Highland Hospital Medicare inpatient and outpatient services

Every DRG and outpatient service group CMS publishes for Highland Hospital, Rochester, NY in 2024, from traditional Medicare claims. Back to the Highland Hospital profile, with quality ratings, finances and negotiated rates.

1,723
Medicare inpatient discharges
In 56 published DRGs
1.56
Case mix index
IPPS FY 2027
12%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
1,442
Medicare outpatient services
In 26 service groups

Inpatient stays by major diagnostic category

Infectious and parasitic diseases346 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	233	$37,747	$15,697	$16,080	1.98
Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical	55	$23,281	$7,853	$9,918	1.03
Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical	33	$94,183	$37,541	$40,122	5.00
Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical	13	$139,938	$59,250	$59,613	6.96
Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical	12	$51,680	$15,323	$22,016	2.04

Circulatory system223 discharges in 6 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Heart failure and shock with MCCMS-DRG 291, medical	144	$25,239	$10,363	$10,752	1.28
Other circulatory system diagnoses with MCCMS-DRG 314, medical	22	$52,176	$18,661	$22,227	2.09
Syncope and collapseMS-DRG 312, medical	21	$20,316	$6,885	$8,655	0.86
Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical	14	$15,109	$4,860	$6,437	0.74
Other vascular procedures with MCCMS-DRG 252, surgical	11	$140,542	$37,825	$59,871	3.35
Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical	11	$33,221	$9,670	$14,152	1.20

Respiratory system211 discharges in 6 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Simple pneumonia and pleurisy with MCCMS-DRG 193, medical	59	$29,725	$10,707	$12,663	1.33
Respiratory infections and inflammations with MCCMS-DRG 177, medical	49	$30,417	$13,802	$12,958	1.70
Respiratory infections and inflammations with CCMS-DRG 178, medical	32	$28,488	$7,298	$12,136	0.99
Pulmonary edema and respiratory failureMS-DRG 189, medical	29	$26,007	$10,382	$11,079	1.23
Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical	23	$43,945	$9,336	$18,721	1.10
Simple pneumonia and pleurisy with CCMS-DRG 194, medical	19	$16,662	$5,663	$7,098	0.82

Musculoskeletal system and connective tissue201 discharges in 9 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	51	$45,610	$14,440	$19,430	1.88
Hip and femur procedures except major joint with CCMS-DRG 481, surgical	37	$54,868	$17,621	$23,374	2.07
Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical	24	$48,505	$18,541	$20,663	2.11
Medical back problems without MCCMS-DRG 552, medical	22	$21,997	$7,874	$9,371	0.97
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical	16	$16,756	$7,171	$7,138	0.90
Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical	15	$17,240	$8,992	$7,344	1.09
Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical	13	$62,194	$24,101	$26,495	2.99
Revision of hip or knee replacement with CCMS-DRG 467, surgical	12	$76,053	$24,060	$32,398	3.49
Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical	11	$107,495	$37,466	$45,793	6.12

Kidney and urinary tract200 discharges in 6 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical	51	$27,693	$13,912	$11,797	1.65
Renal failure with CCMS-DRG 683, medical	39	$19,050	$7,355	$8,115	0.90
Renal failure with MCCMS-DRG 682, medical	35	$28,792	$12,195	$12,265	1.50
Kidney and urinary tract infections without MCCMS-DRG 690, medical	33	$20,526	$6,057	$8,744	0.81
Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical	23	$17,812	$6,988	$7,588	1.02
Kidney and urinary tract infections with MCCMS-DRG 689, medical	19	$41,699	$8,958	$17,764	1.17

Digestive system196 discharges in 8 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	56	$17,933	$5,779	$7,640	0.79
Gastrointestinal hemorrhage with CCMS-DRG 378, medical	29	$24,436	$7,540	$10,410	0.98
Gastrointestinal obstruction with CCMS-DRG 389, medical	24	$17,900	$6,469	$7,625	0.80
Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical	20	$38,501	$10,891	$16,402	1.28
Other digestive system diagnoses with CCMS-DRG 394, medical	20	$17,670	$7,922	$7,527	0.94
Gastrointestinal hemorrhage with MCCMS-DRG 377, medical	19	$46,019	$15,097	$19,604	1.79
Gastrointestinal obstruction with MCCMS-DRG 388, medical	17	$31,737	$12,134	$13,520	1.45
Gastrointestinal obstruction without cc/mccMS-DRG 390, medical	11	$17,425	$3,380	$7,423	0.56

Endocrine, nutritional and metabolic134 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	44	$16,957	$5,557	$7,224	0.78
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical	35	$23,230	$11,175	$9,896	1.32
Diabetes with MCCMS-DRG 637, medical	22	$42,054	$12,428	$17,915	1.45
Diabetes with CCMS-DRG 638, medical	20	$19,294	$6,103	$8,219	0.90
Endocrine disorders with MCCMS-DRG 643, medical	13	$41,688	$12,610	$17,759	1.65

Nervous system52 discharges in 3 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Degenerative nervous system disorders without MCCMS-DRG 057, medical	24	$29,248	$10,878	$12,459	1.36
Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical	14	$26,193	$7,254	$11,158	1.02
Other disorders of nervous system with CCMS-DRG 092, medical	14	$25,031	$9,136	$10,663	1.03

Skin, subcutaneous tissue and breast49 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Cellulitis without MCCMS-DRG 603, medical	37	$16,076	$7,310	$6,848	0.88
Cellulitis with MCCMS-DRG 602, medical	12	$29,378	$11,911	$12,515	1.49

Factors influencing health status36 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Other factors influencing health statusMS-DRG 951, medical	20	$13,454	$4,409	$5,731	0.59
Signs and symptoms without MCCMS-DRG 948, medical	16	$15,537	$7,054	$6,619	0.80

Blood and immune system32 discharges in 1 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Red blood cell disorders without MCCMS-DRG 812, medical	32	$32,323	$7,192	$13,770	0.90

Liver, gallbladder and pancreas24 discharges in 2 DRGs

Condition or procedure	Discharges	Average charges	Average Medicare payment	Estimated cost	DRG weight
Disorders of pancreas except malignancy with CCMS-DRG 439, medical	13	$14,881	$7,162	$6,339	0.86
Disorders of the biliary tract with CCMS-DRG 445, medical	11	$25,182	$7,345	$10,727	1.09

Mental diseases and disorders19 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	19	$47,923	$15,377	$20,415	1.76

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	280	264	$12,471	$2,279	$2,090
Level 5 Musculoskeletal ProceduresAPC 5115	211	205	$31,729	$11,889	$10,772
Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072	102	98	$6,977	$1,368	$1,220
Level 5 Urology and Related ServicesAPC 5375	77	69	$21,400	$4,314	$3,918
Level 1 Laparoscopy and Related ServicesAPC 5361	72	71	$20,985	$4,806	$4,358
Level 3 Urology and Related ServicesAPC 5373	71	39	$11,004	$1,719	$1,516
Level 4 Gynecologic ProceduresAPC 5414	64	60	$12,371	$2,641	$2,389
Level 4 Urology and Related ServicesAPC 5374	60	53	$14,599	$2,896	$2,629
Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341	56	53	$14,852	$2,817	$2,636
Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092	50	49	$28,188	$5,509	$4,982
Level 2 Laparoscopy and Related ServicesAPC 5362	49	49	$36,572	$9,270	$8,164
Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091	38	32	$18,325	$3,220	$2,930
Level 6 Musculoskeletal ProceduresAPC 5116	37	37	$41,014	$18,079	$15,763
Level 4 Musculoskeletal ProceduresAPC 5114	34	34	$23,901	$6,034	$5,339
Level 5 ENT ProceduresAPC 5165	34	34	$22,240	$4,656	$4,436
Level 3 Airway EndoscopyAPC 5153	31	30	$9,547	$1,434	$1,264
Level 3 Vascular ProceduresAPC 5183	31	31	$17,770	$2,693	$2,405
Level 2 Upper GI ProceduresAPC 5302	28	26	$8,186	$1,607	$1,445
Level 4 Airway EndoscopyAPC 5154	23	19	$16,023	$3,163	$2,833
Level 5 Neurostimulator and Related ProceduresAPC 5465	17	17	$74,744	$31,189	$26,719
Level 2 Musculoskeletal ProceduresAPC 5112	16	16	$10,426	$1,356	$1,196
Level 4 Vascular ProceduresAPC 5184	14	14	$22,742	$4,629	$3,946
Level 3 Musculoskeletal ProceduresAPC 5113	13	13	$16,777	$2,731	$2,373
Level 3 Lower GI ProceduresAPC 5313	12	12	$11,754	$2,187	$2,176
Level 6 Urology and Related ServicesAPC 5376	11	11	$25,510	$8,128	$7,291
Level 5 Gynecologic ProceduresAPC 5415	11		$24,004	$4,202	$3,792

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.