Integris Baptist Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Integris Baptist Medical Center, Oklahoma City, OK in 2024, from traditional Medicare claims. Back to the Integris Baptist Medical Center profile, with quality ratings, finances and negotiated rates.
5,874
Medicare inpatient discharges
In 163 published DRGs
2.35
Case mix index
IPPS FY 2027
32%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
7,297
Medicare outpatient services
In 47 service groups
Inpatient stays by major diagnostic category
Circulatory system1,255 discharges in 31 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 294 | $87,683 | $9,127 | $13,766 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 148 | $146,929 | $21,746 | $23,068 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 107 | $234,083 | $32,056 | $36,751 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 51 | $52,686 | $4,956 | $8,272 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 44 | $139,542 | $16,971 | $21,908 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 44 | $127,849 | $11,503 | $20,072 | 1.82 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 42 | $68,480 | $8,478 | $10,751 | 1.20 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 39 | $184,277 | $24,591 | $28,931 | 3.35 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 39 | $180,984 | $18,982 | $28,414 | 2.16 |
| Other vascular procedures with CCMS-DRG 253, surgical | 30 | $135,039 | $16,715 | $21,201 | 2.55 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 29 | $105,432 | $11,112 | $16,553 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 26 | $61,245 | $7,210 | $9,615 | 1.08 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 26 | $68,229 | $6,583 | $10,712 | 0.97 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 26 | $184,470 | $18,654 | $28,962 | 2.87 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 25 | $368,789 | $40,334 | $57,900 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 25 | $246,728 | $24,561 | $38,736 | 3.46 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 23 | $33,801 | $3,559 | $5,307 | 0.55 |
| Syncope and collapseMS-DRG 312, medical | 23 | $48,645 | $6,236 | $7,637 | 0.86 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 22 | $255,402 | $32,744 | $40,098 | 5.20 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 21 | $92,011 | $11,645 | $14,446 | 1.83 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 20 | $321,034 | $27,019 | $50,402 | 4.16 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 19 | $391,253 | $51,896 | $61,427 | 7.80 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 19 | $373,720 | $44,726 | $58,674 | 6.25 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $108,986 | $15,348 | $17,111 | 2.28 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $190,308 | $24,647 | $29,878 | 3.46 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 16 | $379,754 | $34,737 | $59,621 | 5.24 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 13 | $54,954 | $6,155 | $8,628 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 13 | $71,871 | $8,773 | $11,284 | 1.15 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 12 | $233,085 | $24,159 | $36,594 | 4.04 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 12 | $139,114 | $14,013 | $21,841 | 2.81 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $58,151 | $5,834 | $9,130 | 0.86 |
Respiratory system796 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 140 | $102,740 | $10,994 | $16,130 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 119 | $97,345 | $9,437 | $15,283 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 114 | $78,307 | $9,049 | $12,294 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 76 | $46,324 | $5,339 | $7,273 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 64 | $60,329 | $6,423 | $9,472 | 0.99 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 40 | $172,936 | $17,090 | $27,151 | 2.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $71,299 | $7,389 | $11,194 | 1.10 |
| Major chest procedures with CCMS-DRG 164, surgical | 22 | $157,261 | $13,052 | $24,690 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 21 | $97,907 | $9,467 | $15,371 | 1.40 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 21 | $377,421 | $43,879 | $59,255 | 6.91 |
| Major chest procedures with MCCMS-DRG 163, surgical | 18 | $257,152 | $29,897 | $40,373 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 18 | $147,283 | $11,616 | $23,123 | 1.88 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 16 | $45,779 | $4,991 | $7,187 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $36,334 | $5,010 | $5,704 | 0.82 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 14 | $34,021 | $3,855 | $5,341 | 0.63 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 13 | $193,588 | $29,744 | $30,393 | 4.06 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 13 | $137,485 | $15,842 | $21,585 | 1.81 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 13 | $46,378 | $6,173 | $7,281 | 0.91 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 11 | $122,490 | $12,252 | $19,231 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $85,390 | $10,671 | $13,406 | 1.55 |
Kidney and urinary tract718 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 125 | $49,780 | $5,990 | $7,815 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 111 | $43,303 | $5,091 | $6,799 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 99 | $53,651 | $7,900 | $8,423 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 81 | $91,200 | $10,062 | $14,318 | 1.50 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 63 | $113,025 | $12,514 | $17,745 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 63 | $71,633 | $7,190 | $11,246 | 1.02 |
| Kidney transplantMS-DRG 652, surgical | 45 | $353,690 | $18,222 | $55,529 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 30 | $83,986 | $8,712 | $13,186 | 1.35 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 17 | $84,968 | $8,801 | $13,340 | 1.48 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 17 | $138,105 | $17,244 | $21,682 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 16 | $108,250 | $12,412 | $16,995 | 1.84 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $230,972 | $29,536 | $36,263 | 3.70 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 13 | $82,703 | $5,771 | $12,984 | 1.05 |
| Transurethral procedures with CCMS-DRG 669, surgical | 11 | $67,876 | $11,039 | $10,657 | 1.53 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 11 | $97,416 | $16,913 | $15,294 | 2.38 |
Digestive system690 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 122 | $58,308 | $6,565 | $9,154 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 80 | $97,030 | $12,009 | $15,234 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 72 | $46,699 | $5,050 | $7,332 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 68 | $128,185 | $15,007 | $20,125 | 2.37 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 53 | $104,103 | $10,637 | $16,344 | 1.67 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 45 | $255,088 | $30,148 | $40,049 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 45 | $34,302 | $5,410 | $5,385 | 0.80 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 28 | $55,768 | $6,765 | $8,756 | 1.04 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 24 | $87,460 | $9,639 | $13,731 | 1.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 22 | $26,238 | $3,361 | $4,119 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 21 | $98,908 | $11,420 | $15,529 | 1.75 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 18 | $47,342 | $6,308 | $7,433 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 17 | $92,849 | $11,654 | $14,577 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $67,479 | $10,413 | $10,594 | 1.45 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 13 | $107,114 | $13,891 | $16,817 | 2.50 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 13 | $385,954 | $35,871 | $60,595 | 4.28 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $245,562 | $33,397 | $38,553 | 5.08 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 12 | $143,695 | $11,496 | $22,560 | 2.11 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 11 | $98,588 | $10,446 | $15,478 | 1.72 |
Infectious and parasitic diseases573 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 | 376 | $138,449 | $14,141 | $21,736 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 98 | $305,688 | $38,186 | $47,993 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 40 | $449,089 | $50,598 | $70,507 | 6.96 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 33 | $66,342 | $6,163 | $10,416 | 1.03 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 14 | $56,190 | $7,559 | $8,822 | 1.01 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $140,733 | $12,061 | $22,095 | 1.84 |
Nervous system565 discharges in 21 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 | 96 | $63,861 | $6,528 | $10,026 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 94 | $105,406 | $13,078 | $16,549 | 2.00 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 32 | $347,253 | $40,562 | $54,519 | 5.67 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 30 | $259,896 | $30,762 | $40,804 | 4.42 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 30 | $59,916 | $8,484 | $9,407 | 1.32 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 27 | $113,512 | $12,313 | $17,821 | 1.81 |
| Seizures without MCCMS-DRG 101, medical | 26 | $61,166 | $6,284 | $9,603 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 21 | $69,502 | $7,601 | $10,912 | 1.14 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 21 | $46,019 | $7,833 | $7,225 | 1.36 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 21 | $44,016 | $5,265 | $6,910 | 0.80 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 21 | $53,600 | $6,745 | $8,415 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 20 | $93,452 | $11,684 | $14,672 | 1.79 |
| Extracranial procedures with CCMS-DRG 038, surgical | 19 | $92,910 | $10,043 | $14,587 | 1.60 |
| Seizures with MCCMS-DRG 100, medical | 18 | $127,728 | $14,518 | $20,053 | 1.98 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 16 | $55,447 | $4,057 | $8,705 | 0.69 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 14 | $52,190 | $7,602 | $8,194 | 1.06 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 13 | $131,556 | $15,399 | $20,654 | 2.23 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 12 | $81,937 | $11,371 | $12,864 | 1.79 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 12 | $59,726 | $9,372 | $9,377 | 1.36 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 11 | $308,406 | $24,786 | $48,420 | 2.95 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 11 | $143,436 | $18,578 | $22,519 | 2.80 |
Musculoskeletal system and connective tissue353 discharges in 15 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 | 82 | $125,002 | $13,178 | $19,625 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 45 | $135,854 | $14,039 | $21,329 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 29 | $169,302 | $19,620 | $26,580 | 2.95 |
| Medical back problems without MCCMS-DRG 552, medical | 25 | $43,081 | $6,063 | $6,764 | 0.97 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 21 | $178,196 | $16,526 | $27,977 | 2.40 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 20 | $243,241 | $23,582 | $38,189 | 3.49 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 19 | $124,229 | $10,669 | $19,504 | 1.59 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 18 | $35,845 | $5,112 | $5,628 | 0.79 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 17 | $98,363 | $13,121 | $15,443 | 2.04 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 14 | $274,409 | $23,663 | $43,082 | 3.66 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 14 | $141,163 | $16,461 | $22,163 | 2.67 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 14 | $174,792 | $19,871 | $27,442 | 2.96 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 12 | $151,099 | $13,491 | $23,722 | 2.46 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 12 | $33,359 | $5,667 | $5,237 | 0.90 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 11 | $166,504 | $15,753 | $26,141 | 3.00 |
Liver, gallbladder and pancreas316 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 47 | $55,980 | $6,511 | $8,789 | 0.95 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 39 | $184,431 | $16,435 | $28,956 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 39 | $56,822 | $7,712 | $8,921 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 35 | $130,652 | $14,248 | $20,512 | 1.83 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 27 | $114,029 | $10,653 | $17,903 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 26 | $116,770 | $12,411 | $18,333 | 1.76 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 24 | $136,855 | $11,582 | $21,486 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 20 | $60,816 | $6,589 | $9,548 | 1.03 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 17 | $288,405 | $40,369 | $45,280 | 5.51 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 16 | $71,195 | $5,211 | $11,178 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 14 | $109,333 | $12,418 | $17,165 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 12 | $101,205 | $8,032 | $15,889 | 1.31 |
Endocrine, nutritional and metabolic217 discharges in 6 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 | 75 | $63,998 | $8,831 | $10,048 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 64 | $34,988 | $5,304 | $5,493 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 29 | $82,339 | $9,650 | $12,927 | 1.45 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 19 | $72,044 | $11,639 | $11,311 | 1.86 |
| Diabetes with CCMS-DRG 638, medical | 18 | $40,782 | $5,347 | $6,403 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $82,012 | $11,587 | $12,876 | 1.65 |
Transplants, ECMO and tracheostomy (pre-MDC)91 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 | 43 | $1,353,400 | $198,987 | $212,484 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 21 | $2,247,162 | $287,995 | $352,804 | 27.10 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 14 | $666,503 | $88,506 | $104,641 | 14.70 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 13 | $640,784 | $74,140 | $100,603 | 10.35 |
Injuries, poisonings and toxic effects of drugs75 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 18 | $237,919 | $28,634 | $37,353 | 3.72 |
| Complications of treatment with MCCMS-DRG 919, medical | 15 | $93,621 | $13,038 | $14,698 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $57,728 | $6,968 | $9,063 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 14 | $124,552 | $13,655 | $19,555 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 13 | $115,878 | $13,341 | $18,193 | 2.00 |
Mental diseases and disorders63 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 63 | $19,141 | $9,649 | $3,005 | 1.37 |
Blood and immune system54 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 | 25 | $43,466 | $5,531 | $6,824 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 18 | $83,064 | $10,107 | $13,041 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $74,327 | $7,831 | $11,669 | 1.20 |
Skin, subcutaneous tissue and breast51 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 40 | $45,966 | $5,759 | $7,217 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 11 | $80,436 | $9,229 | $12,628 | 1.49 |
Other44 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 | 33 | $310,799 | $36,294 | $48,795 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $183,284 | $17,811 | $28,776 | 2.49 |
Burns13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 13 | $254,629 | $50,941 | $39,977 | 6.92 |
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 | 900 | 832 | $24,443 | $1,833 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 641 | 542 | $16,324 | $1,278 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 590 | 523 | $18,835 | $1,362 | $1,516 |
| Level 4 Urology and Related ServicesAPC 5374 | 448 | 360 | $38,032 | $2,328 | $2,629 |
| Level 1 Endovascular ProceduresAPC 5191 | 431 | 425 | $32,628 | $1,931 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 430 | 416 | $15,556 | $1,086 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 362 | 345 | $44,893 | $3,461 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 275 | 264 | $129,297 | $9,376 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 273 | 255 | $23,038 | $2,144 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 235 | 218 | $94,580 | $7,494 | $8,874 |
| Level 2 Endovascular ProceduresAPC 5192 | 186 | 165 | $40,004 | $3,813 | $4,338 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 180 | 178 | $69,078 | $3,878 | $4,358 |
| Level 4 Vascular ProceduresAPC 5184 | 162 | 126 | $49,158 | $3,182 | $3,946 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 127 | 126 | $23,549 | $1,911 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 126 | 124 | $71,606 | $4,749 | $5,339 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 125 | 125 | $66,613 | $7,347 | $8,569 |
| Level 4 Endovascular ProceduresAPC 5194 | 120 | 109 | $135,117 | $12,753 | $14,606 |
| Complex GI ProceduresAPC 5331 | 110 | 89 | $40,142 | $3,780 | $4,263 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 109 | 109 | $215,600 | $18,055 | $21,117 |
| Level 5 Airway EndoscopyAPC 5155 | 108 | 106 | $57,671 | $4,478 | $5,183 |
| Level 3 Upper GI ProceduresAPC 5303 | 104 | 101 | $24,448 | $2,600 | $2,888 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 103 | 102 | $102,037 | $7,080 | $8,164 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 97 | 71 | $33,826 | $2,324 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 96 | 82 | $15,126 | $1,299 | $1,407 |
| Level 4 Airway EndoscopyAPC 5154 | 94 | 66 | $38,423 | $2,544 | $2,833 |
| Level 3 Lower GI ProceduresAPC 5313 | 92 | 87 | $22,779 | $1,890 | $2,176 |
| Level 2 Vascular ProceduresAPC 5182 | 90 | 87 | $10,964 | $1,085 | $1,204 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 86 | 84 | $42,923 | $2,176 | $2,373 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 78 | 78 | $167,489 | $26,154 | $29,375 |
| Level 2 Intraocular ProceduresAPC 5492 | 77 | 65 | $40,919 | $2,763 | $3,116 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 63 | 59 | $17,581 | $1,059 | $1,196 |
| Level 4 Gynecologic ProceduresAPC 5414 | 40 | 40 | $27,364 | $2,111 | $2,389 |
| Level 1 Intraocular ProceduresAPC 5491 | 36 | 23 | $20,434 | $1,492 | $1,752 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 34 | 34 | $55,188 | $5,724 | $6,514 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 34 | 34 | $134,072 | $14,950 | $17,052 |
| Level 3 Airway EndoscopyAPC 5153 | 29 | 29 | $28,737 | $1,032 | $1,264 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 28 | 28 | $156,241 | $23,930 | $26,719 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 23 | 22 | $198,011 | $14,251 | $15,763 |
| Level 5 ENT ProceduresAPC 5165 | 23 | 23 | $41,665 | $3,802 | $4,436 |
| Level 2 Urology and Related ServicesAPC 5372 | 22 | 20 | $11,673 | $443 | $502 |
| Level 6 Urology and Related ServicesAPC 5376 | 20 | 20 | $85,609 | $6,269 | $7,291 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 17 | 17 | $47,424 | $4,384 | $4,524 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 16 | 16 | $114,896 | $17,244 | $21,011 |
| Level 8 Urology and Related ServicesAPC 5378 | 16 | 16 | $160,544 | $15,585 | $17,428 |
| Level 5 Gynecologic ProceduresAPC 5415 | 15 | 15 | $32,556 | $3,378 | $3,792 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 15 | 15 | $135,032 | $15,900 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 11 | $60,301 | $5,290 | $6,121 |
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.