Good Samaritan Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Good Samaritan Hospital, West Islip, NY in 2024, from traditional Medicare claims. Back to the Good Samaritan Hospital profile, with quality ratings, finances and negotiated rates.
5,930
Medicare inpatient discharges
In 160 published DRGs
1.99
Case mix index
IPPS FY 2027
24%
Surgical stays
64%
Stays with complications
In DRGs with a CC or MCC
4,419
Medicare outpatient services
In 43 service groups
Inpatient stays by major diagnostic category
Circulatory system1,241 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 234 | $70,154 | $10,489 | $13,470 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 164 | $186,489 | $27,213 | $35,806 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 63 | $295,608 | $42,042 | $56,757 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 62 | $93,152 | $12,823 | $17,885 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 56 | $136,940 | $13,183 | $26,292 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 49 | $47,253 | $5,284 | $9,073 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 42 | $116,964 | $16,648 | $22,457 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 40 | $72,925 | $8,250 | $14,002 | 1.08 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 37 | $204,519 | $22,699 | $39,268 | 2.87 |
| Syncope and collapseMS-DRG 312, medical | 36 | $56,916 | $6,706 | $10,928 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 33 | $71,072 | $9,418 | $13,646 | 1.20 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 31 | $255,911 | $29,454 | $49,135 | 4.04 |
| Other vascular procedures with CCMS-DRG 253, surgical | 28 | $139,852 | $19,433 | $26,852 | 2.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 25 | $456,487 | $68,843 | $87,646 | 7.71 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 25 | $277,103 | $44,820 | $53,204 | 5.06 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 24 | $53,323 | $7,114 | $10,238 | 0.91 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 24 | $33,838 | $3,959 | $6,497 | 0.55 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 23 | $280,641 | $38,111 | $53,883 | 5.20 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 23 | $231,622 | $27,807 | $44,471 | 3.27 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 23 | $83,830 | $12,005 | $16,095 | 1.58 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 22 | $50,455 | $8,637 | $9,687 | 1.07 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 19 | $157,904 | $28,086 | $30,318 | 3.35 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 19 | $316,325 | $51,662 | $60,734 | 6.25 |
| Hypertension without MCCMS-DRG 305, medical | 19 | $48,003 | $4,376 | $9,217 | 0.75 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 19 | $129,279 | $16,263 | $24,822 | 2.09 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 16 | $112,311 | $19,494 | $21,564 | 2.28 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 13 | $193,507 | $29,811 | $37,153 | 3.46 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $159,363 | $27,777 | $30,598 | 3.46 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 13 | $259,984 | $26,747 | $49,917 | 3.90 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 12 | $101,560 | $12,708 | $19,500 | 1.83 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 12 | $58,958 | $8,336 | $11,320 | 0.97 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 11 | $104,289 | $11,809 | $20,024 | 1.74 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $211,195 | $32,742 | $40,549 | 4.16 |
Infectious and parasitic diseases807 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 | 556 | $105,793 | $16,464 | $20,312 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 92 | $63,625 | $8,137 | $12,216 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 82 | $281,612 | $45,456 | $54,069 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 49 | $298,557 | $54,345 | $57,323 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 17 | $85,675 | $16,080 | $16,450 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $63,155 | $8,277 | $12,126 | 1.01 |
Respiratory system806 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 146 | $92,448 | $12,860 | $17,750 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 127 | $75,687 | $10,004 | $14,532 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 115 | $73,598 | $10,739 | $14,131 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 56 | $47,101 | $6,187 | $9,043 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 50 | $68,213 | $9,045 | $13,097 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 34 | $80,065 | $7,807 | $15,373 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 34 | $144,439 | $21,014 | $27,732 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 32 | $96,830 | $11,883 | $18,591 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 28 | $60,404 | $7,712 | $11,598 | 1.05 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 25 | $56,165 | $5,931 | $10,784 | 0.82 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 24 | $327,406 | $57,803 | $62,862 | 6.91 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 23 | $53,754 | $7,434 | $10,321 | 0.96 |
| Major chest procedures with MCCMS-DRG 163, surgical | 21 | $307,037 | $36,811 | $58,951 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 19 | $111,693 | $15,402 | $21,445 | 1.74 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 18 | $45,625 | $6,327 | $8,760 | 0.85 |
| Major chest trauma with MCCMS-DRG 183, medical | 17 | $80,990 | $13,005 | $15,550 | 1.57 |
| Major chest procedures with CCMS-DRG 164, surgical | 14 | $169,722 | $20,096 | $32,587 | 2.55 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 12 | $36,695 | $4,653 | $7,045 | 0.63 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 11 | $82,897 | $14,705 | $15,916 | 1.81 |
Nervous system736 discharges in 29 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 86 | $130,523 | $15,916 | $25,060 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 70 | $81,095 | $8,075 | $15,570 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 57 | $61,546 | $5,840 | $11,817 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 48 | $51,299 | $7,005 | $9,849 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 32 | $105,569 | $16,276 | $20,269 | 1.98 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 31 | $153,939 | $17,078 | $29,556 | 2.23 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 28 | $321,067 | $39,861 | $61,645 | 5.67 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 28 | $72,001 | $9,237 | $13,824 | 1.14 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 27 | $67,887 | $6,347 | $13,034 | 0.87 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 26 | $65,638 | $8,252 | $12,602 | 1.03 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 25 | $85,145 | $11,246 | $16,348 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 21 | $247,067 | $36,879 | $47,437 | 4.42 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 20 | $130,836 | $19,513 | $25,121 | 2.30 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 19 | $98,902 | $14,116 | $18,989 | 1.81 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 18 | $74,679 | $10,286 | $14,338 | 1.36 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 18 | $63,386 | $4,486 | $12,170 | 0.69 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 18 | $58,554 | $8,086 | $11,242 | 1.03 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 17 | $211,782 | $32,188 | $40,662 | 3.85 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 16 | $181,559 | $24,875 | $34,859 | 2.95 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 15 | $52,055 | $5,506 | $9,995 | 0.77 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 14 | $177,360 | $20,992 | $34,053 | 2.43 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 14 | $129,125 | $21,147 | $24,792 | 2.28 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 14 | $82,228 | $14,918 | $15,788 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 13 | $209,215 | $30,348 | $40,169 | 3.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 13 | $148,414 | $20,807 | $28,496 | 1.47 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 13 | $60,625 | $18,516 | $11,640 | 2.39 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 13 | $157,335 | $20,427 | $30,208 | 2.27 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 11 | $101,926 | $14,804 | $19,570 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $60,736 | $7,872 | $11,661 | 1.06 |
Digestive system592 discharges in 16 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 | 124 | $44,807 | $5,615 | $8,603 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 106 | $112,072 | $15,145 | $21,518 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 92 | $61,873 | $7,948 | $11,880 | 0.98 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 41 | $53,491 | $7,618 | $10,270 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 37 | $86,088 | $10,248 | $16,529 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 34 | $48,526 | $6,166 | $9,317 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 23 | $103,968 | $15,970 | $19,962 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 22 | $256,497 | $34,281 | $49,247 | 4.52 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 18 | $143,862 | $18,605 | $27,622 | 2.37 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 16 | $84,451 | $11,337 | $16,215 | 1.45 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 14 | $91,473 | $12,674 | $17,563 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 14 | $77,630 | $9,203 | $14,905 | 1.04 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 14 | $35,961 | $5,016 | $6,904 | 0.65 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 13 | $38,003 | $4,602 | $7,297 | 0.63 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 13 | $40,131 | $3,851 | $7,705 | 0.56 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 11 | $82,624 | $17,929 | $15,864 | 2.11 |
Kidney and urinary tract552 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 116 | $43,149 | $6,343 | $8,285 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 96 | $54,812 | $9,370 | $10,524 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 88 | $55,080 | $7,050 | $10,575 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 78 | $88,604 | $13,685 | $17,012 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 68 | $87,285 | $11,631 | $16,759 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 42 | $42,950 | $8,567 | $8,246 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 18 | $181,969 | $32,825 | $34,938 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 16 | $75,598 | $11,187 | $14,515 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 16 | $53,632 | $7,797 | $10,297 | 1.05 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 14 | $49,452 | $5,200 | $9,495 | 0.69 |
Musculoskeletal system and connective tissue439 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 69 | $48,998 | $7,108 | $9,408 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 67 | $125,811 | $17,066 | $24,156 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 35 | $129,742 | $17,527 | $24,910 | 2.11 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 26 | $107,542 | $15,070 | $20,648 | 1.88 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 23 | $201,521 | $25,096 | $38,692 | 2.95 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 22 | $55,809 | $8,671 | $10,715 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 22 | $62,654 | $6,964 | $12,030 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 19 | $67,905 | $13,379 | $13,038 | 1.87 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 19 | $47,757 | $6,825 | $9,169 | 0.88 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 18 | $108,365 | $20,321 | $20,806 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $55,848 | $6,059 | $10,723 | 0.79 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 15 | $49,887 | $6,470 | $9,578 | 0.82 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 14 | $292,164 | $28,352 | $56,096 | 4.61 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 14 | $50,934 | $5,831 | $9,779 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 13 | $253,779 | $32,800 | $48,726 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 13 | $86,021 | $13,553 | $16,516 | 1.70 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 11 | $288,790 | $45,990 | $55,448 | 6.12 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 11 | $137,140 | $22,681 | $26,331 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 11 | $105,600 | $17,422 | $20,275 | 2.04 |
Endocrine, nutritional and metabolic182 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 without MCCMS-DRG 641, medical | 73 | $41,112 | $6,015 | $7,894 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 47 | $75,720 | $10,614 | $14,538 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 33 | $48,618 | $7,089 | $9,335 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 17 | $92,604 | $11,866 | $17,780 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 12 | $110,588 | $16,552 | $21,233 | 1.98 |
Blood and immune system150 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 90 | $72,817 | $11,496 | $13,981 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 45 | $53,820 | $7,505 | $10,333 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 15 | $91,969 | $13,078 | $17,658 | 1.56 |
Skin, subcutaneous tissue and breast123 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 86 | $44,956 | $6,396 | $8,632 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 21 | $82,528 | $12,325 | $15,845 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 16 | $47,195 | $7,406 | $9,061 | 0.91 |
Liver, gallbladder and pancreas74 discharges in 5 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 | 20 | $72,689 | $11,069 | $13,956 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 17 | $105,960 | $19,978 | $20,344 | 2.32 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 14 | $69,136 | $8,601 | $13,274 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 12 | $135,512 | $18,301 | $26,018 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 11 | $65,275 | $13,885 | $12,533 | 1.63 |
Other40 discharges in 2 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 | 26 | $206,753 | $36,211 | $39,697 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $141,408 | $19,082 | $27,150 | 2.49 |
Alcohol and drug use39 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 | 26 | $48,492 | $6,557 | $9,310 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 13 | $84,965 | $15,440 | $16,313 | 1.78 |
Injuries, poisonings and toxic effects of drugs39 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $89,508 | $15,950 | $17,186 | 1.82 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 11 | $115,355 | $16,741 | $22,148 | 2.00 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 11 | $80,836 | $11,048 | $15,521 | 1.60 |
Transplants, ECMO and tracheostomy (pre-MDC)35 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 19 | $452,002 | $103,300 | $86,784 | 14.70 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 16 | $1,156,818 | $179,204 | $222,109 | 21.32 |
Mental diseases and disorders27 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 | 27 | $57,916 | $13,557 | $11,120 | 1.76 |
Factors influencing health status26 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 | 26 | $60,947 | $5,887 | $11,702 | 0.80 |
Ear, nose, mouth and throat22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 22 | $55,420 | $5,523 | $10,641 | 0.74 |
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 | 1,153 | 1,046 | $28,477 | $2,406 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 407 | 406 | $28,351 | $2,583 | $2,208 |
| Level 3 Endovascular ProceduresAPC 5193 | 258 | 237 | $91,194 | $10,565 | $8,874 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 202 | 202 | $63,149 | $7,654 | $6,514 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 162 | 150 | $12,456 | $1,429 | $1,220 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 153 | 152 | $24,689 | $5,034 | $4,358 |
| Level 4 Vascular ProceduresAPC 5184 | 148 | 136 | $17,112 | $4,802 | $3,946 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 139 | 138 | $83,220 | $12,946 | $10,772 |
| Level 1 Nerve ProceduresAPC 5431 | 131 | 96 | $14,901 | $1,715 | $1,407 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 129 | 125 | $193,574 | $24,817 | $21,117 |
| Level 5 Urology and Related ServicesAPC 5375 | 128 | 120 | $27,407 | $4,555 | $3,918 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 106 | 106 | $71,588 | $10,180 | $8,569 |
| Level 2 Upper GI ProceduresAPC 5302 | 97 | 90 | $10,609 | $1,657 | $1,445 |
| Level 4 Urology and Related ServicesAPC 5374 | 89 | 82 | $20,297 | $3,066 | $2,629 |
| Level 4 Gynecologic ProceduresAPC 5414 | 85 | 84 | $15,299 | $2,781 | $2,389 |
| Level 3 Vascular ProceduresAPC 5183 | 80 | 75 | $26,999 | $2,801 | $2,405 |
| Level 4 Endovascular ProceduresAPC 5194 | 80 | 77 | $129,618 | $17,681 | $14,606 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 80 | 80 | $19,860 | $3,006 | $2,636 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 73 | 72 | $33,418 | $6,192 | $5,339 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 59 | 59 | $18,624 | $2,529 | $2,141 |
| Level 4 Airway EndoscopyAPC 5154 | 54 | 51 | $38,630 | $3,270 | $2,833 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 53 | 53 | $19,302 | $2,880 | $2,373 |
| Level 2 Endovascular ProceduresAPC 5192 | 47 | 44 | $49,962 | $4,978 | $4,338 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 41 | $25,930 | $3,392 | $2,930 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 42 | 42 | $233,257 | $34,988 | $29,375 |
| Level 5 Airway EndoscopyAPC 5155 | 41 | 40 | $42,737 | $6,091 | $5,183 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 40 | 40 | $55,639 | $9,851 | $8,164 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 37 | 37 | $15,803 | $1,390 | $1,196 |
| Level 3 Urology and Related ServicesAPC 5373 | 35 | 31 | $19,385 | $1,813 | $1,516 |
| Level 5 ENT ProceduresAPC 5165 | 32 | 32 | $29,104 | $5,211 | $4,436 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 31 | 31 | $40,723 | $5,803 | $4,982 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 29 | 29 | $139,000 | $19,383 | $17,052 |
| Level 2 Vascular ProceduresAPC 5182 | 27 | 27 | $13,421 | $1,320 | $1,204 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 24 | 22 | $95,726 | $19,130 | $15,763 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 17 | 17 | $63,663 | $6,708 | $5,682 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 15 | 15 | $182,991 | $30,730 | $26,955 |
| Complex GI ProceduresAPC 5331 | 15 | 13 | $26,315 | $4,733 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 15 | 11 | $26,762 | $4,426 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 14 | 14 | $16,015 | $3,408 | $2,888 |
| Level 3 Lower GI ProceduresAPC 5313 | 13 | 13 | $13,944 | $2,530 | $2,176 |
| Level 7 Radiation TherapyAPC 5627 | 13 | 12 | $68,210 | $7,063 | $6,121 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 12 | 12 | $157,048 | $22,568 | $21,011 |
| Level 2 Intraocular ProceduresAPC 5492 | 12 | 11 | $20,778 | $3,618 | $3,116 |
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.