592 | $7,912 | 0.82 |
Endocrine, nutritional and metabolic297 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 78 | $84,519 | $11,334 | $12,086 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 75 | $60,337 | $6,359 | $8,628 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 38 | $69,093 | $7,138 | $9,880 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 24 | $106,720 | $12,192 | $15,261 | 1.45 |
| O.r. procedures for obesity with CCMS-DRG 620, surgical | 21 | $84,089 | $13,302 | $12,025 | 1.62 |
| Endocrine disorders with MCCMS-DRG 643, medical | 19 | $105,110 | $13,882 | $15,031 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 16 | $150,111 | $15,474 | $21,466 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $79,470 | $9,045 | $11,364 | 1.06 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 11 | $82,623 | $12,872 | $11,815 | 1.52 |
Liver, gallbladder and pancreas237 discharges in 11 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 | 46 | $151,695 | $13,935 | $21,692 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 28 | $63,678 | $8,377 | $9,106 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 24 | $178,146 | $20,916 | $25,475 | 2.32 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 24 | $117,659 | $16,155 | $16,825 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 23 | $66,205 | $7,126 | $9,467 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 21 | $118,588 | $17,376 | $16,958 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 18 | $122,129 | $15,834 | $17,464 | 1.76 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 14 | $70,942 | $8,744 | $10,145 | 1.03 |
| Disorders of pancreas except malignancy without cc/mccMS-DRG 440, medical | 14 | $52,991 | $4,589 | $7,578 | 0.62 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 13 | $85,692 | $8,337 | $12,254 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 12 | $119,033 | $11,318 | $17,022 | 1.31 |
Mental diseases and disorders138 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 75 | $57,551 | $11,925 | $8,230 | 1.37 |
| Depressive neurosesMS-DRG 881, medical | 29 | $63,536 | $7,663 | $9,086 | 0.91 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 20 | $70,048 | $14,085 | $10,017 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 14 | $58,364 | $7,792 | $8,346 | 0.95 |
Skin, subcutaneous tissue and breast94 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 64 | $57,639 | $7,188 | $8,242 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 30 | $102,251 | $12,610 | $14,622 | 1.49 |
Injuries, poisonings and toxic effects of drugs75 discharges in 3 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 | 36 | $135,683 | $14,247 | $19,403 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 22 | $123,554 | $15,725 | $17,668 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 17 | $80,155 | $8,441 | $11,462 | 1.03 |
Blood and immune system71 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 24 | $95,586 | $13,956 | $13,669 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 21 | $78,209 | $7,288 | $11,184 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 15 | $80,768 | $12,756 | $11,550 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $145,147 | $20,531 | $20,756 | 2.19 |
Other67 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 | 32 | $303,283 | $41,988 | $43,369 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 19 | $261,558 | $31,499 | $37,403 | 3.38 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $186,061 | $21,455 | $26,607 | 2.49 |
Alcohol and drug use25 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 | 25 | $61,980 | $7,295 | $8,863 | 0.86 |
Factors influencing health status25 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 | 25 | $68,741 | $6,645 | $9,830 | 0.80 |
Blood cancers and poorly differentiated neoplasms16 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 | 16 | $89,646 | $11,732 | $12,819 | 1.21 |
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 | 1,506 | 1,346 | $46,965 | $2,644 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 621 | 449 | $2,081 | $287 | $502 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 461 | 440 | $89,004 | $14,484 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 392 | 367 | $14,955 | $1,544 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 364 | 304 | $11,152 | $1,343 | $1,516 |
| Level 2 Upper GI ProceduresAPC 5302 | 343 | 329 | $17,254 | $1,864 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 326 | 324 | $93,980 | $2,842 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 283 | 280 | $63,161 | $5,633 | $4,358 |
| Level 1 Nerve ProceduresAPC 5431 | 259 | 234 | $14,000 | $1,884 | $1,407 |
| Level 3 Vascular ProceduresAPC 5183 | 256 | 228 | $32,152 | $3,102 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 253 | 243 | $144,914 | $27,480 | $21,117 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 252 | 233 | $22,214 | $2,761 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 177 | 168 | $54,534 | $7,160 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 177 | 157 | $54,748 | $5,068 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 161 | 149 | $40,270 | $3,383 | $2,629 |
| Level 3 Upper GI ProceduresAPC 5303 | 135 | 75 | $12,537 | $2,140 | $2,888 |
| Level 3 Endovascular ProceduresAPC 5193 | 132 | 118 | $112,168 | $11,779 | $8,874 |
| Level 2 Endovascular ProceduresAPC 5192 | 130 | 108 | $49,432 | $5,594 | $4,338 |
| Level 2 Vascular ProceduresAPC 5182 | 110 | 109 | $7,478 | $1,551 | $1,204 |
| Level 3 Airway EndoscopyAPC 5153 | 99 | 63 | $9,162 | $1,652 | $1,264 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 73 | 72 | $22,562 | $1,553 | $1,196 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 70 | 70 | $74,933 | $11,472 | $8,569 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 68 | 65 | $48,051 | $3,389 | $2,636 |
| Level 6 Urology and Related ServicesAPC 5376 | 68 | 68 | $60,979 | $9,534 | $7,291 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 62 | 59 | $56,355 | $3,734 | $2,930 |
| Complex GI ProceduresAPC 5331 | 53 | 39 | $31,148 | $4,740 | $4,263 |
| Level 4 Airway EndoscopyAPC 5154 | 52 | 48 | $31,374 | $3,662 | $2,833 |
| Level 4 Vascular ProceduresAPC 5184 | 48 | 45 | $82,453 | $5,383 | $3,946 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 47 | 47 | $165,902 | $38,683 | $29,375 |
| Level 4 Endovascular ProceduresAPC 5194 | 46 | 42 | $138,890 | $19,439 | $14,606 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 38 | 37 | $101,654 | $6,388 | $4,982 |
| Level 4 Gynecologic ProceduresAPC 5414 | 36 | 36 | $35,763 | $2,977 | $2,389 |
| Level 3 Lower GI ProceduresAPC 5313 | 33 | 32 | $30,800 | $2,672 | $2,176 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 33 | 31 | $75,649 | $11,005 | $8,164 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 32 | 32 | $46,176 | $3,121 | $2,373 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 32 | 15 | $25,075 | $3,387 | $4,524 |
| Level 5 ENT ProceduresAPC 5165 | 28 | 28 | $78,292 | $5,532 | $4,436 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 26 | 26 | $109,872 | $21,219 | $15,763 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 22 | 22 | $61,388 | $8,423 | $6,514 |
| Level 5 Airway EndoscopyAPC 5155 | 20 | 20 | $55,048 | $6,781 | $5,183 |
| Level 3 ENT ProceduresAPC 5163 | 20 | 20 | $6,863 | $1,409 | $1,106 |
| Level 4 ENT ProceduresAPC 5164 | 19 | 19 | $32,303 | $2,988 | $2,217 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 18 | 18 | $111,451 | $7,545 | $5,682 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 15 | 15 | $83,785 | $22,259 | $17,052 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 13 | 11 | $30,230 | $2,289 | $1,780 |
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.