Levine Children S Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Levine Children S Hospital, Charlotte, NC in 2024, from traditional Medicare claims. Back to the Levine Children S Hospital profile, with quality ratings, finances and negotiated rates.
6,585
Medicare inpatient discharges
In 206 published DRGs
2.70
Case mix index
IPPS FY 2027
41%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
8,133
Medicare outpatient services
In 50 service groups
Inpatient stays by major diagnostic category
Circulatory system1,345 discharges in 37 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 155 | $49,953 | $10,503 | $11,489 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 138 | $196,776 | $36,539 | $45,259 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 87 | $138,689 | $24,384 | $31,898 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 71 | $48,294 | $7,499 | $11,108 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 64 | $231,886 | $47,602 | $53,334 | 6.25 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 54 | $47,402 | $9,670 | $10,902 | 1.20 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 49 | $124,152 | $18,657 | $28,555 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 44 | $47,426 | $6,254 | $10,908 | 0.74 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 43 | $340,427 | $50,401 | $78,298 | 7.71 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 42 | $114,943 | $20,453 | $26,437 | 2.09 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 40 | $232,924 | $30,541 | $53,573 | 4.16 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 39 | $213,832 | $27,913 | $49,181 | 3.46 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 38 | $132,671 | $13,487 | $30,514 | 1.82 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 35 | $180,419 | $27,577 | $41,496 | 3.35 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 34 | $349,171 | $49,978 | $80,309 | 5.24 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 34 | $67,603 | $8,603 | $15,549 | 1.08 |
| Other vascular procedures with CCMS-DRG 253, surgical | 31 | $142,900 | $18,336 | $32,867 | 2.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 27 | $43,797 | $8,108 | $10,073 | 0.97 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 27 | $166,385 | $23,273 | $38,269 | 2.87 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 25 | $69,904 | $12,412 | $16,078 | 1.59 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 23 | $187,355 | $21,300 | $43,092 | 3.18 |
| Hypertension without MCCMS-DRG 305, medical | 23 | $36,205 | $6,531 | $8,327 | 0.75 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $294,175 | $44,798 | $67,660 | 5.06 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 21 | $39,412 | $9,410 | $9,065 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 19 | $65,935 | $8,867 | $15,165 | 1.15 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 18 | $30,565 | $4,790 | $7,030 | 0.55 |
| Chest painMS-DRG 313, medical | 18 | $35,602 | $7,248 | $8,189 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 14 | $506,124 | $81,363 | $116,409 | 9.71 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 14 | $92,238 | $18,437 | $21,215 | 2.28 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 14 | $51,732 | $7,448 | $11,898 | 0.91 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 13 | $417,349 | $60,099 | $95,990 | 6.85 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 12 | $393,312 | $53,186 | $90,462 | 7.80 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 12 | $277,236 | $37,926 | $63,764 | 5.88 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 12 | $115,823 | $23,582 | $26,639 | 3.27 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 12 | $218,114 | $33,757 | $50,166 | 4.14 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 11 | $207,576 | $30,135 | $47,742 | 4.04 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 11 | $50,025 | $13,012 | $11,506 | 1.58 |
Musculoskeletal system and connective tissue896 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 89 | $272,176 | $47,756 | $62,600 | 6.12 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 80 | $136,913 | $15,988 | $31,490 | 2.07 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 76 | $213,570 | $36,173 | $49,121 | 4.61 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 66 | $186,350 | $27,691 | $42,861 | 3.66 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 57 | $139,547 | $22,580 | $32,096 | 2.96 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 56 | $129,455 | $20,161 | $29,775 | 2.67 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 47 | $184,780 | $25,760 | $42,499 | 3.49 |
| Medical back problems without MCCMS-DRG 552, medical | 47 | $44,554 | $7,629 | $10,247 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 44 | $115,832 | $13,432 | $26,641 | 1.88 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 35 | $143,469 | $19,784 | $32,998 | 2.48 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 34 | $282,142 | $46,773 | $64,893 | 6.08 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 34 | $120,271 | $16,019 | $27,662 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 33 | $176,951 | $23,800 | $40,699 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 30 | $135,572 | $16,999 | $31,182 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 23 | $38,879 | $6,797 | $8,942 | 0.79 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 22 | $42,496 | $7,736 | $9,774 | 0.90 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 18 | $117,592 | $12,967 | $27,046 | 1.97 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 16 | $140,600 | $17,778 | $32,338 | 2.04 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 15 | $172,470 | $25,310 | $39,668 | 3.46 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $83,204 | $13,966 | $19,137 | 1.70 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 13 | $44,249 | $8,912 | $10,177 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 13 | $72,663 | $12,087 | $16,713 | 1.52 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 12 | $116,404 | $14,100 | $26,773 | 1.87 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 11 | $32,090 | $7,142 | $7,381 | 0.82 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 11 | $40,157 | $7,897 | $9,236 | 1.13 |
Nervous system800 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 105 | $99,498 | $16,063 | $22,885 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 90 | $162,088 | $32,615 | $37,280 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 67 | $211,439 | $41,722 | $48,631 | 5.67 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 57 | $54,023 | $8,818 | $12,425 | 1.02 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 38 | $129,195 | $18,953 | $29,715 | 2.43 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 38 | $58,272 | $10,948 | $13,403 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 34 | $103,460 | $17,242 | $23,796 | 1.98 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 33 | $179,535 | $22,591 | $41,293 | 2.95 |
| Seizures without MCCMS-DRG 101, medical | 32 | $50,451 | $7,547 | $11,604 | 0.91 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 29 | $111,140 | $18,935 | $25,562 | 2.28 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $42,773 | $7,639 | $9,838 | 1.03 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 26 | $81,130 | $13,523 | $18,660 | 1.79 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 25 | $97,124 | $13,805 | $22,338 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 22 | $217,997 | $27,938 | $50,139 | 2.39 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 22 | $66,196 | $11,444 | $15,225 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 20 | $156,753 | $29,795 | $36,053 | 3.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 17 | $63,355 | $9,234 | $14,572 | 1.06 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $41,864 | $12,524 | $9,629 | 1.47 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 15 | $78,742 | $12,365 | $18,111 | 1.62 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 13 | $91,270 | $14,675 | $20,992 | 1.81 |
| Extracranial procedures with CCMS-DRG 038, surgical | 13 | $104,051 | $13,796 | $23,932 | 1.60 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 13 | $75,477 | $7,683 | $17,360 | 1.14 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 13 | $44,272 | $7,351 | $10,183 | 0.80 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 13 | $57,059 | $9,213 | $13,124 | 1.03 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 11 | $327,974 | $58,546 | $75,434 | 8.45 |
| Spinal procedures with MCCMS-DRG 028, surgical | 11 | $276,932 | $48,930 | $63,694 | 6.03 |
Digestive system640 discharges in 23 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 | 99 | $37,077 | $6,707 | $8,528 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 62 | $115,434 | $18,120 | $26,550 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 42 | $65,885 | $14,148 | $15,153 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 40 | $53,500 | $8,272 | $12,305 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 39 | $184,059 | $32,271 | $42,334 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 39 | $56,279 | $11,080 | $12,944 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 35 | $62,082 | $12,775 | $14,279 | 1.62 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 28 | $37,253 | $7,204 | $8,568 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 26 | $59,050 | $9,154 | $13,582 | 0.94 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 24 | $150,009 | $19,435 | $34,502 | 2.50 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 23 | $118,303 | $16,768 | $27,210 | 2.11 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 21 | $218,393 | $41,054 | $50,230 | 5.08 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 20 | $81,188 | $9,418 | $18,673 | 1.36 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 19 | $118,954 | $11,245 | $27,359 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $62,718 | $14,037 | $14,425 | 1.75 |
| Digestive malignancy with MCCMS-DRG 374, medical | 17 | $102,334 | $25,240 | $23,537 | 2.10 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 14 | $134,331 | $11,936 | $30,896 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 14 | $44,577 | $8,674 | $10,253 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 14 | $21,654 | $5,470 | $4,980 | 0.56 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 13 | $97,182 | $14,020 | $22,352 | 1.72 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 12 | $123,998 | $28,103 | $28,520 | 4.28 |
| Peritoneal adhesiolysis without cc/mccMS-DRG 337, surgical | 11 | $89,299 | $9,931 | $20,539 | 1.50 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $56,110 | $9,909 | $12,905 | 1.20 |
Respiratory system620 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 106 | $57,839 | $10,682 | $13,303 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 93 | $86,654 | $14,023 | $19,930 | 1.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 65 | $43,645 | $6,932 | $10,038 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 45 | $52,021 | $10,163 | $11,965 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 27 | $55,361 | $8,309 | $12,733 | 0.99 |
| Major chest procedures with CCMS-DRG 164, surgical | 23 | $149,885 | $17,640 | $34,474 | 2.55 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 23 | $195,310 | $32,684 | $44,921 | 4.06 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 23 | $58,267 | $12,025 | $13,401 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 20 | $39,717 | $8,387 | $9,135 | 1.10 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 19 | $65,125 | $14,699 | $14,979 | 1.74 |
| Major chest trauma with MCCMS-DRG 183, medical | 19 | $82,328 | $13,419 | $18,935 | 1.57 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 19 | $144,748 | $22,224 | $33,292 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 18 | $226,145 | $33,766 | $52,013 | 4.71 |
| Major chest trauma with CCMS-DRG 184, medical | 18 | $62,610 | $9,091 | $14,400 | 1.05 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 18 | $34,252 | $7,453 | $7,878 | 0.85 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 18 | $29,481 | $8,730 | $6,781 | 0.96 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 17 | $121,943 | $14,152 | $28,047 | 1.88 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $253,043 | $49,306 | $58,200 | 6.91 |
| Pneumothorax with CCMS-DRG 200, medical | 12 | $43,153 | $8,682 | $9,925 | 1.08 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 11 | $38,948 | $7,617 | $8,958 | 0.82 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 11 | $64,005 | $9,700 | $14,721 | 1.10 |
Kidney and urinary tract554 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 78 | $37,089 | $7,230 | $8,530 | 0.81 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 75 | $46,959 | $8,576 | $10,801 | 1.02 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 66 | $77,250 | $13,192 | $17,768 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 61 | $59,494 | $9,767 | $13,684 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 50 | $37,166 | $8,000 | $8,548 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 49 | $66,853 | $11,282 | $15,376 | 1.50 |
| Kidney transplantMS-DRG 652, surgical | 38 | $286,403 | $16,539 | $65,873 | 3.00 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 29 | $84,373 | $10,530 | $19,406 | 1.35 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 24 | $110,138 | $10,805 | $25,332 | 1.48 |
| Major bladder procedures with CCMS-DRG 654, surgical | 23 | $204,265 | $21,169 | $46,981 | 2.74 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 22 | $162,633 | $24,109 | $37,406 | 2.59 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 20 | $147,660 | $24,041 | $33,962 | 3.14 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 19 | $121,199 | $11,701 | $27,876 | 1.84 |
Infectious and parasitic diseases436 discharges in 8 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 | 260 | $94,586 | $15,592 | $21,755 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 53 | $317,084 | $44,813 | $72,929 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 34 | $45,588 | $8,936 | $10,485 | 1.03 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 21 | $48,129 | $14,778 | $11,070 | 1.84 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 19 | $297,233 | $54,132 | $68,364 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 18 | $96,789 | $17,546 | $22,261 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 16 | $235,266 | $28,283 | $54,111 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 15 | $40,143 | $8,574 | $9,233 | 1.01 |
Endocrine, nutritional and metabolic215 discharges in 5 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 | 84 | $63,201 | $10,876 | $14,536 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 56 | $37,251 | $6,830 | $8,568 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 36 | $57,432 | $11,315 | $13,209 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 26 | $34,584 | $7,405 | $7,954 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $108,483 | $16,845 | $24,951 | 1.98 |
Liver, gallbladder and pancreas191 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 26 | $68,058 | $14,819 | $15,653 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 24 | $51,203 | $9,620 | $11,777 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $102,900 | $17,655 | $23,667 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 19 | $103,542 | $13,381 | $23,815 | 1.63 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 18 | $183,432 | $36,960 | $42,189 | 5.51 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 18 | $40,045 | $6,282 | $9,210 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 17 | $44,472 | $7,232 | $10,229 | 0.95 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 16 | $144,517 | $21,249 | $33,239 | 2.89 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 16 | $67,162 | $11,628 | $15,447 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 15 | $75,282 | $14,148 | $17,315 | 1.92 |
Other176 discharges in 7 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 | 42 | $247,219 | $37,190 | $56,860 | 4.74 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 30 | $305,212 | $53,101 | $70,199 | |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 28 | $223,028 | $28,812 | $51,297 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 24 | $162,854 | $29,601 | $37,456 | |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 23 | $127,373 | $19,166 | $29,296 | 2.49 |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 16 | $235,186 | $32,356 | $54,093 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 13 | $139,281 | $24,022 | $32,035 | 3.38 |
Transplants, ECMO and tracheostomy (pre-MDC)122 discharges in 5 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 | 41 | $834,180 | $151,351 | $191,861 | 21.32 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 27 | $2,663,431 | $504,535 | $612,589 | 36.84 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 21 | $115,798 | $46,855 | $26,634 | 6.18 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 18 | $1,320,342 | $236,446 | $303,679 | 27.10 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 15 | $546,993 | $71,696 | $125,808 | 10.35 |
Blood cancers and poorly differentiated neoplasms110 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 30 | $46,442 | $11,762 | $10,682 | 1.21 |
| Acute leukemia with MCCMS-DRG 834, medical | 19 | $204,543 | $42,362 | $47,045 | 5.60 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 18 | $172,387 | $32,031 | $39,649 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 16 | $80,123 | $14,253 | $18,428 | 1.57 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 15 | $71,918 | $18,600 | $16,541 | 2.44 |
| Lymphoma and non-acute leukemia with other procedures with CCMS-DRG 824, surgical | 12 | $102,213 | $16,954 | $23,509 | 2.23 |
Blood and immune system106 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 | 39 | $42,460 | $8,154 | $9,766 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 24 | $60,610 | $13,668 | $13,940 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 18 | $77,519 | $15,311 | $17,829 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 13 | $72,337 | $13,263 | $16,637 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 12 | $105,850 | $16,795 | $24,346 | 2.19 |
Skin, subcutaneous tissue and breast98 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 55 | $38,517 | $7,892 | $8,859 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 29 | $46,209 | $11,756 | $10,628 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 14 | $84,360 | $13,403 | $19,403 | 1.75 |
Mental diseases and disorders95 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 80 | $44,769 | $11,114 | $10,297 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 15 | $121,648 | $12,669 | $27,979 | 1.76 |
Injuries, poisonings and toxic effects of drugs56 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 22 | $71,917 | $8,924 | $16,541 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 17 | $229,242 | $41,186 | $52,726 | 3.72 |
| Complications of treatment with MCCMS-DRG 919, medical | 17 | $119,740 | $17,936 | $27,540 | 1.82 |
Factors influencing health status48 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 24 | $43,519 | $6,710 | $10,009 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 13 | $53,358 | $10,238 | $12,272 | 1.25 |
| Other factors influencing health statusMS-DRG 951, medical | 11 | $21,700 | $5,719 | $4,991 | 0.59 |
Alcohol and drug use36 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 | 36 | $21,947 | $7,534 | $5,048 | 0.86 |
Multiple significant trauma29 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 15 | $439,591 | $69,245 | $101,106 | 7.23 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 14 | $245,317 | $38,205 | $56,423 | 3.88 |
Ear, nose, mouth and throat12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 12 | $38,103 | $6,671 | $8,764 | 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 |
|---|---|---|---|---|---|
| Level 2 Urology and Related ServicesAPC 5372 | 1,020 | 343 | $3,112 | $457 | $502 |
| Level 2 Upper GI ProceduresAPC 5302 | 465 | 421 | $14,963 | $1,329 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 462 | 426 | $20,743 | $1,933 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 428 | 367 | $24,943 | $1,932 | $2,141 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 427 | 416 | $87,927 | $9,875 | $10,772 |
| Level 5 Urology and Related ServicesAPC 5375 | 367 | 324 | $45,451 | $3,644 | $3,918 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 342 | 320 | $14,072 | $1,120 | $1,220 |
| Level 4 Urology and Related ServicesAPC 5374 | 314 | 253 | $28,439 | $2,451 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 293 | 264 | $24,126 | $2,173 | $2,405 |
| Level 3 Urology and Related ServicesAPC 5373 | 293 | 256 | $12,575 | $1,396 | $1,516 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 273 | 273 | $238,806 | $19,509 | $21,117 |
| Level 1 Endovascular ProceduresAPC 5191 | 267 | 266 | $37,851 | $2,073 | $2,208 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 252 | 247 | $50,392 | $3,941 | $4,358 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 213 | 212 | $82,979 | $7,343 | $8,164 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 212 | 210 | $62,768 | $5,032 | $5,339 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 176 | 174 | $117,791 | $14,905 | $15,763 |
| Level 3 Endovascular ProceduresAPC 5193 | 176 | 156 | $76,913 | $8,101 | $8,874 |
| Level 5 Airway EndoscopyAPC 5155 | 164 | 160 | $31,980 | $4,781 | $5,183 |
| Level 4 Airway EndoscopyAPC 5154 | 124 | 120 | $23,842 | $2,659 | $2,833 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 120 | 114 | $37,559 | $2,201 | $2,373 |
| Level 2 Vascular ProceduresAPC 5182 | 109 | 107 | $9,328 | $1,102 | $1,204 |
| Level 4 Vascular ProceduresAPC 5184 | 102 | 94 | $38,356 | $3,548 | $3,946 |
| Level 3 Upper GI ProceduresAPC 5303 | 102 | 100 | $18,239 | $2,691 | $2,888 |
| Level 2 Endovascular ProceduresAPC 5192 | 98 | 94 | $50,412 | $3,903 | $4,338 |
| Level 4 Endovascular ProceduresAPC 5194 | 93 | 82 | $111,781 | $12,426 | $14,606 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 91 | 86 | $33,991 | $2,653 | $2,930 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 91 | 89 | $55,188 | $4,564 | $4,982 |
| Complex GI ProceduresAPC 5331 | 84 | 77 | $26,947 | $3,933 | $4,263 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 82 | 79 | $29,686 | $2,412 | $2,636 |
| Level 1 Nerve ProceduresAPC 5431 | 73 | 59 | $28,971 | $1,319 | $1,407 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 70 | 70 | $67,258 | $7,947 | $8,569 |
| Level 5 ENT ProceduresAPC 5165 | 66 | 64 | $41,600 | $4,097 | $4,436 |
| Level 5 Gynecologic ProceduresAPC 5415 | 58 | 57 | $40,723 | $3,500 | $3,792 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 56 | 56 | $145,200 | $27,722 | $29,375 |
| Level 4 Gynecologic ProceduresAPC 5414 | 56 | 56 | $31,943 | $2,198 | $2,389 |
| Level 7 Radiation TherapyAPC 5627 | 56 | 49 | $220,721 | $5,575 | $6,121 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 53 | 46 | $44,084 | $4,334 | $4,524 |
| Level 3 Airway EndoscopyAPC 5153 | 51 | 49 | $17,880 | $1,189 | $1,264 |
| Level 3 Lower GI ProceduresAPC 5313 | 50 | 50 | $19,143 | $1,993 | $2,176 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 43 | 42 | $15,047 | $1,147 | $1,196 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 43 | 42 | $114,950 | $17,130 | $18,465 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 33 | 33 | $32,966 | $6,082 | $6,514 |
| Level 8 Urology and Related ServicesAPC 5378 | 33 | 33 | $116,147 | $15,954 | $17,428 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 32 | 31 | $132,709 | $14,343 | $17,052 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 32 | 32 | $139,093 | $26,190 | $26,719 |
| Level 4 ENT ProceduresAPC 5164 | 28 | 28 | $31,073 | $2,297 | $2,217 |
| Level 6 Urology and Related ServicesAPC 5376 | 22 | 22 | $61,247 | $6,343 | $7,291 |
| Level 1 Intraocular ProceduresAPC 5491 | 14 | 11 | $21,350 | $1,668 | $1,752 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 13 | 13 | $99,914 | $17,995 | $21,011 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 11 | $127,891 | $6,215 | $7,546 |
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.