Evanston Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Evanston Hospital, Evanston, IL in 2024, from traditional Medicare claims. Back to the Evanston Hospital profile, with quality ratings, finances and negotiated rates.
12,535
Medicare inpatient discharges
In 231 published DRGs
1.87
Case mix index
IPPS FY 2027
27%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
17,502
Medicare outpatient services
In 57 service groups
Inpatient stays by major diagnostic category
Circulatory system2,443 discharges in 44 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 428 | $39,208 | $9,711 | $11,684 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 192 | $57,696 | $12,227 | $17,193 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 173 | $229,879 | $38,365 | $68,504 | 4.88 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 101 | $46,683 | $8,962 | $13,912 | 1.20 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 100 | $29,862 | $5,114 | $8,899 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 95 | $85,285 | $17,104 | $25,415 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 94 | $104,724 | $13,416 | $31,208 | 1.82 |
| Syncope and collapseMS-DRG 312, medical | 92 | $28,667 | $6,238 | $8,543 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 85 | $143,727 | $23,108 | $42,831 | 2.87 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 78 | $117,410 | $25,346 | $34,988 | 3.24 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 67 | $67,204 | $17,162 | $20,027 | 2.09 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 59 | $38,038 | $6,506 | $11,335 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 59 | $58,176 | $7,657 | $17,336 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 53 | $35,596 | $7,982 | $10,608 | 1.07 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 53 | $50,679 | $12,585 | $15,102 | 1.54 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 48 | $206,825 | $44,758 | $61,634 | 5.06 |
| Other vascular procedures with CCMS-DRG 253, surgical | 47 | $96,717 | $19,953 | $28,822 | 2.55 |
| Hypertension without MCCMS-DRG 305, medical | 43 | $31,898 | $5,193 | $9,506 | 0.75 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 39 | $130,966 | $27,896 | $39,028 | 3.35 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 36 | $290,803 | $52,218 | $86,659 | 6.25 |
| Heart failure and shock with CCMS-DRG 292, medical | 33 | $29,419 | $6,485 | $8,767 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 33 | $26,727 | $3,471 | $7,965 | 0.55 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 31 | $78,363 | $17,140 | $23,352 | 2.28 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 31 | $33,077 | $7,194 | $9,857 | 0.97 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 29 | $125,055 | $25,764 | $37,266 | 3.18 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 29 | $179,826 | $34,374 | $53,588 | 4.16 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 27 | $119,071 | $26,340 | $35,483 | 3.46 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 26 | $40,102 | $11,956 | $11,950 | 1.58 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 23 | $92,634 | $25,066 | $27,605 | 3.46 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 21 | $146,831 | $31,521 | $43,756 | 3.90 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 21 | $37,420 | $4,373 | $11,151 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 19 | $176,467 | $36,959 | $52,587 | 5.24 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 19 | $59,998 | $14,377 | $17,880 | 1.97 |
| Hypertension with MCCMS-DRG 304, medical | 18 | $38,645 | $8,665 | $11,516 | 1.15 |
| Chest painMS-DRG 313, medical | 17 | $29,717 | $5,181 | $8,856 | 0.72 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 16 | $145,822 | $28,814 | $43,455 | 4.04 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 16 | $148,228 | $23,727 | $44,172 | 2.97 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 14 | $293,583 | $64,032 | $87,488 | 7.71 |
| Atherosclerosis without MCCMS-DRG 303, medical | 14 | $32,499 | $4,427 | $9,685 | 0.66 |
| Other endovascular cardiac valve procedures with MCCMS-DRG 319, surgical | 14 | $121,366 | $34,923 | $36,167 | 4.36 |
| Other heart assist system implantMS-DRG 215, surgical | 13 | $333,901 | $78,119 | $99,503 | 10.21 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 13 | $439,741 | $91,301 | $131,043 | 9.71 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 13 | $155,489 | $41,453 | $46,336 | 5.04 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $94,308 | $23,886 | $28,104 | 3.27 |
Musculoskeletal system and connective tissue1,905 discharges in 40 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 | 366 | $67,089 | $14,088 | $19,993 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 224 | $66,274 | $15,267 | $19,750 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 105 | $31,923 | $6,802 | $9,513 | 0.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 93 | $33,893 | $7,647 | $10,100 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 84 | $69,374 | $16,112 | $20,673 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 67 | $118,565 | $27,467 | $35,332 | 3.66 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 59 | $92,474 | $21,827 | $27,557 | 2.95 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 54 | $163,140 | $47,835 | $48,616 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 53 | $58,688 | $15,475 | $17,489 | 2.04 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 49 | $115,956 | $34,045 | $34,555 | 4.61 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 47 | $29,180 | $6,214 | $8,696 | 0.90 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 46 | $90,453 | $25,133 | $26,955 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 45 | $69,500 | $17,811 | $20,711 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 45 | $55,646 | $13,603 | $16,583 | 1.82 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 37 | $78,838 | $20,359 | $23,494 | 2.67 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 37 | $49,590 | $11,290 | $14,778 | 1.59 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 35 | $116,988 | $19,340 | $34,862 | 2.48 |
| Pathological fractures and musculoskeletal and connective tissue malignancy without cc/mMS-DRG 544, medical | 35 | $24,712 | $5,266 | $7,364 | 0.77 |
| Medical back problems with MCCMS-DRG 551, medical | 32 | $52,322 | $12,453 | $15,592 | 1.70 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 30 | $27,677 | $5,581 | $8,248 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 29 | $101,234 | $22,424 | $30,168 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 28 | $30,892 | $5,252 | $9,206 | 0.79 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 26 | $99,022 | $22,758 | $29,509 | 2.96 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 26 | $68,376 | $19,399 | $20,376 | 2.49 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 24 | $71,237 | $15,063 | $21,228 | 1.97 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 24 | $30,896 | $5,966 | $9,207 | 0.82 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 23 | $51,745 | $11,099 | $15,420 | 1.49 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 20 | $57,420 | $14,281 | $17,111 | 1.87 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 18 | $100,767 | $24,938 | $30,029 | 3.33 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 16 | $97,665 | $23,774 | $29,104 | 3.16 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 15 | $58,851 | $10,489 | $17,538 | 1.43 |
| Knee procedures with principal diagnosis of infection with CCMS-DRG 486, surgical | 14 | $70,103 | $15,746 | $20,891 | 2.01 |
| Connective tissue disorders with CCMS-DRG 546, medical | 14 | $38,343 | $8,805 | $11,426 | 1.20 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 14 | $33,880 | $5,447 | $10,096 | 0.88 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 13 | $38,124 | $7,989 | $11,361 | 1.13 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $30,625 | $7,601 | $9,126 | 1.00 |
| Soft tissue procedures without cc/mccMS-DRG 502, surgical | 12 | $47,203 | $10,106 | $14,067 | 1.38 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 11 | $57,444 | $21,645 | $17,118 | 3.00 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 11 | $40,767 | $9,020 | $12,149 | 1.30 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 11 | $55,177 | $11,753 | $16,443 | 1.56 |
Respiratory system1,715 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 419 | $45,833 | $12,177 | $13,658 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 176 | $43,491 | $9,830 | $12,960 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 169 | $27,865 | $6,998 | $8,304 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 166 | $45,974 | $9,460 | $13,700 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 149 | $28,151 | $5,664 | $8,389 | 0.82 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 66 | $73,860 | $13,821 | $22,010 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 48 | $47,291 | $10,342 | $14,093 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 48 | $54,900 | $13,189 | $16,360 | 1.74 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 46 | $35,839 | $5,774 | $10,680 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 45 | $37,845 | $7,063 | $11,278 | 0.96 |
| Major chest procedures with CCMS-DRG 164, surgical | 44 | $96,213 | $18,901 | $28,671 | 2.55 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $34,597 | $7,873 | $10,310 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 32 | $26,164 | $5,855 | $7,797 | 0.85 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 31 | $49,769 | $13,207 | $14,831 | 1.81 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 30 | $22,312 | $3,993 | $6,649 | 0.63 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 28 | $27,152 | $5,233 | $8,091 | 0.76 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 25 | $80,954 | $21,418 | $24,124 | 2.70 |
| Major chest trauma with CCMS-DRG 184, medical | 22 | $34,919 | $7,491 | $10,406 | 1.05 |
| Pneumothorax with CCMS-DRG 200, medical | 22 | $32,957 | $7,970 | $9,821 | 1.08 |
| Major chest procedures with MCCMS-DRG 163, surgical | 21 | $130,655 | $35,973 | $38,935 | 4.71 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 20 | $34,129 | $7,851 | $10,170 | 1.10 |
| Pneumothorax with MCCMS-DRG 199, medical | 19 | $56,773 | $13,645 | $16,918 | 1.77 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 17 | $29,154 | $6,357 | $8,688 | 0.91 |
| Major chest trauma with MCCMS-DRG 183, medical | 12 | $47,007 | $11,958 | $14,008 | 1.57 |
| Interstitial lung disease with CCMS-DRG 197, medical | 12 | $33,155 | $6,761 | $9,880 | 1.00 |
| Pleural effusion with CCMS-DRG 187, medical | 11 | $32,094 | $7,199 | $9,564 | 1.00 |
Infectious and parasitic diseases1,373 discharges in 10 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 | 950 | $64,673 | $14,704 | $19,272 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 177 | $35,842 | $7,397 | $10,681 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 104 | $182,654 | $41,153 | $54,431 | 5.00 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 30 | $66,588 | $16,507 | $19,843 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 29 | $75,578 | $15,030 | $22,522 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 20 | $28,926 | $7,156 | $8,620 | 1.01 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 20 | $239,278 | $56,814 | $71,305 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 18 | $55,007 | $15,833 | $16,392 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 14 | $27,005 | $6,773 | $8,047 | 0.88 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $111,763 | $34,103 | $33,305 | 4.43 |
Digestive system1,324 discharges in 23 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 | 231 | $26,023 | $5,485 | $7,755 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 184 | $32,757 | $7,274 | $9,762 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 94 | $59,915 | $13,772 | $17,855 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 74 | $27,979 | $5,542 | $8,338 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 74 | $28,869 | $6,875 | $8,603 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 72 | $86,494 | $17,254 | $25,775 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 72 | $34,797 | $9,578 | $10,370 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 61 | $141,809 | $35,496 | $42,259 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 58 | $48,787 | $12,214 | $14,538 | 1.62 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 56 | $21,998 | $3,323 | $6,555 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 52 | $35,610 | $7,768 | $10,612 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 44 | $58,361 | $11,972 | $17,392 | 1.67 |
| Digestive malignancy with MCCMS-DRG 374, medical | 41 | $63,119 | $15,069 | $18,810 | 2.10 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 36 | $43,269 | $10,541 | $12,894 | 1.45 |
| Digestive malignancy with CCMS-DRG 375, medical | 35 | $33,610 | $8,700 | $10,016 | 1.20 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 26 | $51,111 | $12,734 | $15,231 | 1.75 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 19 | $84,909 | $16,254 | $25,303 | 2.50 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 19 | $59,095 | $9,931 | $17,610 | 1.36 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 17 | $24,188 | $4,078 | $7,208 | 0.63 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 16 | $67,469 | $12,185 | $20,106 | 1.72 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 16 | $136,532 | $33,992 | $40,687 | 4.28 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 14 | $18,669 | $4,244 | $5,563 | 0.65 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 13 | $143,215 | $38,741 | $42,678 | 5.08 |
Kidney and urinary tract1,107 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 220 | $26,520 | $5,623 | $7,903 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 177 | $28,553 | $6,151 | $8,509 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 173 | $30,951 | $8,608 | $9,223 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 140 | $42,351 | $10,875 | $12,621 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 140 | $52,727 | $12,331 | $15,713 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 86 | $29,635 | $7,652 | $8,831 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 44 | $54,835 | $9,801 | $16,341 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 34 | $41,799 | $7,546 | $12,456 | 1.05 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 19 | $78,248 | $14,095 | $23,318 | 1.84 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 18 | $102,349 | $21,477 | $30,500 | 2.59 |
| Urinary stones without MCCMS-DRG 694, medical | 17 | $24,716 | $5,377 | $7,365 | 0.78 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 15 | $69,031 | $18,835 | $20,571 | 2.38 |
| Renal failure without cc/mccMS-DRG 684, medical | 13 | $22,013 | $4,135 | $6,560 | 0.61 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 11 | $93,703 | $29,385 | $27,924 | 3.70 |
Nervous system827 discharges in 22 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 | 126 | $48,287 | $7,230 | $14,390 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 90 | $64,312 | $14,668 | $19,165 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 79 | $30,066 | $9,661 | $8,960 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 64 | $34,280 | $7,389 | $10,215 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 61 | $147,144 | $32,587 | $43,849 | 4.42 |
| Seizures without MCCMS-DRG 101, medical | 44 | $29,527 | $6,368 | $8,799 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 37 | $37,358 | $4,481 | $11,133 | 0.69 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 37 | $34,051 | $7,943 | $10,147 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 36 | $55,074 | $13,452 | $16,412 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 33 | $39,052 | $16,949 | $11,638 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 32 | $69,607 | $16,170 | $20,743 | 1.98 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 28 | $73,142 | $17,589 | $21,796 | 2.28 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 23 | $35,046 | $5,744 | $10,444 | 0.80 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 21 | $39,236 | $9,946 | $11,692 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 18 | $176,486 | $42,433 | $52,593 | 5.67 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 17 | $49,965 | $10,389 | $14,889 | 1.47 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 16 | $31,096 | $9,862 | $9,267 | 1.32 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 15 | $79,972 | $16,720 | $23,832 | 2.27 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 14 | $93,829 | $18,790 | $27,961 | 2.43 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 13 | $26,518 | $5,826 | $7,902 | 0.77 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $109,129 | $22,635 | $32,520 | 2.95 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 11 | $103,802 | $26,810 | $30,933 | 3.79 |
Endocrine, nutritional and metabolic602 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 | 190 | $28,323 | $5,656 | $8,440 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 155 | $36,431 | $9,893 | $10,856 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 67 | $33,107 | $6,108 | $9,866 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 52 | $53,763 | $10,820 | $16,021 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 51 | $30,870 | $7,650 | $9,199 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 50 | $45,178 | $12,177 | $13,463 | 1.65 |
| Endocrine disorders without cc/mccMS-DRG 645, medical | 24 | $24,009 | $4,777 | $7,155 | 0.76 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $62,613 | $11,466 | $18,659 | 1.98 |
Liver, gallbladder and pancreas254 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 | 36 | $72,590 | $12,198 | $21,632 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 35 | $42,577 | $8,049 | $12,688 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 31 | $54,939 | $13,846 | $16,372 | 1.76 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 27 | $54,252 | $12,102 | $16,167 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 22 | $55,980 | $14,214 | $16,682 | 1.83 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 19 | $64,309 | $12,769 | $19,164 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $51,138 | $15,275 | $15,239 | 1.92 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 18 | $38,591 | $5,488 | $11,500 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 17 | $102,525 | $16,907 | $30,552 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 17 | $64,740 | $9,071 | $19,293 | 1.31 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 14 | $39,075 | $8,193 | $11,644 | 1.10 |
Skin, subcutaneous tissue and breast250 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 178 | $25,162 | $6,135 | $7,498 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 33 | $48,533 | $11,025 | $14,463 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 22 | $30,688 | $6,447 | $9,145 | 0.91 |
| Minor skin disorders without MCCMS-DRG 607, medical | 17 | $24,499 | $6,348 | $7,301 | 0.89 |
Blood and immune system204 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 64 | $44,501 | $11,538 | $13,261 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 63 | $32,134 | $6,261 | $9,576 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 47 | $43,874 | $10,839 | $13,075 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 17 | $38,533 | $8,942 | $11,483 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 13 | $58,287 | $17,356 | $17,370 | 2.19 |
Other126 discharges in 6 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 | 54 | $167,743 | $37,491 | $49,987 | 4.74 |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 19 | $130,889 | $33,522 | $39,005 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 18 | $103,428 | $24,913 | $30,822 | 3.38 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 12 | $180,432 | $59,998 | $53,769 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 12 | $62,299 | $12,426 | $18,565 | 1.70 |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 11 | $150,884 | $34,268 | $44,964 |
Injuries, poisonings and toxic effects of drugs122 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 29 | $49,433 | $14,516 | $14,731 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 25 | $36,563 | $7,822 | $10,896 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 23 | $168,719 | $32,407 | $50,278 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 17 | $71,776 | $16,995 | $21,389 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 15 | $65,417 | $14,506 | $19,494 | 1.60 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 13 | $33,637 | $5,617 | $10,024 | 0.86 |
Ear, nose, mouth and throat75 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 42 | $27,137 | $4,999 | $8,087 | 0.74 |
| Otitis media and uri without MCCMS-DRG 153, medical | 19 | $25,512 | $5,017 | $7,603 | 0.73 |
| Other ear, nose, mouth and throat diagnoses with CCMS-DRG 155, medical | 14 | $27,796 | $7,149 | $8,283 | 0.95 |
Male reproductive system48 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 35 | $50,645 | $10,724 | $15,092 | 1.45 |
| Benign prostatic hypertrophy without MCCMS-DRG 726, medical | 13 | $23,001 | $5,747 | $6,854 | 0.73 |
Blood cancers and poorly differentiated neoplasms42 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 26 | $74,263 | $23,068 | $22,130 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 16 | $26,098 | $10,627 | $7,777 | 1.21 |
Mental diseases and disorders39 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 39 | $33,863 | $11,781 | $10,091 | 1.76 |
Factors influencing health status33 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 | 33 | $26,914 | $5,589 | $8,020 | 0.80 |
Alcohol and drug use33 discharges in 2 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 | 21 | $26,624 | $6,061 | $7,934 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 12 | $62,290 | $12,334 | $18,563 | 1.78 |
Transplants, ECMO and tracheostomy (pre-MDC)13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 13 | $630,661 | $171,229 | $187,937 | 21.32 |
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 1 Intraocular ProceduresAPC 5491 | 2,412 | 1,573 | $16,316 | $1,722 | $1,752 |
| Level 2 Urology and Related ServicesAPC 5372 | 1,908 | 1,265 | $1,420 | $501 | $502 |
| Comprehensive Observation ServicesAPC 8011 | 1,713 | 1,605 | $18,551 | $2,011 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 1,343 | 1,287 | $57,916 | $10,486 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 946 | 861 | $8,116 | $1,193 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 926 | 693 | $6,325 | $1,509 | $1,516 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 493 | 487 | $32,578 | $4,241 | $4,358 |
| Level 3 Vascular ProceduresAPC 5183 | 482 | 448 | $14,841 | $2,348 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 477 | 470 | $33,367 | $5,250 | $5,339 |
| Level 4 Urology and Related ServicesAPC 5374 | 466 | 374 | $18,754 | $2,583 | $2,629 |
| Level 2 Upper GI ProceduresAPC 5302 | 455 | 404 | $11,471 | $1,417 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 440 | 419 | $107,018 | $20,346 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 383 | 376 | $27,613 | $2,165 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 283 | 264 | $28,390 | $3,830 | $3,918 |
| Level 1 Nerve ProceduresAPC 5431 | 276 | 202 | $7,852 | $1,425 | $1,407 |
| Level 3 Endovascular ProceduresAPC 5193 | 250 | 240 | $69,176 | $8,596 | $8,874 |
| Level 2 Intraocular ProceduresAPC 5492 | 249 | 219 | $24,065 | $2,963 | $3,116 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 241 | 238 | $59,762 | $7,918 | $8,164 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 231 | 223 | $14,568 | $1,530 | $2,141 |
| Level 2 Endovascular ProceduresAPC 5192 | 207 | 142 | $29,565 | $4,241 | $4,338 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 206 | 161 | $14,824 | $2,572 | $2,636 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 189 | 183 | $19,605 | $2,383 | $2,373 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 186 | 174 | $16,763 | $2,823 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 182 | 165 | $7,040 | $1,182 | $1,204 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 180 | 178 | $84,588 | $15,657 | $15,763 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 180 | 180 | $52,750 | $8,322 | $8,569 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 177 | 167 | $12,186 | $1,176 | $1,196 |
| Level 4 Gynecologic ProceduresAPC 5414 | 177 | 171 | $13,900 | $2,258 | $2,389 |
| Level 4 Endovascular ProceduresAPC 5194 | 168 | 124 | $71,183 | $11,165 | $14,606 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 137 | 109 | $29,555 | $5,089 | $4,524 |
| Level 6 Urology and Related ServicesAPC 5376 | 124 | 124 | $47,922 | $7,056 | $7,291 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 114 | 112 | $32,129 | $4,814 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 108 | 88 | $6,337 | $1,213 | $1,264 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 104 | 96 | $15,095 | $1,735 | $1,780 |
| Level 4 Vascular ProceduresAPC 5184 | 93 | 86 | $33,235 | $3,809 | $3,946 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 84 | 84 | $27,010 | $6,257 | $6,514 |
| Level 5 ENT ProceduresAPC 5165 | 83 | 83 | $38,536 | $4,379 | $4,436 |
| Level 3 Lower GI ProceduresAPC 5313 | 83 | 78 | $14,421 | $2,115 | $2,176 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 75 | 74 | $175,256 | $28,959 | $29,375 |
| Complex GI ProceduresAPC 5331 | 69 | 57 | $33,866 | $4,231 | $4,263 |
| Level 4 Airway EndoscopyAPC 5154 | 67 | 67 | $27,869 | $2,773 | $2,833 |
| Level 5 Airway EndoscopyAPC 5155 | 64 | 64 | $40,374 | $5,013 | $5,183 |
| Level 3 Upper GI ProceduresAPC 5303 | 64 | 62 | $20,731 | $2,853 | $2,888 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 59 | 59 | $122,197 | $26,934 | $26,719 |
| Level 5 Gynecologic ProceduresAPC 5415 | 50 | 50 | $24,018 | $3,718 | $3,792 |
| Level 6 Gynecologic ProceduresAPC 5416 | 43 | 43 | $35,390 | $5,642 | $5,836 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 39 | 39 | $98,776 | $16,519 | $17,052 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 39 | 37 | $90,083 | $18,303 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 26 | 26 | $52,208 | $5,768 | $6,121 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 25 | 23 | $45,234 | $7,155 | $7,546 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 25 | 23 | $64,826 | $14,727 | $15,549 |
| Level 3 Intraocular ProceduresAPC 5493 | 20 | 16 | $29,461 | $3,872 | $4,004 |
| Level 4 ENT ProceduresAPC 5164 | 19 | 19 | $18,593 | $2,400 | $2,217 |
| Cochlear Implant ProcedureAPC 5166 | 18 | 18 | $132,821 | $27,867 | $29,489 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 16 | 16 | $136,298 | $25,439 | $26,955 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 16 | 16 | $28,477 | $2,457 | $2,547 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 12 | 12 | $47,735 | $5,539 | $5,682 |
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.