Henry Ford Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Henry Ford Hospital, Detroit, MI in 2024, from traditional Medicare claims. Back to the Henry Ford Hospital profile, with quality ratings, finances and negotiated rates.
3,929
Medicare inpatient discharges
In 142 published DRGs
2.61
Case mix index
IPPS FY 2027
30%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
6,938
Medicare outpatient services
In 48 service groups
Inpatient stays by major diagnostic category
Circulatory system1,147 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 206 | $36,060 | $12,295 | $11,070 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 118 | $167,268 | $45,855 | $51,351 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 78 | $92,649 | $30,988 | $28,443 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 73 | $71,292 | $19,180 | $21,887 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 50 | $25,368 | $6,530 | $7,788 | 0.74 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 44 | $237,663 | $64,707 | $72,963 | 6.25 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 33 | $73,469 | $15,890 | $22,555 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 32 | $125,003 | $34,718 | $38,376 | 3.35 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 32 | $51,052 | $19,491 | $15,673 | 2.09 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 31 | $160,205 | $51,451 | $49,183 | 5.06 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 28 | $83,204 | $16,464 | $25,544 | 1.82 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 27 | $36,333 | $8,437 | $11,154 | 0.91 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 26 | $171,488 | $36,337 | $52,647 | 4.04 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 25 | $43,527 | $9,858 | $13,363 | 1.08 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 25 | $49,157 | $11,893 | $15,091 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 24 | $115,460 | $26,784 | $35,446 | 2.87 |
| Other vascular procedures with CCMS-DRG 253, surgical | 22 | $114,916 | $21,786 | $35,279 | 2.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 22 | $31,896 | $8,093 | $9,792 | 0.97 |
| Syncope and collapseMS-DRG 312, medical | 21 | $26,943 | $8,008 | $8,272 | 0.86 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 19 | $138,981 | $32,340 | $42,667 | 3.46 |
| Other endovascular cardiac valve procedures with MCCMS-DRG 319, surgical | 19 | $127,763 | $46,740 | $39,223 | 4.36 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $56,411 | $16,204 | $17,318 | 1.58 |
| Hypertension with MCCMS-DRG 304, medical | 17 | $56,466 | $10,171 | $17,335 | 1.15 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 15 | $342,933 | $100,730 | $105,280 | 9.71 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 15 | $241,313 | $49,634 | $74,083 | 5.24 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $24,862 | $5,624 | $7,633 | 0.75 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 13 | $336,031 | $86,685 | $103,161 | 7.71 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 13 | $215,358 | $53,577 | $66,115 | 5.88 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 13 | $253,585 | $58,246 | $77,851 | 6.85 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 13 | $103,717 | $34,820 | $31,841 | 3.90 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $29,902 | $7,946 | $9,180 | 0.86 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 13 | $37,162 | $8,963 | $11,409 | 1.07 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 12 | $149,244 | $32,929 | $45,818 | 3.18 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 11 | $194,676 | $48,854 | $59,766 | 4.81 |
| Other endovascular cardiac valve procedures without MCCMS-DRG 320, surgical | 11 | $64,687 | $21,998 | $19,859 | 2.23 |
Respiratory system503 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 71 | $49,913 | $11,860 | $15,323 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 47 | $41,531 | $15,328 | $12,750 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 47 | $26,877 | $12,416 | $8,251 | 1.33 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 37 | $19,245 | $7,896 | $5,908 | 0.85 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 37 | $23,129 | $7,065 | $7,101 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 36 | $65,964 | $19,001 | $20,251 | 2.55 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 33 | $27,905 | $10,703 | $8,567 | 1.10 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 21 | $31,570 | $7,828 | $9,692 | 0.99 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 21 | $68,425 | $16,814 | $21,007 | 1.81 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 21 | $71,995 | $24,786 | $22,103 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 19 | $58,290 | $12,810 | $17,895 | 1.40 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 16 | $74,226 | $18,622 | $22,787 | 1.90 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 16 | $35,797 | $8,588 | $10,990 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 14 | $56,012 | $17,625 | $17,196 | 1.88 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 14 | $40,738 | $17,308 | $12,507 | 1.74 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $282,858 | $73,706 | $86,837 | 6.91 |
| Major chest procedures with MCCMS-DRG 163, surgical | 13 | $114,615 | $45,966 | $35,187 | 4.71 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 13 | $88,895 | $33,058 | $27,291 | 4.06 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 13 | $55,292 | $15,874 | $16,975 | 1.82 |
Digestive system397 discharges in 15 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 | 75 | $27,016 | $7,034 | $8,294 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 65 | $30,063 | $8,164 | $9,229 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 45 | $68,983 | $18,352 | $21,178 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 35 | $90,118 | $20,549 | $27,666 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 19 | $125,333 | $37,897 | $38,477 | 4.52 |
| Digestive malignancy with MCCMS-DRG 374, medical | 19 | $48,324 | $19,577 | $14,836 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 18 | $37,640 | $11,106 | $11,555 | 1.20 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 18 | $41,274 | $12,462 | $12,671 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 18 | $36,442 | $14,775 | $11,188 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 18 | $21,855 | $8,745 | $6,710 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 16 | $23,805 | $7,988 | $7,308 | 0.80 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $118,752 | $24,846 | $36,457 | 2.50 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 14 | $16,671 | $4,190 | $5,118 | 0.56 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 12 | $65,107 | $15,764 | $19,988 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 11 | $65,022 | $14,943 | $19,962 | 1.75 |
Infectious and parasitic diseases382 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 | 211 | $68,675 | $18,890 | $21,083 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 68 | $31,627 | $8,882 | $9,710 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 46 | $175,880 | $55,521 | $53,995 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 34 | $203,416 | $62,215 | $62,449 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $69,972 | $14,274 | $21,482 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 11 | $60,615 | $17,693 | $18,609 | 2.04 |
Nervous system282 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 56 | $168,595 | $39,997 | $51,759 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 45 | $48,010 | $8,779 | $14,739 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 40 | $87,486 | $22,197 | $26,858 | 2.00 |
| Seizures without MCCMS-DRG 101, medical | 28 | $47,304 | $7,189 | $14,522 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 20 | $201,774 | $58,885 | $61,945 | 5.67 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $59,125 | $13,814 | $18,151 | 1.47 |
| Seizures with MCCMS-DRG 100, medical | 16 | $118,015 | $22,251 | $36,231 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 15 | $24,593 | $5,670 | $7,550 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 13 | $46,011 | $12,004 | $14,125 | 1.36 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 11 | $76,577 | $21,114 | $23,509 | 2.43 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $52,752 | $12,646 | $16,195 | 1.03 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 11 | $41,889 | $8,154 | $12,860 | 1.03 |
Liver, gallbladder and pancreas274 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 40 | $51,554 | $16,955 | $15,827 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 39 | $74,717 | $17,008 | $22,938 | 1.83 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 30 | $77,157 | $20,109 | $23,687 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 27 | $45,520 | $16,176 | $13,975 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 27 | $28,789 | $9,260 | $8,838 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 24 | $33,459 | $7,975 | $10,272 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 23 | $56,582 | $16,473 | $17,371 | 1.67 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 18 | $37,063 | $8,708 | $11,378 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 18 | $33,698 | $9,122 | $10,345 | 0.95 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 15 | $116,689 | $27,835 | $35,823 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 13 | $79,926 | $14,765 | $24,537 | 1.63 |
Kidney and urinary tract258 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 42 | $22,523 | $8,365 | $6,915 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 38 | $24,919 | $6,875 | $7,650 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 35 | $26,568 | $8,657 | $8,156 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 34 | $57,368 | $13,750 | $17,612 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 27 | $39,676 | $15,231 | $12,181 | 1.65 |
| Kidney transplantMS-DRG 652, surgical | 21 | $286,665 | $25,321 | $88,006 | 3.00 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 18 | $317,809 | $44,498 | $97,567 | 4.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 16 | $33,965 | $10,073 | $10,427 | 1.17 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 15 | $110,710 | $37,397 | $33,988 | 3.70 |
| Major bladder procedures with CCMS-DRG 654, surgical | 12 | $123,223 | $26,601 | $37,829 | 2.74 |
Endocrine, nutritional and metabolic148 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 | 47 | $29,451 | $6,856 | $9,041 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 45 | $38,628 | $12,528 | $11,859 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 38 | $22,563 | $8,114 | $6,927 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 18 | $41,976 | $12,294 | $12,887 | 1.45 |
Musculoskeletal system and connective tissue117 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 25 | $32,400 | $9,201 | $9,947 | 0.97 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 19 | $248,412 | $54,571 | $76,263 | 6.12 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 18 | $66,800 | $18,469 | $20,508 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 16 | $75,401 | $20,240 | $23,148 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $111,686 | $32,296 | $34,288 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $105,575 | $28,331 | $32,411 | 2.96 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 12 | $152,253 | $36,727 | $46,742 | 4.61 |
Blood cancers and poorly differentiated neoplasms96 discharges in 5 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 | 37 | $27,726 | $8,956 | $8,512 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 20 | $239,674 | $56,483 | $73,580 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 15 | $38,451 | $16,521 | $11,805 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 12 | $61,669 | $52,699 | $18,932 | 4.84 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 12 | $74,950 | $17,856 | $23,010 | 1.57 |
Injuries, poisonings and toxic effects of drugs81 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 25 | $38,514 | $17,509 | $11,824 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 18 | $39,826 | $13,533 | $12,227 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 14 | $111,660 | $34,828 | $34,280 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $42,849 | $17,383 | $13,155 | 2.00 |
| Complications of treatment with CCMS-DRG 920, medical | 12 | $35,147 | $8,120 | $10,790 | 1.03 |
Transplants, ECMO and tracheostomy (pre-MDC)76 discharges in 4 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 | 38 | $553,036 | $186,962 | $169,782 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 14 | $426,458 | $133,628 | $130,923 | 14.70 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 13 | $661,570 | $126,065 | $203,102 | 10.35 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 11 | $884,886 | $250,940 | $271,660 | 27.10 |
Blood and immune system58 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 27 | $29,339 | $8,312 | $9,007 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 18 | $34,901 | $13,439 | $10,715 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 13 | $45,908 | $11,872 | $14,094 | 1.20 |
Skin, subcutaneous tissue and breast37 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 37 | $22,778 | $7,821 | $6,993 | 0.88 |
Other30 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 | 16 | $141,275 | $45,551 | $43,371 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 14 | $101,190 | $21,348 | $31,065 | 2.49 |
Factors influencing health status21 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 | 21 | $25,954 | $7,449 | $7,968 | 0.80 |
Mental diseases and disorders11 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 | 11 | $30,638 | $13,803 | $9,406 | 1.76 |
Alcohol and drug use11 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 | 11 | $22,375 | $8,186 | $6,869 | 0.86 |
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 | 1,070 | 732 | $8,783 | $1,343 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 602 | 531 | $15,215 | $1,909 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 557 | 348 | $1,538 | $442 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 398 | 371 | $5,629 | $1,121 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 389 | 314 | $7,079 | $1,297 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 345 | 290 | $4,888 | $1,384 | $1,516 |
| Level 1 Nerve ProceduresAPC 5431 | 237 | 208 | $6,852 | $1,100 | $1,407 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 207 | 175 | $8,045 | $1,778 | $2,141 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 203 | 195 | $36,055 | $7,045 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 196 | 186 | $10,309 | $2,046 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 176 | 146 | $11,174 | $2,195 | $2,405 |
| Level 4 Urology and Related ServicesAPC 5374 | 169 | 152 | $10,720 | $2,192 | $2,629 |
| Level 3 Endovascular ProceduresAPC 5193 | 156 | 127 | $43,244 | $8,128 | $8,874 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 151 | 143 | $3,502 | $998 | $1,196 |
| Level 3 Airway EndoscopyAPC 5153 | 147 | 111 | $3,581 | $1,182 | $1,264 |
| Level 4 Airway EndoscopyAPC 5154 | 137 | 102 | $13,870 | $2,643 | $2,833 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 132 | 128 | $65,957 | $18,929 | $21,117 |
| Level 2 Intraocular ProceduresAPC 5492 | 120 | 99 | $14,106 | $1,938 | $3,116 |
| Complex GI ProceduresAPC 5331 | 118 | 92 | $19,936 | $3,986 | $4,263 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 115 | 114 | $25,039 | $4,606 | $5,339 |
| Level 4 Endovascular ProceduresAPC 5194 | 110 | 96 | $76,690 | $13,862 | $14,606 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 103 | 99 | $13,077 | $1,945 | $2,373 |
| Level 2 Endovascular ProceduresAPC 5192 | 88 | 76 | $11,398 | $4,020 | $4,338 |
| Level 5 Airway EndoscopyAPC 5155 | 87 | 85 | $36,591 | $4,780 | $5,183 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 81 | 43 | $10,817 | $2,395 | $2,636 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 74 | 74 | $33,242 | $3,994 | $4,358 |
| Level 3 Lower GI ProceduresAPC 5313 | 68 | 66 | $7,868 | $1,722 | $2,176 |
| Level 4 Vascular ProceduresAPC 5184 | 66 | 63 | $20,494 | $3,670 | $3,946 |
| Level 2 Vascular ProceduresAPC 5182 | 65 | 60 | $6,107 | $1,027 | $1,204 |
| Level 3 Upper GI ProceduresAPC 5303 | 61 | 61 | $11,671 | $2,725 | $2,888 |
| Level 5 Urology and Related ServicesAPC 5375 | 61 | 59 | $24,001 | $3,343 | $3,918 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 48 | 48 | $56,502 | $7,398 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 46 | 43 | $14,162 | $2,645 | $2,930 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 43 | 41 | $9,585 | $1,461 | $1,780 |
| Level 5 ENT ProceduresAPC 5165 | 34 | 33 | $23,331 | $3,921 | $4,436 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 34 | 34 | $11,148 | $4,093 | $4,524 |
| Level 4 Gynecologic ProceduresAPC 5414 | 32 | 31 | $8,458 | $1,696 | $2,389 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 29 | 29 | $23,686 | $4,639 | $4,982 |
| Level 7 Radiation TherapyAPC 5627 | 29 | 27 | $16,731 | $5,426 | $6,121 |
| Level 4 ENT ProceduresAPC 5164 | 26 | 24 | $13,847 | $2,178 | $2,217 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 25 | 25 | $70,730 | $13,601 | $15,763 |
| Level 3 ENT ProceduresAPC 5163 | 22 | 16 | $1,554 | $1,040 | $1,106 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 15 | 15 | $49,420 | $7,897 | $8,569 |
| Level 3 Intraocular ProceduresAPC 5493 | 15 | 14 | $22,234 | $2,826 | $4,004 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 13 | 13 | $122,683 | $27,658 | $29,375 |
| Level 6 Urology and Related ServicesAPC 5376 | 13 | 13 | $36,524 | $5,677 | $7,291 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 13 | 13 | $80,269 | $16,481 | $18,465 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 12 | 12 | $29,948 | $6,044 | $6,514 |
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.