Lake Cumberland Regional Hosp Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Lake Cumberland Regional Hosp, Somerset, KY in 2024, from traditional Medicare claims. Back to the Lake Cumberland Regional Hosp profile, with quality ratings, finances and negotiated rates.
1,155
Medicare inpatient discharges
In 41 published DRGs
1.69
Case mix index
IPPS FY 2027
12%
Surgical stays
69%
Stays with complications
In DRGs with a CC or MCC
1,273
Medicare outpatient services
In 27 service groups
Inpatient stays by major diagnostic category
Circulatory system294 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 81 | $64,697 | $8,361 | $6,599 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 55 | $80,980 | $10,068 | $8,260 | 1.59 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 26 | $64,957 | $5,460 | $6,626 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $174,970 | $11,133 | $17,847 | 1.82 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 20 | $189,696 | $19,749 | $19,349 | 2.87 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 19 | $61,410 | $4,146 | $6,264 | 0.72 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 19 | $43,166 | $4,183 | $4,403 | 0.74 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 14 | $33,865 | $3,103 | $3,454 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 13 | $71,882 | $6,781 | $7,332 | 1.08 |
| Syncope and collapseMS-DRG 312, medical | 12 | $43,421 | $5,417 | $4,429 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 11 | $58,203 | $7,855 | $5,937 | 1.20 |
Respiratory system258 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 69 | $79,587 | $8,288 | $8,118 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 56 | $72,789 | $8,280 | $7,424 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 52 | $104,369 | $10,777 | $10,646 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 39 | $63,223 | $7,010 | $6,449 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 16 | $68,884 | $4,804 | $7,026 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 15 | $150,762 | $17,722 | $15,378 | 2.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 11 | $65,488 | $9,196 | $6,680 | 1.40 |
Infectious and parasitic diseases140 discharges in 2 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 | 115 | $121,573 | $13,052 | $12,400 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 25 | $282,890 | $34,248 | $28,855 | 5.00 |
Digestive system97 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 27 | $51,582 | $6,145 | $5,261 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 26 | $47,833 | $4,537 | $4,879 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 19 | $83,237 | $11,335 | $8,490 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 14 | $46,112 | $4,844 | $4,703 | 0.80 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 11 | $55,425 | $9,455 | $5,653 | 1.45 |
Kidney and urinary tract77 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 25 | $70,371 | $9,663 | $7,178 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 18 | $54,872 | $7,094 | $5,597 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 18 | $50,794 | $4,725 | $5,181 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 16 | $40,218 | $5,536 | $4,102 | 0.90 |
Nervous system66 discharges in 3 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 | 34 | $66,391 | $5,864 | $6,772 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 19 | $104,654 | $11,797 | $10,675 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 13 | $80,684 | $4,537 | $8,230 | 0.80 |
Mental diseases and disorders65 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 65 | $37,893 | $8,877 | $3,865 | 1.37 |
Endocrine, nutritional and metabolic65 discharges in 4 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 | 24 | $43,747 | $4,297 | $4,462 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 16 | $73,971 | $8,674 | $7,545 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 13 | $43,102 | $5,936 | $4,396 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 12 | $86,298 | $9,385 | $8,802 | 1.45 |
Musculoskeletal system and connective tissue64 discharges in 2 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 | 34 | $121,083 | $13,709 | $12,350 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 30 | $135,208 | $13,913 | $13,791 | 2.11 |
Skin, subcutaneous tissue and breast16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 16 | $53,629 | $4,962 | $5,470 | 0.88 |
Blood and immune system13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 13 | $41,466 | $5,203 | $4,230 | 0.90 |
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 | 231 | 220 | $36,975 | $1,982 | $2,090 |
| Level 1 Endovascular ProceduresAPC 5191 | 148 | 148 | $41,675 | $2,099 | $2,208 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 81 | 76 | $68,388 | $4,984 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 67 | 62 | $130,090 | $8,307 | $8,874 |
| Level 2 Upper GI ProceduresAPC 5302 | 67 | 64 | $18,732 | $1,404 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 57 | 55 | $45,790 | $4,163 | $4,358 |
| Level 5 Urology and Related ServicesAPC 5375 | 56 | 54 | $38,063 | $3,796 | $3,918 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 54 | 44 | $13,115 | $1,167 | $1,220 |
| Level 1 Nerve ProceduresAPC 5431 | 51 | 38 | $13,276 | $1,390 | $1,407 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 49 | 48 | $135,405 | $9,836 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 49 | 43 | $28,492 | $2,293 | $2,405 |
| Level 2 Endovascular ProceduresAPC 5192 | 49 | 45 | $46,142 | $4,112 | $4,338 |
| Level 4 Urology and Related ServicesAPC 5374 | 38 | 29 | $29,389 | $2,557 | $2,629 |
| Level 3 Airway EndoscopyAPC 5153 | 37 | 36 | $23,807 | $1,239 | $1,264 |
| Level 3 Urology and Related ServicesAPC 5373 | 36 | 30 | $22,471 | $1,492 | $1,516 |
| Level 4 Airway EndoscopyAPC 5154 | 32 | 30 | $37,548 | $2,750 | $2,833 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 30 | 27 | $36,984 | $2,292 | $2,373 |
| Level 4 Vascular ProceduresAPC 5184 | 23 | 20 | $46,587 | $4,036 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 18 | 18 | $116,842 | $7,957 | $8,569 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 16 | 16 | $427,730 | $28,602 | $29,375 |
| Level 4 Endovascular ProceduresAPC 5194 | 14 | 14 | $157,777 | $14,498 | $14,606 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 13 | 13 | $175,769 | $14,316 | $15,763 |
| Level 5 Airway EndoscopyAPC 5155 | 13 | 13 | $40,927 | $4,637 | $5,183 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 11 | 11 | $25,364 | $2,087 | $2,141 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 11 | 11 | $69,496 | $4,789 | $4,982 |
| Level 4 Gynecologic ProceduresAPC 5414 | 11 | 11 | $22,528 | $2,280 | $2,389 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 11 | 11 | $178,386 | $24,461 | $26,719 |
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.