Huntsville Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Huntsville Hospital, Huntsville, AL in 2024, from traditional Medicare claims. Back to the Huntsville Hospital profile, with quality ratings, finances and negotiated rates.
9,210
Medicare inpatient discharges
In 195 published DRGs
2.01
Case mix index
IPPS FY 2027
30%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
8,056
Medicare outpatient services
In 49 service groups
Inpatient stays by major diagnostic category
Circulatory system2,248 discharges in 41 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 389 | $40,675 | $7,931 | $9,070 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 140 | $71,853 | $10,154 | $16,023 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 119 | $59,428 | $12,960 | $13,252 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 116 | $28,490 | $5,051 | $6,353 | 0.86 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 113 | $124,180 | $19,238 | $27,692 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 109 | $212,976 | $30,304 | $47,494 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 109 | $24,636 | $4,175 | $5,494 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 102 | $39,319 | $7,357 | $8,768 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 75 | $36,451 | $6,419 | $8,129 | 1.08 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 72 | $58,876 | $10,014 | $13,129 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 66 | $110,787 | $17,229 | $24,705 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 55 | $76,419 | $13,318 | $17,041 | 2.09 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 47 | $31,178 | $4,989 | $6,953 | 0.91 |
| Heart failure and shock with CCMS-DRG 292, medical | 45 | $29,281 | $4,997 | $6,530 | 0.86 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 42 | $222,894 | $27,417 | $49,705 | 5.20 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 41 | $196,547 | $23,408 | $43,830 | 4.04 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 39 | $81,090 | $13,905 | $18,083 | 2.28 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 37 | $263,518 | $40,233 | $58,765 | 6.25 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 35 | $235,173 | $34,413 | $52,444 | 5.06 |
| Hypertension without MCCMS-DRG 305, medical | 35 | $26,141 | $4,530 | $5,829 | 0.75 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 33 | $66,410 | $10,929 | $14,809 | 1.83 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 31 | $110,775 | $21,141 | $24,703 | 3.46 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 29 | $277,068 | $30,396 | $61,786 | 5.24 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 29 | $305,221 | $43,469 | $68,064 | 7.80 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 29 | $247,465 | $37,853 | $55,185 | 5.88 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 28 | $169,322 | $24,793 | $37,759 | 3.35 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 27 | $145,803 | $17,006 | $32,514 | 3.46 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 25 | $428,527 | $62,630 | $95,562 | 7.71 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 23 | $48,396 | $10,011 | $10,792 | 1.58 |
| Other vascular procedures with CCMS-DRG 253, surgical | 22 | $103,608 | $15,301 | $23,105 | 2.55 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 22 | $75,871 | $13,309 | $16,919 | 1.97 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 22 | $16,435 | $2,981 | $3,665 | 0.55 |
| Chest painMS-DRG 313, medical | 21 | $23,234 | $4,281 | $5,181 | 0.72 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 19 | $224,441 | $22,198 | $50,050 | 4.16 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 19 | $26,195 | $6,550 | $5,841 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 18 | $67,967 | $8,786 | $15,157 | 1.15 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 15 | $28,063 | $3,791 | $6,258 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 14 | $38,471 | $5,469 | $8,579 | 0.97 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 13 | $93,136 | $9,883 | $20,769 | 1.74 |
| Percutaneous cardiovascular procedures without intraluminal device with MCCMS-DRG 250, surgical | 12 | $108,835 | $15,074 | $24,270 | 2.35 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $107,530 | $20,006 | $23,979 | 3.27 |
Infectious and parasitic diseases1,170 discharges in 8 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 | 814 | $69,535 | $11,854 | $15,506 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 127 | $34,866 | $5,986 | $7,775 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 114 | $165,694 | $31,419 | $36,950 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 35 | $250,530 | $42,977 | $55,868 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 30 | $82,738 | $11,749 | $18,451 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 24 | $51,998 | $11,357 | $11,596 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 14 | $42,390 | $5,429 | $9,453 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 12 | $528,587 | $72,077 | $117,875 | 4.43 |
Musculoskeletal system and connective tissue1,093 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 133 | $81,133 | $12,131 | $18,093 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 92 | $74,785 | $12,696 | $16,677 | 2.11 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 90 | $255,971 | $28,982 | $57,081 | 4.61 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 90 | $106,849 | $11,414 | $23,827 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 86 | $33,274 | $5,554 | $7,420 | 0.97 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 49 | $174,036 | $21,849 | $38,810 | 3.66 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 48 | $164,765 | $20,902 | $36,743 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 40 | $119,533 | $16,976 | $26,656 | 2.96 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 38 | $144,072 | $14,050 | $32,128 | 2.67 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 38 | $91,738 | $13,597 | $20,458 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 38 | $25,378 | $4,806 | $5,659 | 0.79 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 37 | $113,257 | $17,450 | $25,256 | 2.95 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 31 | $293,831 | $40,672 | $65,524 | 6.12 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 31 | $26,679 | $5,064 | $5,949 | 0.90 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 29 | $97,738 | $15,236 | $21,796 | 2.46 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 28 | $103,398 | $15,697 | $23,058 | 2.48 |
| Medical back problems with MCCMS-DRG 551, medical | 27 | $42,011 | $10,505 | $9,369 | 1.70 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 26 | $78,426 | $12,099 | $17,489 | 2.04 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 24 | $34,067 | $5,175 | $7,597 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 21 | $115,901 | $17,343 | $25,846 | 2.99 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 20 | $92,490 | $9,743 | $20,625 | 1.87 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 19 | $50,483 | $8,314 | $11,258 | 1.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 19 | $32,410 | $6,670 | $7,227 | 1.09 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 14 | $74,375 | $11,120 | $16,586 | 1.97 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 13 | $37,283 | $7,285 | $8,314 | 1.30 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 12 | $66,683 | $10,170 | $14,870 | 1.59 |
Respiratory system1,061 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 200 | $56,526 | $9,543 | $12,605 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 108 | $44,075 | $8,053 | $9,829 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 94 | $40,841 | $5,809 | $9,108 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 86 | $28,157 | $4,599 | $6,279 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 63 | $47,370 | $7,527 | $10,564 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 51 | $39,407 | $6,392 | $8,788 | 1.10 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 51 | $27,097 | $4,656 | $6,043 | 0.85 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 46 | $52,885 | $8,503 | $11,793 | 1.40 |
| Major chest procedures with CCMS-DRG 164, surgical | 39 | $118,281 | $15,608 | $26,377 | 2.55 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 34 | $26,860 | $4,569 | $5,990 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 33 | $26,283 | $5,496 | $5,861 | 0.96 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 30 | $78,878 | $15,157 | $17,590 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 27 | $175,512 | $25,224 | $39,139 | 4.71 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 22 | $63,778 | $10,584 | $14,223 | 1.74 |
| Pneumothorax with CCMS-DRG 200, medical | 22 | $41,607 | $5,233 | $9,278 | 1.08 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 20 | $51,615 | $11,343 | $11,510 | 1.81 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 19 | $186,113 | $39,833 | $41,503 | 6.91 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 17 | $22,973 | $3,001 | $5,123 | 0.63 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 17 | $63,114 | $11,958 | $14,075 | 1.90 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 16 | $27,681 | $5,883 | $6,173 | 0.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 14 | $105,737 | $26,309 | $23,579 | 4.06 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 13 | $88,073 | $10,033 | $19,640 | 1.88 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 13 | $42,437 | $4,046 | $9,464 | 0.76 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 13 | $40,050 | $6,920 | $8,931 | 1.10 |
| Major chest trauma with CCMS-DRG 184, medical | 13 | $31,359 | $6,151 | $6,993 | 1.05 |
Nervous system1,048 discharges in 26 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 | 186 | $46,660 | $5,899 | $10,405 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 123 | $79,201 | $13,263 | $17,662 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 57 | $35,290 | $4,681 | $7,870 | 0.80 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 53 | $34,068 | $8,224 | $7,597 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 52 | $219,102 | $28,255 | $48,860 | 4.42 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 50 | $50,632 | $6,655 | $11,291 | 1.14 |
| Seizures without MCCMS-DRG 101, medical | 48 | $38,208 | $5,554 | $8,520 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 46 | $28,877 | $3,911 | $6,440 | 0.69 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 43 | $37,800 | $6,179 | $8,429 | 1.03 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 41 | $41,862 | $7,852 | $9,335 | 1.32 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 36 | $245,688 | $35,805 | $54,788 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 32 | $70,111 | $11,795 | $15,635 | 1.98 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 31 | $43,837 | $8,414 | $9,776 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 30 | $176,258 | $20,843 | $39,306 | 3.79 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 29 | $62,673 | $10,868 | $13,976 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 23 | $49,588 | $8,497 | $11,058 | 1.47 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 23 | $62,455 | $14,312 | $13,928 | 2.28 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 21 | $134,301 | $15,703 | $29,949 | 2.43 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 21 | $86,193 | $10,228 | $19,221 | 1.81 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 19 | $48,812 | $6,225 | $10,885 | 1.03 |
| Extracranial procedures with CCMS-DRG 038, surgical | 18 | $68,920 | $8,819 | $15,369 | 1.60 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 17 | $88,260 | $13,105 | $19,682 | 2.39 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 14 | $194,469 | $16,655 | $43,366 | 2.95 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 13 | $79,188 | $12,545 | $17,659 | 2.27 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $63,630 | $6,108 | $14,189 | 1.06 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $73,681 | $7,841 | $16,431 | 1.51 |
Digestive system782 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 116 | $36,702 | $5,780 | $8,184 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 116 | $30,162 | $4,318 | $6,726 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 69 | $63,958 | $11,673 | $14,263 | 1.79 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 56 | $90,758 | $9,313 | $20,239 | 1.67 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 52 | $101,543 | $14,264 | $22,644 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 48 | $44,009 | $7,356 | $9,814 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 43 | $24,476 | $4,271 | $5,458 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 41 | $176,339 | $27,127 | $39,324 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 40 | $31,532 | $5,716 | $7,032 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 30 | $43,161 | $8,715 | $9,625 | 1.45 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 27 | $34,093 | $5,821 | $7,603 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 24 | $48,715 | $9,727 | $10,863 | 1.75 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 21 | $202,744 | $30,977 | $45,212 | 4.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $20,364 | $2,834 | $4,541 | 0.56 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 17 | $71,465 | $11,267 | $15,937 | 1.62 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $127,596 | $15,793 | $28,454 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 14 | $101,675 | $8,331 | $22,674 | 1.60 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 13 | $70,795 | $6,284 | $15,787 | 1.36 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 11 | $97,420 | $9,281 | $21,725 | 2.11 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 11 | $29,815 | $5,930 | $6,649 | 0.97 |
Kidney and urinary tract542 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 96 | $25,272 | $5,485 | $5,636 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 95 | $35,530 | $7,027 | $7,923 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 95 | $26,230 | $4,544 | $5,849 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 91 | $60,248 | $10,330 | $13,435 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 88 | $38,944 | $8,677 | $8,685 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 40 | $24,426 | $6,091 | $5,447 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 19 | $140,408 | $23,182 | $31,311 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $51,487 | $7,954 | $11,481 | 1.35 |
Endocrine, nutritional and metabolic435 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 131 | $37,301 | $8,192 | $8,318 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 130 | $27,355 | $4,701 | $6,100 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 80 | $34,084 | $5,089 | $7,601 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 42 | $69,953 | $8,448 | $15,600 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 25 | $51,566 | $10,487 | $11,499 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $36,227 | $6,224 | $8,079 | 1.06 |
| Endocrine disorders without cc/mccMS-DRG 645, medical | 11 | $18,302 | $4,799 | $4,081 | 0.76 |
Liver, gallbladder and pancreas181 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 28 | $50,534 | $12,035 | $11,269 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 25 | $56,943 | $10,997 | $12,698 | 1.83 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 23 | $95,275 | $11,291 | $21,246 | 1.76 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 23 | $34,174 | $4,771 | $7,621 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 21 | $72,923 | $9,043 | $16,262 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $49,255 | $6,310 | $10,984 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 18 | $83,814 | $12,203 | $18,690 | 2.32 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $70,213 | $8,846 | $15,658 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $45,234 | $5,527 | $10,087 | 1.03 |
Blood and immune system127 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 | 65 | $26,863 | $4,845 | $5,990 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 39 | $52,773 | $7,729 | $11,768 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 23 | $51,008 | $9,666 | $11,375 | 1.56 |
Other111 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 | 40 | $156,433 | $27,789 | $34,885 | 4.74 |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 22 | $209,000 | $20,425 | $46,607 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 14 | $350,594 | $53,857 | $78,182 | 3.38 |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 12 | $322,864 | $35,165 | $71,999 | |
| Single level spinal fusion except cervical without MCCMS-DRG 451 | 12 | $191,837 | $15,031 | $42,780 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $113,917 | $16,082 | $25,404 | 2.49 |
Skin, subcutaneous tissue and breast102 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 64 | $25,625 | $4,668 | $5,714 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 22 | $31,259 | $5,315 | $6,971 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 16 | $49,999 | $8,444 | $11,150 | 1.49 |
Injuries, poisonings and toxic effects of drugs89 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 34 | $66,047 | $8,940 | $14,728 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 30 | $63,016 | $11,032 | $14,053 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $219,743 | $32,003 | $49,003 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $75,795 | $11,707 | $16,902 | 2.00 |
Mental diseases and disorders85 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 59 | $36,702 | $9,890 | $8,185 | 1.76 |
| PsychosesMS-DRG 885, medical | 14 | $28,426 | $8,725 | $6,339 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 12 | $28,321 | $5,722 | $6,316 | 0.95 |
Factors influencing health status52 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 | 52 | $25,769 | $4,764 | $5,747 | 0.80 |
Transplants, ECMO and tracheostomy (pre-MDC)31 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 | 17 | $480,044 | $74,123 | $107,050 | 14.70 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 14 | $974,696 | $158,401 | $217,357 | 21.32 |
Multiple significant trauma22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 22 | $154,350 | $25,848 | $34,420 | 3.88 |
Alcohol and drug use17 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 | 17 | $31,421 | $5,067 | $7,007 | 0.86 |
Blood cancers and poorly differentiated neoplasms14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 14 | $148,928 | $19,778 | $33,211 | 3.13 |
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 | 943 | 903 | $17,355 | $1,771 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 806 | 768 | $74,965 | $9,050 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 685 | 681 | $12,726 | $1,912 | $2,208 |
| Level 1 Nerve ProceduresAPC 5431 | 631 | 523 | $8,571 | $1,267 | $1,407 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 469 | 458 | $34,593 | $4,616 | $5,339 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 432 | 411 | $9,070 | $1,063 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 319 | 281 | $16,950 | $2,088 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 243 | 231 | $52,599 | $7,339 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 223 | 221 | $38,153 | $3,654 | $4,358 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 218 | 208 | $16,796 | $2,056 | $2,373 |
| Level 4 Urology and Related ServicesAPC 5374 | 202 | 176 | $20,472 | $2,274 | $2,629 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 194 | 194 | $114,557 | $18,094 | $21,117 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 186 | 186 | $46,680 | $7,370 | $8,569 |
| Level 2 Upper GI ProceduresAPC 5302 | 176 | 153 | $7,270 | $1,218 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 149 | 142 | $25,154 | $1,875 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 145 | 137 | $23,384 | $3,436 | $3,918 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 140 | 137 | $92,552 | $13,675 | $15,763 |
| Level 3 Urology and Related ServicesAPC 5373 | 135 | 83 | $12,112 | $1,340 | $1,516 |
| Level 4 Vascular ProceduresAPC 5184 | 134 | 114 | $39,345 | $3,248 | $3,946 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 124 | 123 | $88,340 | $6,789 | $8,164 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 96 | 91 | $20,106 | $2,226 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 93 | 91 | $8,248 | $1,056 | $1,196 |
| Level 1 Intraocular ProceduresAPC 5491 | 88 | 59 | $9,105 | $1,533 | $1,752 |
| Level 4 Endovascular ProceduresAPC 5194 | 85 | 81 | $94,402 | $12,374 | $14,606 |
| Level 4 Airway EndoscopyAPC 5154 | 82 | 74 | $16,955 | $2,490 | $2,833 |
| Level 2 Endovascular ProceduresAPC 5192 | 82 | 80 | $28,751 | $3,585 | $4,338 |
| Level 2 Vascular ProceduresAPC 5182 | 79 | 74 | $7,199 | $1,063 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 75 | 75 | $145,504 | $25,147 | $29,375 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 73 | 70 | $9,486 | $1,530 | $1,780 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 69 | 65 | $18,970 | $2,488 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 69 | 68 | $31,241 | $4,322 | $4,982 |
| Level 3 Lower GI ProceduresAPC 5313 | 63 | 63 | $15,127 | $1,778 | $2,176 |
| Level 4 Gynecologic ProceduresAPC 5414 | 62 | 62 | $13,755 | $2,001 | $2,389 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 62 | 59 | $150,130 | $22,545 | $26,719 |
| Level 5 ENT ProceduresAPC 5165 | 55 | 55 | $25,438 | $3,798 | $4,436 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 55 | 55 | $71,639 | $14,792 | $17,052 |
| Level 3 Airway EndoscopyAPC 5153 | 49 | 47 | $9,100 | $1,072 | $1,264 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 49 | 49 | $35,697 | $5,499 | $6,514 |
| Level 7 Radiation TherapyAPC 5627 | 36 | 31 | $8,362 | $5,095 | $6,121 |
| Level 2 Intraocular ProceduresAPC 5492 | 26 | 26 | $25,246 | $2,736 | $3,116 |
| Complex GI ProceduresAPC 5331 | 22 | 16 | $25,547 | $3,836 | $4,263 |
| Level 5 Gynecologic ProceduresAPC 5415 | 21 | 18 | $22,681 | $3,026 | $3,792 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 20 | 19 | $136,648 | $16,803 | $18,465 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 19 | 18 | $41,743 | $4,360 | $4,524 |
| Level 3 Upper GI ProceduresAPC 5303 | 18 | 18 | $10,686 | $2,567 | $2,888 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 16 | 16 | $104,371 | $18,230 | $21,011 |
| Level 6 Urology and Related ServicesAPC 5376 | 15 | 15 | $51,450 | $6,200 | $7,291 |
| Level 8 Urology and Related ServicesAPC 5378 | 12 | 12 | $91,989 | $14,089 | $17,428 |
| Implantation of Drug Infusion DeviceAPC 5471 | 11 | 11 | $88,504 | $12,185 | $14,829 |
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.