Falmouth Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Falmouth Hospital, Falmouth, MA in 2024, from traditional Medicare claims. Back to the Falmouth Hospital profile, with quality ratings, finances and negotiated rates.
2,570
Medicare inpatient discharges
In 64 published DRGs
1.47
Case mix index
IPPS FY 2027
7%
Surgical stays
73%
Stays with complications
In DRGs with a CC or MCC
1,694
Medicare outpatient services
In 22 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases686 discharges in 5 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 | 509 | $31,143 | $13,685 | $13,734 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 106 | $20,589 | $6,899 | $9,080 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 40 | $78,724 | $36,069 | $34,717 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 17 | $42,488 | $14,756 | $18,737 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 14 | $125,464 | $55,045 | $55,330 | 6.96 |
Respiratory system449 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 119 | $27,243 | $11,668 | $12,014 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 100 | $22,478 | $9,136 | $9,913 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 57 | $25,764 | $9,013 | $11,362 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 42 | $17,448 | $7,531 | $7,695 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 37 | $18,762 | $5,230 | $8,274 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 32 | $20,618 | $6,527 | $9,092 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 28 | $26,442 | $9,280 | $11,661 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $19,671 | $6,179 | $8,675 | 0.96 |
| Major chest trauma with CCMS-DRG 184, medical | 11 | $25,279 | $7,090 | $11,148 | 1.05 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 11 | $14,346 | $3,645 | $6,327 | 0.63 |
Circulatory system372 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 169 | $23,637 | $9,022 | $10,424 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 55 | $32,807 | $11,516 | $14,468 | 1.59 |
| Syncope and collapseMS-DRG 312, medical | 35 | $27,854 | $5,669 | $12,283 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 28 | $19,829 | $5,820 | $8,745 | 0.91 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 20 | $17,803 | $4,654 | $7,851 | 0.72 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 20 | $25,668 | $7,442 | $11,320 | 1.20 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 16 | $23,704 | $4,549 | $10,453 | 0.74 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $23,133 | $4,821 | $10,202 | 0.75 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 14 | $17,927 | $3,060 | $7,906 | 0.55 |
Kidney and urinary tract287 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 103 | $20,092 | $7,846 | $8,861 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 59 | $27,845 | $12,138 | $12,280 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 53 | $19,225 | $5,271 | $8,478 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 40 | $28,526 | $10,744 | $12,580 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 32 | $17,921 | $6,152 | $7,903 | 0.90 |
Digestive system252 discharges in 10 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 | 76 | $19,696 | $5,001 | $8,686 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 50 | $27,101 | $6,487 | $11,952 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 25 | $28,844 | $9,399 | $12,720 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 20 | $39,169 | $12,848 | $17,273 | 1.79 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 17 | $16,821 | $3,195 | $7,418 | 0.56 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 16 | $26,436 | $10,985 | $11,658 | 1.45 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 13 | $89,912 | $33,886 | $39,651 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 12 | $16,991 | $5,137 | $7,493 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 12 | $31,990 | $11,507 | $14,107 | 1.62 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 11 | $69,249 | $17,732 | $30,539 | 2.37 |
Musculoskeletal system and connective tissue189 discharges in 10 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 | 35 | $42,242 | $13,599 | $18,629 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 34 | $20,850 | $6,565 | $9,195 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 17 | $44,345 | $15,066 | $19,556 | 2.07 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $18,173 | $4,580 | $8,014 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 17 | $28,009 | $11,426 | $12,352 | 1.70 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 15 | $65,418 | $19,015 | $28,849 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 15 | $54,721 | $20,589 | $24,132 | 2.99 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 15 | $19,040 | $5,666 | $8,397 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 13 | $53,242 | $15,399 | $23,480 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 11 | $56,883 | $21,136 | $25,086 | 2.95 |
Nervous system160 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 63 | $33,580 | $13,357 | $14,809 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 51 | $26,333 | $6,700 | $11,613 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 24 | $23,705 | $5,150 | $10,454 | 0.80 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 11 | $25,266 | $3,636 | $11,143 | 0.69 |
| Seizures with MCCMS-DRG 100, medical | 11 | $37,832 | $13,666 | $16,684 | 1.98 |
Skin, subcutaneous tissue and breast63 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 40 | $17,062 | $5,882 | $7,524 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 23 | $26,066 | $10,148 | $11,495 | 1.49 |
Endocrine, nutritional and metabolic60 discharges in 4 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 | 24 | $17,449 | $5,295 | $7,695 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 13 | $26,343 | $9,682 | $11,617 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 12 | $17,560 | $5,720 | $7,744 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 11 | $31,973 | $9,878 | $14,100 | 1.45 |
Blood and immune system28 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 15 | $23,261 | $11,550 | $10,258 | 1.56 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 13 | $25,907 | $6,389 | $11,425 | 0.90 |
Alcohol and drug use13 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 with MCCMS-DRG 896, medical | 13 | $28,842 | $13,394 | $12,719 | 1.78 |
Liver, gallbladder and pancreas11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of pancreas except malignancy without cc/mccMS-DRG 440, medical | 11 | $17,277 | $3,544 | $7,619 | 0.62 |
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 | 471 | 449 | $18,977 | $2,297 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 172 | 156 | $6,875 | $1,371 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 152 | 150 | $29,860 | $12,396 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 124 | 123 | $21,588 | $6,121 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 99 | 94 | $9,920 | $2,768 | $2,373 |
| Level 1 Nerve ProceduresAPC 5431 | 97 | 92 | $10,914 | $1,647 | $1,407 |
| Level 2 Upper GI ProceduresAPC 5302 | 66 | 61 | $9,258 | $1,634 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 60 | 60 | $22,538 | $4,852 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 57 | 55 | $12,802 | $4,424 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 51 | 51 | $14,875 | $2,724 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 51 | 44 | $11,692 | $2,983 | $2,629 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 46 | 40 | $6,527 | $1,375 | $1,196 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 45 | 45 | $16,663 | $2,955 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 44 | 44 | $9,965 | $2,614 | $2,389 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 31 | 29 | $18,972 | $3,262 | $2,930 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 23 | 22 | $10,616 | $2,428 | $2,141 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 22 | 22 | $44,504 | $17,500 | $15,763 |
| Level 3 Urology and Related ServicesAPC 5373 | 20 | 19 | $9,077 | $1,739 | $1,516 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 18 | 18 | $41,270 | $9,822 | $8,569 |
| Level 2 Vascular ProceduresAPC 5182 | 17 | 16 | $7,214 | $1,367 | $1,204 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 16 | 16 | $37,428 | $5,580 | $4,982 |
| Level 2 Urology and Related ServicesAPC 5372 | 12 | $41,092 | $585 | $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.