Lee Memorial Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Lee Memorial Hospital, Fort Myers, FL in 2024, from traditional Medicare claims. Back to the Lee Memorial Hospital profile, with quality ratings, finances and negotiated rates.
7,560
Medicare inpatient discharges
In 165 published DRGs
1.87
Case mix index
IPPS FY 2027
27%
Surgical stays
64%
Stays with complications
In DRGs with a CC or MCC
6,734
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system2,534 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 | 580 | $46,514 | $9,027 | $10,140 | 1.28 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 160 | $29,520 | $5,313 | $6,435 | 0.74 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 126 | $22,284 | $3,692 | $4,858 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 107 | $113,300 | $11,935 | $24,699 | 1.82 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 106 | $306,213 | $35,796 | $66,754 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 104 | $173,541 | $22,890 | $37,832 | 3.24 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 90 | $43,342 | $8,613 | $9,449 | 1.20 |
| Syncope and collapseMS-DRG 312, medical | 77 | $38,156 | $6,396 | $8,318 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 74 | $83,318 | $15,103 | $18,163 | 2.16 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 74 | $154,808 | $20,578 | $33,748 | 2.87 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 73 | $80,483 | $11,962 | $17,545 | 1.59 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 72 | $57,149 | $7,002 | $12,458 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 62 | $349,640 | $44,065 | $76,222 | 6.25 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 54 | $75,679 | $14,333 | $16,498 | 2.09 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 49 | $242,966 | $27,798 | $52,966 | 4.04 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 45 | $255,980 | $33,492 | $55,804 | 5.88 |
| Hypertension without MCCMS-DRG 305, medical | 45 | $29,719 | $5,272 | $6,479 | 0.75 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 44 | $49,515 | $6,092 | $10,794 | 0.91 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 43 | $104,549 | $16,619 | $22,792 | 2.28 |
| Chest painMS-DRG 313, medical | 42 | $30,049 | $5,010 | $6,551 | 0.72 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 36 | $44,875 | $7,768 | $9,783 | 1.07 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 35 | $417,893 | $62,713 | $91,101 | 7.71 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 31 | $176,743 | $21,159 | $38,530 | 2.97 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 30 | $133,144 | $22,766 | $29,025 | 3.18 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 29 | $37,125 | $6,810 | $8,093 | 0.97 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 24 | $291,491 | $45,680 | $63,545 | 5.06 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 24 | $250,861 | $33,671 | $54,688 | 4.14 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 22 | $395,305 | $56,337 | $86,176 | 7.80 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 20 | $184,162 | $25,115 | $40,147 | 3.46 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 19 | $184,348 | $35,454 | $40,188 | 5.04 |
| Atherosclerosis without MCCMS-DRG 303, medical | 19 | $32,535 | $4,584 | $7,093 | 0.66 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 18 | $134,152 | $24,455 | $29,245 | 3.46 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 18 | $83,672 | $22,044 | $18,240 | 3.27 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $70,984 | $11,163 | $15,475 | 1.58 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 17 | $341,822 | $41,349 | $74,517 | 5.24 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 15 | $275,168 | $29,204 | $59,987 | 4.16 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $168,988 | $28,722 | $36,839 | 3.90 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $45,895 | $5,073 | $10,005 | 0.72 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $198,922 | $27,242 | $43,365 | 3.35 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 12 | $523,976 | $76,661 | $114,227 | 9.71 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 12 | $296,951 | $35,874 | $64,735 | 5.20 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 11 | $313,067 | $45,872 | $68,249 | 6.21 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 11 | $63,981 | $14,536 | $13,948 | 1.97 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $27,425 | $5,811 | $5,979 | 0.86 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $46,481 | $8,298 | $10,133 | 1.15 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 11 | $50,169 | $11,262 | $10,937 | 1.54 |
| Cardiac congenital and valvular disorders without MCCMS-DRG 307, medical | 11 | $36,781 | $6,972 | $8,018 | 0.94 |
Respiratory system977 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 254 | $60,530 | $11,478 | $13,195 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 167 | $45,149 | $9,170 | $9,843 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 151 | $54,954 | $8,835 | $11,980 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 65 | $39,611 | $6,781 | $8,635 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 52 | $34,479 | $5,830 | $7,517 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 51 | $44,827 | $7,573 | $9,772 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 37 | $50,870 | $9,683 | $11,090 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 35 | $37,851 | $6,490 | $8,251 | 0.96 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 29 | $122,584 | $18,378 | $26,723 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 23 | $193,096 | $30,905 | $42,095 | 4.71 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 23 | $37,637 | $5,081 | $8,205 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 20 | $166,863 | $16,754 | $36,376 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 18 | $31,930 | $6,287 | $6,961 | 0.85 |
| Pleural effusion with MCCMS-DRG 186, medical | 14 | $63,124 | $10,515 | $13,761 | 1.55 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 14 | $79,822 | $13,885 | $17,401 | 1.90 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 13 | $28,661 | $4,392 | $6,248 | 0.63 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 11 | $40,498 | $4,603 | $8,829 | 0.76 |
Musculoskeletal system and connective tissue787 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 237 | $108,508 | $13,119 | $23,655 | 1.88 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 71 | $174,037 | $21,741 | $37,940 | 3.49 |
| Medical back problems without MCCMS-DRG 552, medical | 62 | $35,692 | $6,500 | $7,781 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 47 | $118,465 | $14,787 | $25,825 | 2.11 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 46 | $106,472 | $14,404 | $23,211 | 2.07 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 37 | $116,423 | $17,756 | $25,380 | 2.48 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 36 | $141,513 | $18,432 | $30,850 | 2.67 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 33 | $28,627 | $5,983 | $6,241 | 0.90 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 28 | $43,014 | $7,602 | $9,377 | 1.09 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 19 | $105,206 | $16,339 | $22,935 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 18 | $132,412 | $18,174 | $28,866 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 17 | $141,136 | $19,297 | $30,768 | 3.33 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 17 | $138,816 | $19,339 | $30,262 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 17 | $42,593 | $5,474 | $9,285 | 0.79 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 15 | $263,410 | $41,395 | $57,423 | 6.12 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 15 | $74,894 | $12,341 | $16,327 | 1.82 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 13 | $222,191 | $26,613 | $48,438 | 3.66 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 13 | $46,114 | $7,177 | $10,053 | 1.00 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 12 | $79,068 | $9,878 | $17,237 | 1.49 |
| Medical back problems with MCCMS-DRG 551, medical | 12 | $54,480 | $11,181 | $11,877 | 1.70 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 11 | $227,746 | $32,663 | $49,649 | 4.61 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $33,600 | $6,090 | $7,325 | 0.88 |
Digestive system744 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 152 | $34,099 | $5,319 | $7,434 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 146 | $42,134 | $7,060 | $9,185 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 70 | $74,090 | $12,174 | $16,152 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 51 | $34,864 | $5,694 | $7,600 | 0.80 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 51 | $54,708 | $9,069 | $11,926 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 51 | $38,422 | $6,809 | $8,376 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 47 | $214,169 | $34,301 | $46,689 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 38 | $38,472 | $7,361 | $8,387 | 1.04 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 30 | $171,627 | $16,272 | $37,415 | 2.37 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 21 | $30,152 | $3,892 | $6,573 | 0.56 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 19 | $51,039 | $12,339 | $11,126 | 1.62 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 17 | $49,454 | $7,525 | $10,781 | 1.07 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 15 | $62,460 | $10,318 | $13,616 | 1.45 |
| Appendix procedures with CCMS-DRG 398, surgical | 13 | $78,632 | $10,557 | $17,142 | 1.51 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $60,504 | $8,429 | $13,190 | 1.20 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 11 | $48,800 | $11,545 | $10,638 | 1.75 |
Infectious and parasitic diseases684 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 | 488 | $82,970 | $13,782 | $18,087 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 78 | $42,056 | $7,298 | $9,168 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 68 | $209,722 | $36,815 | $45,719 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 21 | $228,479 | $45,427 | $49,808 | 6.96 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 15 | $33,180 | $7,262 | $7,233 | 1.01 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 14 | $104,959 | $13,409 | $22,881 | 2.04 |
Kidney and urinary tract657 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 181 | $32,414 | $5,495 | $7,066 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 128 | $35,354 | $6,408 | $7,707 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 81 | $41,892 | $8,047 | $9,132 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 73 | $63,620 | $11,626 | $13,869 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 61 | $56,526 | $10,169 | $12,323 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 55 | $34,864 | $7,593 | $7,600 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 30 | $73,175 | $9,568 | $15,952 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 23 | $55,242 | $7,083 | $12,043 | 1.05 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 13 | $21,925 | $5,342 | $4,780 | 0.69 |
| Renal failure without cc/mccMS-DRG 684, medical | 12 | $27,228 | $4,187 | $5,936 | 0.61 |
Endocrine, nutritional and metabolic278 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 without MCCMS-DRG 641, medical | 117 | $29,139 | $5,430 | $6,352 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 57 | $49,481 | $8,653 | $10,787 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 38 | $36,502 | $5,919 | $7,957 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 32 | $41,038 | $7,342 | $8,946 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 22 | $52,748 | $11,752 | $11,499 | 1.65 |
| Endocrine disorders without cc/mccMS-DRG 645, medical | 12 | $29,373 | $5,769 | $6,403 | 0.76 |
Nervous system265 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 47 | $35,731 | $9,020 | $7,789 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 37 | $41,308 | $7,060 | $9,005 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 23 | $47,853 | $12,666 | $10,432 | 2.00 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 19 | $50,665 | $14,139 | $11,045 | 2.39 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 18 | $137,297 | $13,238 | $29,931 | 1.81 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 18 | $38,773 | $5,543 | $8,452 | 0.80 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 17 | $36,282 | $6,944 | $7,910 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 15 | $76,943 | $12,008 | $16,773 | 1.79 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 14 | $32,687 | $4,430 | $7,126 | 0.69 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 13 | $61,724 | $9,339 | $13,456 | 1.32 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 11 | $113,421 | $7,637 | $24,726 | 1.14 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $46,991 | $7,038 | $10,244 | 1.06 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 11 | $40,332 | $7,678 | $8,792 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 11 | $70,461 | $11,471 | $15,360 | 1.98 |
Liver, gallbladder and pancreas211 discharges in 9 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 | 42 | $93,761 | $11,460 | $20,440 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 28 | $50,075 | $7,670 | $10,916 | 1.09 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 27 | $37,136 | $5,853 | $8,096 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 26 | $67,967 | $14,341 | $14,817 | 1.92 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 23 | $142,166 | $18,510 | $30,992 | 2.32 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 21 | $94,634 | $11,794 | $20,630 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 19 | $87,541 | $9,222 | $19,084 | 1.31 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 13 | $99,371 | $11,609 | $21,663 | 1.67 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 12 | $76,684 | $11,896 | $16,717 | 1.76 |
Skin, subcutaneous tissue and breast157 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 84 | $25,972 | $5,987 | $5,662 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 25 | $51,343 | $10,236 | $11,193 | 1.49 |
| Skin graft for skin ulcer or cellulitis with CCMS-DRG 574, surgical | 19 | $90,765 | $22,661 | $19,787 | 3.41 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 18 | $34,839 | $6,796 | $7,595 | 0.91 |
| Skin graft for skin ulcer or cellulitis with MCCMS-DRG 573, surgical | 11 | $156,126 | $41,281 | $34,036 | 6.22 |
Blood and immune system87 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 | 44 | $32,410 | $6,863 | $7,065 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 29 | $43,111 | $11,242 | $9,398 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 14 | $51,502 | $9,657 | $11,227 | 1.40 |
Other53 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 | 30 | $118,100 | $15,838 | $25,746 | 2.49 |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 23 | $183,322 | $30,216 | $39,964 | 4.74 |
Mental diseases and disorders38 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 27 | $35,971 | $11,452 | $7,842 | 1.76 |
| PsychosesMS-DRG 885, medical | 11 | $73,679 | $5,180 | $16,062 | 1.37 |
Factors influencing health status34 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| O.r. procedures with diagnoses of other contact with health services with CCMS-DRG 940, surgical | 20 | $114,282 | $15,308 | $24,913 | 2.17 |
| Signs and symptoms without MCCMS-DRG 948, medical | 14 | $30,113 | $5,608 | $6,565 | 0.80 |
Injuries, poisonings and toxic effects of drugs27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 16 | $79,266 | $13,757 | $17,280 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 11 | $39,972 | $7,824 | $8,714 | 1.03 |
Alcohol and drug use16 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 | 16 | $35,598 | $5,965 | $7,760 | 0.86 |
Ear, nose, mouth and throat11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 11 | $32,952 | $5,125 | $7,183 | 0.74 |
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 | 1,339 | 1,276 | $22,365 | $1,959 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 678 | 650 | $97,453 | $10,171 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 558 | 520 | $11,921 | $988 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 382 | 344 | $15,546 | $1,311 | $1,445 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 252 | 250 | $23,803 | $1,414 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 245 | 241 | $63,110 | $4,854 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 240 | 240 | $29,137 | $2,103 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 239 | 239 | $53,323 | $3,515 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 232 | 225 | $91,243 | $8,297 | $8,874 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 207 | 202 | $40,934 | $2,017 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 157 | 153 | $33,781 | $1,988 | $2,373 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 143 | 141 | $74,149 | $3,166 | $4,982 |
| Level 3 Vascular ProceduresAPC 5183 | 138 | 135 | $24,792 | $2,239 | $2,405 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 128 | 127 | $180,404 | $19,672 | $21,117 |
| Level 2 Vascular ProceduresAPC 5182 | 126 | 123 | $12,900 | $1,120 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 124 | 119 | $15,901 | $1,115 | $1,196 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 123 | 122 | $115,251 | $14,493 | $15,763 |
| Level 1 Nerve ProceduresAPC 5431 | 123 | 116 | $17,835 | $1,339 | $1,407 |
| Level 3 Urology and Related ServicesAPC 5373 | 112 | 88 | $19,940 | $1,257 | $1,516 |
| Level 5 Airway EndoscopyAPC 5155 | 91 | 86 | $53,755 | $4,874 | $5,183 |
| Level 5 ENT ProceduresAPC 5165 | 85 | 85 | $67,787 | $4,016 | $4,436 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 73 | 73 | $59,647 | $8,034 | $8,569 |
| Level 2 Urology and Related ServicesAPC 5372 | 73 | 54 | $8,480 | $258 | $502 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 72 | 69 | $42,625 | $2,310 | $2,636 |
| Level 5 Urology and Related ServicesAPC 5375 | 71 | 71 | $48,874 | $3,261 | $3,918 |
| Level 3 Lower GI ProceduresAPC 5313 | 64 | 64 | $19,012 | $1,955 | $2,176 |
| Complex GI ProceduresAPC 5331 | 61 | 45 | $38,455 | $4,113 | $4,263 |
| Level 4 Airway EndoscopyAPC 5154 | 58 | 57 | $24,836 | $2,647 | $2,833 |
| Level 3 Upper GI ProceduresAPC 5303 | 56 | 54 | $24,083 | $2,764 | $2,888 |
| Level 4 Urology and Related ServicesAPC 5374 | 52 | 47 | $34,714 | $2,309 | $2,629 |
| Level 4 Endovascular ProceduresAPC 5194 | 51 | 51 | $137,118 | $14,038 | $14,606 |
| Level 3 Airway EndoscopyAPC 5153 | 50 | 49 | $12,531 | $980 | $1,264 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 41 | 41 | $80,360 | $6,809 | $8,164 |
| Level 4 Gynecologic ProceduresAPC 5414 | 38 | 38 | $27,316 | $2,144 | $2,389 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 37 | 37 | $211,366 | $28,080 | $29,375 |
| Level 1 Intraocular ProceduresAPC 5491 | 36 | 28 | $18,441 | $897 | $1,752 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 33 | 33 | $63,520 | $6,128 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 30 | 30 | $207,332 | $18,271 | $26,719 |
| Cochlear Implant ProcedureAPC 5166 | 23 | 23 | $173,619 | $24,524 | $29,489 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 23 | 23 | $120,789 | $15,979 | $17,052 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 23 | 19 | $47,134 | $2,919 | $4,524 |
| Level 4 Vascular ProceduresAPC 5184 | 17 | 17 | $57,513 | $3,944 | $3,946 |
| Level 3 ENT ProceduresAPC 5163 | 16 | 16 | $16,844 | $1,086 | $1,106 |
| Level 2 Endovascular ProceduresAPC 5192 | 14 | 14 | $55,686 | $3,770 | $4,338 |
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.