Long Island Jewish Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Long Island Jewish Medical Center, New Hyde Park, NY in 2024, from traditional Medicare claims. Back to the Long Island Jewish Medical Center profile, with quality ratings, finances and negotiated rates.
10,061
Medicare inpatient discharges
In 207 published DRGs
1.77
Case mix index
IPPS FY 2027
18%
Surgical stays
68%
Stays with complications
In DRGs with a CC or MCC
4,133
Medicare outpatient services
In 43 service groups
Inpatient stays by major diagnostic category
Infectious and parasitic diseases1,789 discharges in 9 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 | 1,307 | $155,760 | $20,700 | $25,700 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 201 | $79,623 | $10,112 | $13,138 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 138 | $359,356 | $53,759 | $59,294 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 60 | $576,938 | $84,690 | $95,195 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 27 | $146,267 | $18,895 | $24,134 | 1.84 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 20 | $205,341 | $19,798 | $33,881 | 2.04 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 13 | $52,910 | $9,771 | $8,730 | 0.88 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 12 | $49,226 | $9,426 | $8,122 | 1.01 |
| Viral illness with MCCMS-DRG 865, medical | 11 | $115,584 | $13,800 | $19,071 | 1.64 |
Circulatory system1,581 discharges in 34 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 412 | $119,142 | $12,942 | $19,658 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 171 | $71,031 | $8,408 | $11,720 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 82 | $70,622 | $7,259 | $11,653 | 0.74 |
| Chest painMS-DRG 313, medical | 82 | $68,350 | $6,612 | $11,278 | 0.72 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 77 | $126,054 | $15,806 | $20,799 | 1.59 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 64 | $78,502 | $10,444 | $12,953 | 1.07 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 57 | $147,911 | $21,112 | $24,405 | 2.09 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 51 | $188,562 | $21,106 | $31,113 | 2.16 |
| Hypertension without MCCMS-DRG 305, medical | 50 | $65,640 | $6,669 | $10,831 | 0.75 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 48 | $82,225 | $10,682 | $13,567 | 1.08 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 48 | $114,125 | $11,934 | $18,831 | 1.20 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 43 | $119,558 | $14,948 | $19,727 | 1.58 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 35 | $252,100 | $36,826 | $41,597 | 3.35 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 30 | $49,948 | $4,753 | $8,241 | 0.55 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 27 | $83,898 | $8,498 | $13,843 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 26 | $129,955 | $19,011 | $21,443 | 1.82 |
| Hypertension with MCCMS-DRG 304, medical | 23 | $115,532 | $10,376 | $19,063 | 1.15 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 21 | $283,483 | $44,393 | $46,775 | 5.06 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 19 | $66,633 | $6,660 | $10,994 | 0.71 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 19 | $62,209 | $9,454 | $10,264 | 0.97 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $157,269 | $23,093 | $25,949 | 2.28 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 18 | $245,086 | $25,024 | $40,439 | 2.87 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 17 | $355,572 | $43,643 | $58,669 | 3.90 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 15 | $379,323 | $59,002 | $62,588 | 5.04 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 15 | $191,339 | $32,411 | $31,571 | 3.46 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 15 | $318,075 | $43,203 | $52,482 | 3.27 |
| Other vascular procedures with CCMS-DRG 253, surgical | 14 | $150,665 | $25,603 | $24,860 | 2.55 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 13 | $57,546 | $7,034 | $9,495 | 0.72 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 12 | $388,887 | $51,120 | $64,166 | 4.81 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 12 | $115,147 | $17,305 | $18,999 | 1.83 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 12 | $211,647 | $31,904 | $34,922 | 3.24 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $71,501 | $8,814 | $11,798 | 0.86 |
| Atherosclerosis without MCCMS-DRG 303, medical | 12 | $45,571 | $5,546 | $7,519 | 0.66 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 11 | $203,187 | $33,814 | $33,526 | 3.18 |
Respiratory system1,228 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 224 | $133,780 | $16,953 | $22,074 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 132 | $126,069 | $13,014 | $20,801 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 127 | $110,334 | $13,614 | $18,205 | 1.33 |
| Major chest procedures with CCMS-DRG 164, surgical | 91 | $143,861 | $24,774 | $23,737 | 2.55 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 61 | $124,036 | $12,872 | $20,466 | 1.10 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 57 | $95,001 | $18,312 | $15,675 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 51 | $128,193 | $13,660 | $21,152 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 50 | $208,469 | $28,196 | $34,397 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 49 | $265,033 | $47,227 | $43,730 | 4.71 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 49 | $79,605 | $7,698 | $13,135 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 47 | $89,868 | $9,700 | $14,828 | 0.99 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 40 | $310,842 | $43,363 | $51,289 | 4.06 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 35 | $83,768 | $9,330 | $13,822 | 0.96 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 34 | $160,555 | $18,704 | $26,492 | 1.74 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 32 | $77,358 | $7,495 | $12,764 | 0.82 |
| Pleural effusion with MCCMS-DRG 186, medical | 23 | $140,515 | $17,549 | $23,185 | 1.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 23 | $83,586 | $8,118 | $13,792 | 0.85 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 20 | $610,542 | $80,859 | $100,739 | 6.91 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 19 | $126,724 | $19,992 | $20,909 | 1.90 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 17 | $92,749 | $18,668 | $15,304 | 1.81 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 16 | $57,587 | $5,477 | $9,502 | 0.63 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 16 | $49,224 | $8,170 | $8,122 | 0.91 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 15 | $142,324 | $19,512 | $23,484 | 1.82 |
Kidney and urinary tract1,049 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 224 | $107,337 | $12,624 | $17,711 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 166 | $119,835 | $15,107 | $19,773 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 161 | $66,190 | $7,824 | $10,921 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 155 | $133,938 | $17,982 | $22,100 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 115 | $78,793 | $9,124 | $13,001 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 60 | $89,971 | $10,520 | $14,845 | 1.02 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 37 | $105,827 | $19,310 | $17,462 | 1.84 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 28 | $278,792 | $38,394 | $46,001 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 23 | $108,401 | $13,288 | $17,886 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $235,786 | $28,575 | $38,905 | 2.59 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 17 | $49,626 | $6,519 | $8,188 | 0.69 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 16 | $191,355 | $21,159 | $31,574 | 2.38 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 14 | $62,007 | $9,619 | $10,231 | 1.05 |
| Transurethral procedures with CCMS-DRG 669, surgical | 14 | $134,033 | $14,033 | $22,115 | 1.53 |
Digestive system1,006 discharges in 25 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 | 137 | $65,981 | $7,470 | $10,887 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 101 | $81,082 | $9,281 | $13,379 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 99 | $134,213 | $18,025 | $22,145 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 77 | $85,485 | $12,415 | $14,105 | 1.28 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 72 | $144,719 | $18,671 | $23,879 | 1.62 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 69 | $245,691 | $45,319 | $40,539 | 4.52 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 47 | $143,638 | $23,692 | $23,700 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 39 | $70,929 | $9,090 | $11,703 | 0.94 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 36 | $114,855 | $14,981 | $18,951 | 1.45 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 36 | $75,492 | $7,731 | $12,456 | 0.80 |
| Digestive malignancy with MCCMS-DRG 374, medical | 35 | $130,323 | $21,769 | $21,503 | 2.10 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 34 | $337,783 | $55,211 | $55,734 | 5.08 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 26 | $42,545 | $4,867 | $7,020 | 0.56 |
| Digestive malignancy with CCMS-DRG 375, medical | 23 | $97,993 | $12,430 | $16,169 | 1.20 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 22 | $101,960 | $16,372 | $16,823 | 1.60 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 21 | $54,216 | $5,924 | $8,946 | 0.65 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 20 | $93,877 | $17,222 | $15,490 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 19 | $193,315 | $20,680 | $31,897 | 1.75 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 19 | $51,460 | $5,265 | $8,491 | 0.63 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $147,175 | $24,510 | $24,284 | 2.50 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 14 | $83,142 | $9,892 | $13,718 | 0.97 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 12 | $96,488 | $16,791 | $15,920 | 1.72 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 12 | $66,401 | $10,165 | $10,956 | 1.04 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 11 | $256,999 | $39,267 | $42,405 | 3.58 |
| Appendix procedures with CCMS-DRG 398, surgical | 11 | $116,593 | $16,101 | $19,238 | 1.51 |
Musculoskeletal system and connective tissue960 discharges in 29 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 | 184 | $95,061 | $17,869 | $15,685 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 105 | $80,393 | $9,141 | $13,265 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 72 | $135,884 | $21,099 | $22,421 | 2.07 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 52 | $73,498 | $8,376 | $12,127 | 0.90 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 40 | $69,684 | $8,363 | $11,498 | 0.82 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 38 | $127,659 | $20,928 | $21,064 | 2.11 |
| Medical back problems with MCCMS-DRG 551, medical | 38 | $110,373 | $17,187 | $18,211 | 1.70 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 36 | $71,451 | $8,438 | $11,789 | 0.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 33 | $189,746 | $29,112 | $31,308 | 2.95 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 31 | $112,726 | $14,673 | $18,600 | 1.52 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 30 | $57,386 | $7,511 | $9,469 | 0.79 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 28 | $193,996 | $37,691 | $32,009 | 3.66 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 25 | $183,991 | $33,632 | $30,359 | 3.49 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 23 | $132,406 | $23,095 | $21,847 | 2.67 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 23 | $255,758 | $35,056 | $42,200 | 2.99 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 21 | $82,899 | $8,410 | $13,678 | 0.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 20 | $161,521 | $17,310 | $26,651 | 1.82 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 16 | $109,977 | $16,321 | $18,146 | 1.59 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 15 | $109,514 | $26,336 | $18,070 | 2.48 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 15 | $89,980 | $15,342 | $14,847 | 1.49 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 15 | $125,736 | $10,415 | $20,746 | 1.09 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 13 | $239,443 | $26,615 | $39,508 | 3.00 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $167,896 | $31,138 | $27,703 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 13 | $181,754 | $23,410 | $29,989 | 2.40 |
| Signs and symptoms of musculoskeletal system and connective tissue with MCCMS-DRG 555, medical | 13 | $80,974 | $12,726 | $13,361 | 1.40 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 12 | $176,748 | $26,116 | $29,163 | 3.33 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 12 | $110,876 | $11,378 | $18,294 | 1.30 |
| Bone diseases and arthropathies with MCCMS-DRG 553, medical | 12 | $181,009 | $16,593 | $29,866 | 1.35 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 12 | $78,493 | $9,347 | $12,951 | 1.00 |
Nervous system699 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 88 | $108,000 | $13,206 | $17,820 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 84 | $176,185 | $19,904 | $29,071 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 75 | $106,020 | $10,178 | $17,493 | 1.02 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 70 | $151,751 | $23,032 | $25,039 | 2.39 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 61 | $74,586 | $7,712 | $12,307 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 60 | $74,460 | $8,644 | $12,286 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 46 | $199,723 | $21,697 | $32,954 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 32 | $96,313 | $10,498 | $15,892 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 27 | $203,237 | $20,104 | $33,534 | 1.47 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 25 | $98,046 | $17,725 | $16,178 | 1.79 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 23 | $145,066 | $17,400 | $23,936 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 23 | $81,884 | $10,109 | $13,511 | 1.03 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 17 | $243,779 | $35,255 | $40,224 | 3.85 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 16 | $145,734 | $22,276 | $24,046 | 2.23 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 16 | $89,771 | $10,272 | $14,812 | 1.06 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 14 | $67,710 | $6,416 | $11,172 | 0.69 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 11 | $261,963 | $41,137 | $43,224 | 4.42 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 11 | $48,293 | $7,431 | $7,968 | 0.77 |
Endocrine, nutritional and metabolic428 discharges in 8 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 | 152 | $117,486 | $14,407 | $19,385 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 75 | $72,901 | $7,440 | $12,029 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 63 | $117,781 | $15,614 | $19,434 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 57 | $81,177 | $8,113 | $13,394 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 27 | $155,268 | $18,629 | $25,619 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 24 | $103,450 | $9,957 | $17,069 | 1.06 |
| Thyroid, parathyroid and thyroglossal procedures with CCMS-DRG 626, surgical | 15 | $84,288 | $14,246 | $13,908 | 1.49 |
| Thyroid, parathyroid and thyroglossal procedures without cc/mccMS-DRG 627, surgical | 15 | $47,009 | $9,831 | $7,756 | 1.24 |
Mental diseases and disorders270 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 163 | $145,725 | $18,339 | $24,045 | 1.76 |
| PsychosesMS-DRG 885, medical | 83 | $132,157 | $14,440 | $21,806 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 24 | $113,301 | $9,930 | $18,695 | 0.95 |
Liver, gallbladder and pancreas233 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 31 | $152,363 | $17,111 | $25,140 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 30 | $160,321 | $16,315 | $26,453 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 25 | $114,315 | $16,959 | $18,862 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 20 | $85,337 | $9,527 | $14,081 | 1.31 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 19 | $416,276 | $71,554 | $68,685 | 5.51 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 19 | $183,829 | $30,053 | $30,332 | 2.89 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 19 | $94,258 | $11,050 | $15,553 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 16 | $169,692 | $17,867 | $27,999 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 16 | $167,944 | $20,424 | $27,711 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $92,022 | $8,441 | $15,184 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 13 | $140,308 | $19,657 | $23,151 | 1.67 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 11 | $93,710 | $7,669 | $15,462 | 0.80 |
Skin, subcutaneous tissue and breast165 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 94 | $73,495 | $8,777 | $12,127 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 29 | $115,595 | $14,985 | $19,073 | 1.49 |
| Minor skin disorders without MCCMS-DRG 607, medical | 17 | $64,316 | $8,910 | $10,612 | 0.89 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 14 | $68,914 | $8,990 | $11,371 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with MCCMS-DRG 579, surgical | 11 | $196,270 | $31,584 | $32,385 | 3.34 |
Blood and immune system131 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 57 | $94,536 | $8,424 | $15,598 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 49 | $140,669 | $15,489 | $23,210 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 14 | $153,466 | $18,598 | $25,322 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $174,530 | $24,521 | $28,797 | 2.19 |
Factors influencing health status113 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 58 | $47,164 | $5,918 | $7,782 | 0.59 |
| Signs and symptoms without MCCMS-DRG 948, medical | 44 | $60,815 | $7,693 | $10,034 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 11 | $169,998 | $7,944 | $28,050 | 1.25 |
Injuries, poisonings and toxic effects of drugs98 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 34 | $63,342 | $9,806 | $10,451 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 30 | $148,020 | $19,337 | $24,423 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 22 | $109,032 | $15,806 | $17,990 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 12 | $105,169 | $20,758 | $17,353 | 2.00 |
Ear, nose, mouth and throat91 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 53 | $73,734 | $6,864 | $12,166 | 0.74 |
| Dental and oral diseases with CCMS-DRG 158, medical | 14 | $83,381 | $9,756 | $13,758 | 0.94 |
| Other ear, nose, mouth and throat o.r. procedures with CCMS-DRG 144, surgical | 12 | $112,917 | $14,524 | $18,631 | 1.73 |
| Otitis media and uri without MCCMS-DRG 153, medical | 12 | $68,620 | $6,423 | $11,322 | 0.73 |
Other54 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 MCCMS-DRG 981, surgical | 42 | $350,849 | $49,998 | $57,890 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 12 | $125,600 | $22,741 | $20,724 | 2.49 |
Blood cancers and poorly differentiated neoplasms51 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 24 | $257,780 | $33,882 | $42,534 | 3.13 |
| RadiotherapyMS-DRG 849, medical | 14 | $284,841 | $35,646 | $46,999 | 2.69 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 13 | $67,434 | $12,874 | $11,127 | 1.21 |
Alcohol and drug use47 discharges in 2 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 | 28 | $85,736 | $8,615 | $14,146 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 19 | $127,038 | $16,276 | $20,961 | 1.78 |
Female reproductive system40 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with CCMS-DRG 740, surgical | 15 | $114,754 | $17,674 | $18,934 | 1.79 |
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 13 | $189,063 | $17,984 | $31,195 | 1.85 |
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 12 | $124,625 | $19,380 | $20,563 | 1.97 |
Transplants, ECMO and tracheostomy (pre-MDC)14 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 | 14 | $1,941,204 | $245,344 | $320,299 | 21.32 |
Eye14 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of the eye without MCCMS-DRG 125, medical | 14 | $67,674 | $8,346 | $11,166 | 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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 320 | 308 | $31,305 | $2,398 | $2,090 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 251 | 250 | $30,308 | $4,971 | $4,358 |
| Level 2 Upper GI ProceduresAPC 5302 | 246 | 219 | $14,070 | $1,666 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 228 | 219 | $17,528 | $1,359 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 194 | 186 | $35,232 | $4,413 | $3,918 |
| Level 4 Airway EndoscopyAPC 5154 | 188 | 172 | $26,005 | $3,189 | $2,833 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 172 | 168 | $25,995 | $3,329 | $2,930 |
| Level 5 ENT ProceduresAPC 5165 | 163 | 162 | $28,259 | $4,949 | $4,436 |
| Level 4 Urology and Related ServicesAPC 5374 | 159 | 145 | $19,806 | $3,057 | $2,629 |
| Level 4 Gynecologic ProceduresAPC 5414 | 156 | 156 | $20,519 | $2,701 | $2,389 |
| Level 3 Vascular ProceduresAPC 5183 | 143 | 141 | $17,592 | $2,813 | $2,405 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 134 | 130 | $24,883 | $2,504 | $2,141 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 134 | 123 | $21,424 | $3,060 | $2,636 |
| Level 3 Urology and Related ServicesAPC 5373 | 125 | 93 | $14,433 | $1,672 | $1,516 |
| Level 1 Endovascular ProceduresAPC 5191 | 113 | 113 | $18,099 | $2,538 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 95 | 92 | $199,314 | $24,991 | $21,117 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 93 | 93 | $34,851 | $6,052 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 90 | 89 | $22,952 | $2,811 | $2,373 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 85 | 85 | $33,977 | $5,618 | $4,982 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 78 | 78 | $15,243 | $1,376 | $1,196 |
| Level 5 Airway EndoscopyAPC 5155 | 78 | 76 | $34,157 | $5,812 | $5,183 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 75 | 75 | $53,874 | $9,709 | $8,164 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 64 | 64 | $56,276 | $7,752 | $6,514 |
| Level 3 Lower GI ProceduresAPC 5313 | 61 | 56 | $17,756 | $2,396 | $2,176 |
| Level 7 Radiation TherapyAPC 5627 | 60 | 56 | $138,287 | $6,899 | $6,121 |
| Level 2 Vascular ProceduresAPC 5182 | 59 | 57 | $6,900 | $1,331 | $1,204 |
| Level 3 Airway EndoscopyAPC 5153 | 57 | 55 | $16,700 | $1,448 | $1,264 |
| Level 4 ENT ProceduresAPC 5164 | 52 | 40 | $18,177 | $2,056 | $2,217 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 52 | 52 | $60,280 | $10,380 | $8,569 |
| Level 3 Endovascular ProceduresAPC 5193 | 51 | 44 | $64,121 | $10,658 | $8,874 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 39 | 38 | $19,360 | $2,081 | $1,780 |
| Level 3 Upper GI ProceduresAPC 5303 | 38 | 37 | $19,731 | $3,347 | $2,888 |
| Level 6 Urology and Related ServicesAPC 5376 | 37 | 34 | $34,890 | $8,405 | $7,291 |
| Complex GI ProceduresAPC 5331 | 36 | 33 | $28,419 | $4,972 | $4,263 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 35 | 33 | $58,398 | $13,165 | $10,772 |
| Level 2 Endovascular ProceduresAPC 5192 | 29 | 26 | $26,855 | $4,953 | $4,338 |
| Level 1 Nerve ProceduresAPC 5431 | 28 | 28 | $17,802 | $1,733 | $1,407 |
| Level 4 Vascular ProceduresAPC 5184 | 27 | 27 | $52,300 | $4,713 | $3,946 |
| Level 5 Gynecologic ProceduresAPC 5415 | 24 | 13 | $38,640 | $4,278 | $3,792 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 20 | 20 | $192,769 | $35,307 | $29,375 |
| Cochlear Implant ProcedureAPC 5166 | 16 | 16 | $189,586 | $33,769 | $29,489 |
| Level 2 Urology and Related ServicesAPC 5372 | 16 | 12 | $9,115 | $613 | $502 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 12 | 12 | $40,735 | $8,951 | $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.