John T Mather Memorial Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for John T Mather Memorial Hospital, Port Jefferson, NY in 2024, from traditional Medicare claims. Back to the John T Mather Memorial Hospital profile, with quality ratings, finances and negotiated rates.
3,485
Medicare inpatient discharges
In 97 published DRGs
1.67
Case mix index
IPPS FY 2027
12%
Surgical stays
74%
Stays with complications
In DRGs with a CC or MCC
2,782
Medicare outpatient services
In 33 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases684 discharges in 4 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 | 472 | $120,309 | $17,087 | $26,709 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 124 | $76,010 | $7,954 | $16,874 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 69 | $297,933 | $51,331 | $66,141 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 19 | $187,410 | $17,755 | $41,605 | 2.04 |
Circulatory system551 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 193 | $90,549 | $11,553 | $20,102 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 38 | $60,486 | $6,115 | $13,428 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 36 | $88,532 | $14,106 | $19,654 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 35 | $49,979 | $9,174 | $11,095 | 1.08 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 35 | $57,837 | $4,651 | $12,840 | 0.74 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 30 | $103,773 | $10,269 | $23,038 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 25 | $80,805 | $10,305 | $17,939 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $61,902 | $7,108 | $13,742 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 20 | $103,864 | $17,778 | $23,058 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 19 | $163,789 | $21,869 | $36,361 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 18 | $159,596 | $27,036 | $35,430 | 2.87 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 16 | $100,373 | $15,667 | $22,283 | 1.58 |
| Other vascular procedures with CCMS-DRG 253, surgical | 14 | $172,000 | $20,090 | $38,184 | 2.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 14 | $63,292 | $8,494 | $14,051 | 1.07 |
| Hypertension without MCCMS-DRG 305, medical | 13 | $55,958 | $5,549 | $12,423 | 0.75 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 12 | $212,056 | $33,676 | $47,077 | 3.35 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 12 | $50,994 | $4,263 | $11,321 | 0.55 |
Respiratory system498 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 163 | $82,977 | $13,351 | $18,421 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 88 | $76,523 | $10,075 | $16,988 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 51 | $68,777 | $9,071 | $15,269 | 0.99 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 47 | $65,373 | $9,658 | $14,513 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 42 | $76,874 | $9,210 | $17,066 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 24 | $48,235 | $5,319 | $10,708 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 20 | $157,509 | $24,390 | $34,967 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 18 | $114,015 | $12,199 | $25,311 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 12 | $63,733 | $8,813 | $14,149 | 1.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 11 | $68,029 | $9,479 | $15,102 | 1.40 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 11 | $75,198 | $7,833 | $16,694 | 0.85 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 11 | $106,174 | $15,736 | $23,571 | 1.90 |
Digestive system411 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 87 | $73,341 | $7,021 | $16,282 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 62 | $62,888 | $5,570 | $13,961 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 51 | $124,395 | $14,765 | $27,616 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 33 | $105,240 | $12,373 | $23,363 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 28 | $213,997 | $35,772 | $47,507 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 24 | $66,666 | $6,106 | $14,800 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 20 | $136,541 | $18,966 | $30,312 | 2.37 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 19 | $75,496 | $10,412 | $16,760 | 1.45 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 19 | $89,893 | $11,846 | $19,956 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 16 | $105,063 | $15,256 | $23,324 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 16 | $85,340 | $8,775 | $18,946 | 1.04 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 13 | $80,468 | $7,593 | $17,864 | 0.94 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 12 | $66,897 | $10,076 | $14,851 | 1.07 |
| Digestive malignancy with MCCMS-DRG 374, medical | 11 | $179,101 | $17,929 | $39,760 | 2.10 |
Kidney and urinary tract384 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 93 | $59,665 | $6,114 | $13,246 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 91 | $81,577 | $9,856 | $18,110 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 72 | $91,358 | $13,879 | $20,282 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 61 | $55,845 | $7,028 | $12,398 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 47 | $84,040 | $12,079 | $18,657 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 20 | $66,195 | $7,903 | $14,695 | 1.02 |
Musculoskeletal system and connective tissue270 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 52 | $56,855 | $7,257 | $12,622 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 41 | $79,797 | $16,478 | $17,715 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 30 | $92,738 | $17,348 | $20,588 | 2.07 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 28 | $156,251 | $31,126 | $34,688 | 3.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 23 | $52,144 | $6,223 | $11,576 | 0.90 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 20 | $150,929 | $22,969 | $33,506 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 14 | $97,206 | $17,464 | $21,580 | 2.04 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $49,426 | $5,710 | $10,972 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 13 | $87,422 | $14,211 | $19,408 | 1.70 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 12 | $105,597 | $21,233 | $23,443 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 12 | $110,827 | $19,291 | $24,604 | 2.11 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 11 | $73,420 | $8,367 | $16,299 | 1.09 |
Nervous system255 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of nervous system with CCMS-DRG 092, medical | 44 | $60,699 | $8,270 | $13,475 | 1.03 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 36 | $102,901 | $16,718 | $22,844 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 34 | $78,349 | $6,566 | $17,394 | 1.02 |
| Seizures without MCCMS-DRG 101, medical | 23 | $69,446 | $8,126 | $15,417 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 20 | $83,371 | $14,961 | $18,508 | 1.79 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 19 | $57,623 | $12,070 | $12,792 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 16 | $89,087 | $11,458 | $19,777 | 1.32 |
| Seizures with MCCMS-DRG 100, medical | 15 | $83,862 | $18,663 | $18,617 | 1.98 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 13 | $54,986 | $6,218 | $12,207 | 0.77 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 12 | $65,740 | $7,441 | $14,594 | 0.80 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 12 | $92,650 | $16,419 | $20,568 | 1.79 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $107,302 | $20,250 | $23,821 | 2.27 |
Endocrine, nutritional and metabolic147 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 | 33 | $95,087 | $11,198 | $21,109 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 30 | $46,281 | $5,188 | $10,274 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 25 | $59,951 | $5,831 | $13,309 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 22 | $60,959 | $8,740 | $13,533 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $86,442 | $13,114 | $19,190 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $117,492 | $17,269 | $26,083 | 1.65 |
Skin, subcutaneous tissue and breast97 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 80 | $69,450 | $6,708 | $15,418 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 17 | $96,749 | $10,335 | $21,478 | 1.49 |
Liver, gallbladder and pancreas59 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 24 | $113,573 | $10,855 | $25,213 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 13 | $155,301 | $16,642 | $34,477 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 11 | $143,971 | $18,076 | $31,962 | 2.32 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 11 | $51,041 | $6,435 | $11,331 | 0.86 |
Factors influencing health status49 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 33 | $58,648 | $6,286 | $13,020 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 16 | $101,610 | $10,447 | $22,557 | 1.25 |
Blood and immune system44 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 | 16 | $59,539 | $5,941 | $13,218 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 15 | $72,266 | $12,071 | $16,043 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 13 | $91,650 | $10,011 | $20,346 | 1.20 |
Injuries, poisonings and toxic effects of drugs23 discharges in 2 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 | 12 | $94,437 | $13,103 | $20,965 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 11 | $143,859 | $15,100 | $31,937 | 1.82 |
Other13 discharges in 1 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 | 13 | $174,856 | $36,510 | $38,818 | 4.74 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 733 | 657 | $31,994 | $1,972 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 375 | 332 | $10,629 | $1,194 | $1,220 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 218 | 211 | $52,181 | $10,850 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 168 | 168 | $33,473 | $4,177 | $4,358 |
| Level 1 Intraocular ProceduresAPC 5491 | 162 | 121 | $13,830 | $1,823 | $1,752 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 145 | 137 | $32,386 | $5,154 | $5,339 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 92 | 91 | $93,863 | $16,510 | $15,763 |
| Level 1 Endovascular ProceduresAPC 5191 | 85 | 85 | $24,756 | $1,987 | $2,208 |
| Level 4 Urology and Related ServicesAPC 5374 | 70 | 62 | $17,765 | $2,340 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 68 | 66 | $16,211 | $2,316 | $2,405 |
| Level 4 Airway EndoscopyAPC 5154 | 61 | 61 | $18,946 | $2,928 | $2,833 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 50 | 50 | $17,983 | $1,922 | $2,141 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 50 | 46 | $25,212 | $2,832 | $2,636 |
| Level 3 Endovascular ProceduresAPC 5193 | 43 | 42 | $59,124 | $8,906 | $8,874 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 42 | 38 | $22,986 | $2,907 | $2,930 |
| Level 5 Urology and Related ServicesAPC 5375 | 42 | 41 | $22,718 | $3,327 | $3,918 |
| Level 2 Upper GI ProceduresAPC 5302 | 40 | 28 | $19,569 | $1,194 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 36 | 28 | $11,627 | $1,306 | $1,516 |
| Level 2 Vascular ProceduresAPC 5182 | 34 | 33 | $7,745 | $1,165 | $1,204 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 30 | 30 | $16,474 | $2,591 | $2,373 |
| Level 3 Lower GI ProceduresAPC 5313 | 27 | 26 | $17,647 | $1,943 | $2,176 |
| Level 1 Nerve ProceduresAPC 5431 | 26 | 25 | $14,254 | $1,451 | $1,407 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 25 | 24 | $45,186 | $7,802 | $8,164 |
| Level 5 Gynecologic ProceduresAPC 5415 | 23 | 23 | $31,353 | $4,003 | $3,792 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 22 | 22 | $34,039 | $5,012 | $4,982 |
| Level 4 Vascular ProceduresAPC 5184 | 17 | 14 | $27,483 | $4,315 | $3,946 |
| Level 2 Endovascular ProceduresAPC 5192 | 16 | 16 | $35,957 | $4,768 | $4,338 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 16 | 16 | $73,505 | $7,353 | $6,514 |
| Level 7 Radiation TherapyAPC 5627 | 16 | 14 | $81,527 | $6,180 | $6,121 |
| Level 4 Endovascular ProceduresAPC 5194 | 14 | 12 | $97,487 | $15,348 | $14,606 |
| Level 2 Intraocular ProceduresAPC 5492 | 13 | 13 | $21,353 | $2,783 | $3,116 |
| Level 4 Gynecologic ProceduresAPC 5414 | 12 | 12 | $19,799 | $2,550 | $2,389 |
| Level 3 Intraocular ProceduresAPC 5493 | 11 | $26,955 | $4,651 | $4,004 |
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.