Kennestone Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Kennestone Hospital, Marietta, GA in 2024, from traditional Medicare claims. Back to the Kennestone Hospital profile, with quality ratings, finances and negotiated rates.
8,238
Medicare inpatient discharges
In 196 published DRGs
2.09
Case mix index
IPPS FY 2027
27%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
6,349
Medicare outpatient services
In 46 service groups
Inpatient stays by major diagnostic category
Circulatory system2,041 discharges in 47 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 424 | $87,141 | $11,866 | $14,553 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 132 | $148,357 | $26,259 | $24,776 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 113 | $50,373 | $8,068 | $8,412 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 97 | $54,874 | $7,409 | $9,164 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 78 | $144,172 | $19,076 | $24,077 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 77 | $250,198 | $38,926 | $41,783 | 4.88 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 67 | $123,705 | $14,351 | $20,659 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 65 | $83,888 | $10,791 | $14,009 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 55 | $313,044 | $53,839 | $52,278 | 6.25 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 54 | $116,227 | $14,462 | $19,410 | 1.82 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 53 | $38,177 | $5,680 | $6,376 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 51 | $75,740 | $9,454 | $12,649 | 1.08 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 47 | $504,485 | $68,107 | $84,249 | 7.71 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 47 | $142,347 | $19,249 | $23,772 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 41 | $173,790 | $23,569 | $29,023 | 2.87 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 39 | $410,156 | $49,352 | $68,496 | 5.88 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 39 | $50,587 | $9,854 | $8,448 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 38 | $134,228 | $18,871 | $22,416 | 2.28 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 31 | $364,766 | $40,575 | $60,916 | 5.24 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 31 | $64,463 | $8,912 | $10,765 | 0.91 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 30 | $443,076 | $61,882 | $73,994 | 7.80 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 29 | $251,818 | $29,583 | $42,054 | 3.46 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 28 | $47,545 | $9,296 | $7,940 | 0.97 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 22 | $197,338 | $26,205 | $32,956 | 3.18 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 20 | $400,179 | $48,242 | $66,830 | 5.06 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 20 | $103,267 | $14,001 | $17,246 | 1.58 |
| Chest painMS-DRG 313, medical | 20 | $52,422 | $7,265 | $8,754 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 19 | $683,250 | $82,641 | $114,103 | 9.71 |
| Other vascular procedures with CCMS-DRG 253, surgical | 19 | $179,014 | $21,650 | $29,895 | 2.55 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 19 | $232,548 | $27,608 | $38,836 | 3.46 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $38,872 | $7,669 | $6,492 | 0.75 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 17 | $330,010 | $32,075 | $55,112 | 3.35 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 16 | $321,617 | $39,219 | $53,710 | 5.20 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 16 | $276,551 | $28,506 | $46,184 | 4.04 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 16 | $324,676 | $31,734 | $54,221 | 4.16 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 16 | $49,673 | $7,317 | $8,295 | 0.72 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 15 | $201,261 | $27,126 | $33,611 | 3.27 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 14 | $378,712 | $49,103 | $63,245 | 5.04 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 14 | $398,387 | $57,691 | $66,531 | 7.04 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 13 | $272,180 | $38,539 | $45,454 | 4.14 |
| Other heart assist system implantMS-DRG 215, surgical | 12 | $592,602 | $79,740 | $98,965 | 10.21 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $148,501 | $32,168 | $24,800 | 3.90 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 12 | $318,294 | $51,158 | $53,155 | 6.21 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $48,424 | $7,605 | $8,087 | 0.86 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 11 | $111,438 | $15,712 | $18,610 | 1.83 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 11 | $253,575 | $39,764 | $42,347 | 4.78 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 11 | $153,816 | $17,252 | $25,687 | 1.97 |
Respiratory system1,115 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 218 | $93,212 | $14,889 | $15,566 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 180 | $87,054 | $11,711 | $14,538 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 97 | $85,587 | $10,951 | $14,293 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 71 | $67,746 | $9,917 | $11,314 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 63 | $93,838 | $11,797 | $15,671 | 1.40 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 51 | $46,601 | $7,848 | $7,782 | 0.82 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 44 | $49,589 | $7,379 | $8,281 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 43 | $59,654 | $8,813 | $9,962 | 0.96 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 38 | $57,849 | $9,259 | $9,661 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 36 | $137,731 | $18,334 | $23,001 | 2.55 |
| Major chest procedures with MCCMS-DRG 163, surgical | 34 | $278,297 | $37,616 | $46,476 | 4.71 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 31 | $187,001 | $23,988 | $31,229 | 2.70 |
| Major chest trauma with CCMS-DRG 184, medical | 27 | $77,626 | $9,473 | $12,964 | 1.05 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 26 | $59,618 | $7,876 | $9,956 | 0.85 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 20 | $92,442 | $14,811 | $15,438 | 1.74 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 20 | $137,227 | $16,465 | $22,917 | 1.90 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $115,084 | $15,267 | $19,219 | 1.88 |
| Major chest trauma with MCCMS-DRG 183, medical | 17 | $141,732 | $13,150 | $23,669 | 1.57 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 16 | $217,890 | $36,668 | $36,388 | 4.06 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 14 | $126,041 | $16,382 | $21,049 | 1.81 |
| Pneumothorax with MCCMS-DRG 199, medical | 13 | $114,137 | $14,003 | $19,061 | 1.77 |
| Pneumothorax with CCMS-DRG 200, medical | 13 | $111,897 | $9,734 | $18,687 | 1.08 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 13 | $395,081 | $50,181 | $65,979 | 6.91 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $108,419 | $14,057 | $18,106 | 1.55 |
Nervous system1,060 discharges in 28 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 | 143 | $80,532 | $9,605 | $13,449 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 138 | $128,939 | $16,545 | $21,533 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 70 | $56,382 | $7,597 | $9,416 | 0.80 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 68 | $441,994 | $52,694 | $73,813 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 59 | $105,404 | $15,773 | $17,602 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 44 | $54,994 | $8,267 | $9,184 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 38 | $49,033 | $6,598 | $8,188 | 0.69 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 38 | $70,290 | $9,964 | $11,738 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 37 | $99,458 | $20,421 | $16,609 | 2.39 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 37 | $60,123 | $11,102 | $10,040 | 1.36 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 32 | $97,155 | $11,516 | $16,225 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 29 | $286,063 | $39,303 | $47,772 | 4.42 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 29 | $60,063 | $9,685 | $10,030 | 1.06 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 29 | $187,266 | $21,910 | $31,273 | 2.28 |
| Extracranial procedures with CCMS-DRG 038, surgical | 28 | $112,356 | $13,625 | $18,763 | 1.60 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 27 | $277,980 | $31,344 | $46,423 | 3.79 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 26 | $92,046 | $10,525 | $15,372 | 1.14 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 24 | $184,300 | $19,056 | $30,778 | 2.43 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 24 | $139,828 | $17,201 | $23,351 | 1.79 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 23 | $99,373 | $11,874 | $16,595 | 1.32 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 21 | $124,336 | $14,269 | $20,764 | 1.87 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 18 | $174,809 | $18,400 | $29,193 | 2.23 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 15 | $110,003 | $15,642 | $18,371 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $85,358 | $11,701 | $14,255 | 1.47 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 14 | $171,523 | $23,424 | $28,644 | 2.27 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $206,374 | $24,598 | $34,464 | 2.95 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 11 | $249,628 | $27,998 | $41,688 | 3.85 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $64,701 | $8,728 | $10,805 | 1.03 |
Infectious and parasitic diseases801 discharges in 7 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 | 512 | $132,946 | $16,989 | $22,202 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 125 | $323,947 | $42,905 | $54,099 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 83 | $47,852 | $9,165 | $7,991 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 33 | $484,222 | $56,049 | $80,865 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 20 | $83,535 | $16,877 | $13,950 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $118,044 | $17,421 | $19,713 | 2.04 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $56,971 | $7,458 | $9,514 | 1.01 |
Digestive system783 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 146 | $72,252 | $9,135 | $12,066 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 101 | $42,527 | $7,492 | $7,102 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 68 | $115,851 | $15,287 | $19,347 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 58 | $134,775 | $18,767 | $22,507 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 57 | $70,978 | $10,791 | $11,853 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 53 | $49,169 | $9,090 | $8,211 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 50 | $248,148 | $35,571 | $41,441 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 45 | $46,775 | $7,642 | $7,811 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 35 | $142,600 | $16,923 | $23,814 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $50,020 | $9,776 | $8,353 | 1.04 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 22 | $117,743 | $20,813 | $19,663 | 2.50 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 22 | $83,774 | $15,036 | $13,990 | 1.75 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $28,027 | $5,965 | $4,680 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 17 | $382,695 | $47,935 | $63,910 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 15 | $84,574 | $12,509 | $14,124 | 1.45 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 14 | $116,679 | $12,894 | $19,485 | 1.60 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 14 | $108,505 | $13,408 | $18,120 | 1.67 |
| Digestive malignancy with MCCMS-DRG 374, medical | 12 | $121,129 | $18,032 | $20,229 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $92,654 | $10,931 | $15,473 | 1.20 |
Musculoskeletal system and connective tissue763 discharges in 25 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 | 139 | $127,440 | $17,356 | $21,283 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 67 | $55,124 | $8,517 | $9,206 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 66 | $174,843 | $22,857 | $29,199 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 53 | $115,026 | $17,594 | $19,209 | 2.11 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 45 | $150,749 | $19,841 | $25,175 | 2.40 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 36 | $50,693 | $8,019 | $8,466 | 0.90 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 34 | $45,556 | $7,831 | $7,608 | 0.79 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 29 | $147,020 | $22,579 | $24,552 | 2.99 |
| Medical back problems with MCCMS-DRG 551, medical | 29 | $84,732 | $14,652 | $14,150 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 24 | $133,917 | $21,060 | $22,364 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 24 | $122,618 | $17,476 | $20,477 | 2.04 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 20 | $93,728 | $13,559 | $15,653 | 1.59 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 18 | $166,106 | $22,848 | $27,740 | 3.66 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 18 | $250,330 | $27,000 | $41,805 | 3.16 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 17 | $92,130 | $11,578 | $15,386 | 1.30 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 16 | $202,617 | $34,379 | $33,837 | 4.61 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 16 | $197,386 | $28,480 | $32,964 | 3.46 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 16 | $129,216 | $13,873 | $21,579 | 1.87 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 16 | $47,671 | $9,651 | $7,961 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 15 | $85,314 | $13,226 | $14,247 | 1.52 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 14 | $105,693 | $15,093 | $17,651 | 1.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 14 | $100,892 | $15,496 | $16,849 | 1.82 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 14 | $55,805 | $8,055 | $9,319 | 1.00 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 12 | $246,555 | $40,277 | $41,175 | 6.12 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 11 | $41,482 | $7,244 | $6,928 | 0.82 |
Kidney and urinary tract692 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 158 | $56,950 | $10,709 | $9,511 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 125 | $49,150 | $8,687 | $8,208 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 123 | $38,573 | $7,575 | $6,442 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 100 | $87,129 | $15,576 | $14,551 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 95 | $85,608 | $12,930 | $14,297 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 44 | $44,187 | $9,191 | $7,379 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 29 | $78,786 | $12,043 | $13,157 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 18 | $155,593 | $21,817 | $25,984 | 2.59 |
Endocrine, nutritional and metabolic369 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 without MCCMS-DRG 641, medical | 120 | $46,883 | $7,720 | $7,829 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 104 | $80,721 | $11,771 | $13,480 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 42 | $46,111 | $8,194 | $7,700 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 38 | $88,780 | $13,233 | $14,826 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 29 | $80,654 | $9,721 | $13,469 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 23 | $115,271 | $17,075 | $19,250 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $136,164 | $16,943 | $22,739 | 1.98 |
Liver, gallbladder and pancreas160 discharges in 8 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 | 28 | $120,467 | $14,166 | $20,118 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 25 | $148,735 | $19,921 | $24,839 | 2.32 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 20 | $112,410 | $13,915 | $18,772 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 20 | $81,528 | $10,004 | $13,615 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 19 | $37,670 | $8,383 | $6,291 | 0.86 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 18 | $176,060 | $23,898 | $29,402 | 2.89 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $91,323 | $15,294 | $15,251 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 12 | $126,932 | $15,643 | $21,198 | 1.76 |
Blood and immune system119 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 52 | $56,974 | $8,962 | $9,515 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 24 | $111,506 | $13,411 | $18,622 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 18 | $103,107 | $14,766 | $17,219 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 14 | $57,453 | $9,327 | $9,595 | 1.20 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $143,647 | $15,561 | $23,989 | 2.19 |
Skin, subcutaneous tissue and breast114 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 55 | $40,704 | $7,648 | $6,798 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 29 | $67,343 | $12,300 | $11,246 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 19 | $65,978 | $8,758 | $11,018 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 11 | $78,914 | $14,039 | $13,179 | 1.75 |
Injuries, poisonings and toxic effects of drugs61 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 18 | $63,474 | $15,361 | $10,600 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 16 | $118,195 | $16,605 | $19,739 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $42,141 | $10,179 | $7,037 | 1.03 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $158,322 | $17,393 | $26,440 | 2.00 |
Multiple significant trauma40 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with CCMS-DRG 964, medical | 15 | $113,242 | $12,245 | $18,911 | 1.50 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 14 | $188,342 | $30,950 | $31,453 | 3.88 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 11 | $769,040 | $94,937 | $128,430 | 7.23 |
Other25 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 CCMS-DRG 982, surgical | 14 | $155,729 | $20,601 | $26,007 | 2.49 |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 11 | $255,493 | $33,217 | $42,667 | 4.74 |
Transplants, ECMO and tracheostomy (pre-MDC)24 discharges in 1 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 | 24 | $1,560,365 | $210,556 | $260,581 | 21.32 |
Mental diseases and disorders24 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 | 24 | $55,212 | $13,306 | $9,220 | 1.76 |
Ear, nose, mouth and throat23 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 23 | $46,471 | $7,197 | $7,761 | 0.74 |
Alcohol and drug use13 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 | 13 | $62,905 | $8,268 | $10,505 | 0.86 |
Factors influencing health status11 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 | 11 | $39,489 | $7,665 | $6,595 | 0.80 |
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 2 Urology and Related ServicesAPC 5372 | 1,307 | 1,025 | $3,611 | $494 | $502 |
| Level 3 Urology and Related ServicesAPC 5373 | 484 | 457 | $16,653 | $1,476 | $1,516 |
| Comprehensive Observation ServicesAPC 8011 | 478 | 472 | $28,251 | $1,956 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 356 | 356 | $28,009 | $2,149 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 283 | 263 | $38,325 | $3,790 | $3,918 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 269 | 263 | $46,613 | $4,178 | $4,358 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 256 | 245 | $19,823 | $1,163 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 225 | 205 | $26,341 | $1,366 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 197 | 193 | $89,293 | $10,356 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 191 | 188 | $64,840 | $4,740 | $5,339 |
| Level 4 Urology and Related ServicesAPC 5374 | 162 | 135 | $31,015 | $2,515 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 147 | 146 | $83,688 | $7,751 | $8,164 |
| Level 3 Endovascular ProceduresAPC 5193 | 135 | 125 | $82,941 | $8,441 | $8,874 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 128 | 126 | $137,778 | $19,875 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 104 | 102 | $35,600 | $2,255 | $2,405 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 90 | 83 | $34,767 | $1,698 | $2,373 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 86 | 86 | $57,872 | $8,268 | $8,569 |
| Level 4 Vascular ProceduresAPC 5184 | 82 | 68 | $71,550 | $3,419 | $3,946 |
| Level 4 Airway EndoscopyAPC 5154 | 81 | 80 | $30,171 | $2,769 | $2,833 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 79 | 78 | $33,355 | $2,317 | $2,636 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 76 | 73 | $30,586 | $1,954 | $2,141 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 76 | 76 | $20,356 | $886 | $1,196 |
| Level 2 Endovascular ProceduresAPC 5192 | 76 | 75 | $42,556 | $4,171 | $4,338 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 76 | 76 | $190,383 | $28,429 | $29,375 |
| Level 3 Airway EndoscopyAPC 5153 | 75 | 74 | $19,133 | $1,218 | $1,264 |
| Level 5 Airway EndoscopyAPC 5155 | 71 | 68 | $49,269 | $4,904 | $5,183 |
| Level 4 Gynecologic ProceduresAPC 5414 | 70 | 69 | $27,880 | $2,287 | $2,389 |
| Level 4 Endovascular ProceduresAPC 5194 | 61 | 57 | $111,223 | $13,889 | $14,606 |
| Level 2 Vascular ProceduresAPC 5182 | 59 | 59 | $16,308 | $1,158 | $1,204 |
| Level 3 Lower GI ProceduresAPC 5313 | 54 | 51 | $29,141 | $2,051 | $2,176 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 53 | 53 | $48,356 | $6,161 | $6,514 |
| Level 5 ENT ProceduresAPC 5165 | 50 | 50 | $63,504 | $4,149 | $4,436 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 46 | 45 | $36,247 | $2,757 | $2,930 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 44 | 44 | $120,085 | $15,625 | $15,763 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 43 | 43 | $45,755 | $4,710 | $4,982 |
| Level 1 Nerve ProceduresAPC 5431 | 39 | 28 | $22,363 | $725 | $1,407 |
| Level 6 Urology and Related ServicesAPC 5376 | 36 | 36 | $55,138 | $6,915 | $7,291 |
| Level 3 Upper GI ProceduresAPC 5303 | 34 | 34 | $40,214 | $2,740 | $2,888 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 31 | 31 | $88,753 | $15,881 | $17,052 |
| Complex GI ProceduresAPC 5331 | 31 | 24 | $53,015 | $3,996 | $4,263 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 27 | 27 | $169,135 | $25,434 | $26,719 |
| Level 5 Gynecologic ProceduresAPC 5415 | 20 | 20 | $38,926 | $2,675 | $3,792 |
| Cochlear Implant ProcedureAPC 5166 | 18 | 17 | $161,306 | $29,396 | $29,489 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 18 | 17 | $138,966 | $16,235 | $18,465 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $34,966 | $2,279 | $2,217 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 11 | 11 | $128,021 | $20,175 | $21,011 |
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.