Loyola University Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Loyola University Medical Center, Maywood, IL in 2024, from traditional Medicare claims. Back to the Loyola University Medical Center profile, with quality ratings, finances and negotiated rates.
3,458
Medicare inpatient discharges
In 139 published DRGs
2.56
Case mix index
IPPS FY 2027
33%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
5,743
Medicare outpatient services
In 49 service groups
Inpatient stays by major diagnostic category
Circulatory system863 discharges in 30 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 154 | $61,394 | $11,698 | $13,814 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 84 | $132,875 | $45,859 | $29,897 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 55 | $142,397 | $22,187 | $32,039 | 2.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 46 | $263,233 | $74,313 | $59,227 | 7.71 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 38 | $36,362 | $6,647 | $8,181 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 30 | $74,709 | $20,592 | $16,810 | 2.09 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 29 | $88,951 | $31,964 | $20,014 | 3.24 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 28 | $50,854 | $9,951 | $11,442 | 1.07 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 27 | $59,266 | $9,594 | $13,335 | 1.08 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 26 | $231,975 | $44,782 | $52,194 | 5.06 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 26 | $80,208 | $16,705 | $18,047 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 25 | $171,136 | $52,917 | $38,506 | 5.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 24 | $71,013 | $16,041 | $15,978 | 1.59 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 23 | $59,495 | $11,788 | $13,386 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 23 | $111,967 | $26,449 | $25,193 | 2.87 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 20 | $159,739 | $33,169 | $35,941 | 4.04 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 20 | $124,117 | $33,897 | $27,926 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 18 | $85,733 | $24,644 | $19,290 | 2.55 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 17 | $259,252 | $57,700 | $58,332 | 5.88 |
| Syncope and collapseMS-DRG 312, medical | 16 | $42,577 | $8,433 | $9,580 | 0.86 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 16 | $46,957 | $9,097 | $10,565 | 0.97 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 15 | $265,267 | $64,340 | $59,685 | 6.25 |
| Hypertension without MCCMS-DRG 305, medical | 15 | $39,811 | $6,128 | $8,957 | 0.75 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 15 | $25,955 | $4,859 | $5,840 | 0.55 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 14 | $121,902 | $32,190 | $27,428 | 3.46 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 13 | $93,479 | $31,434 | $21,033 | 3.18 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 12 | $88,128 | $22,919 | $19,829 | 2.28 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 12 | $126,585 | $41,472 | $28,482 | 4.16 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 11 | $419,692 | $99,376 | $94,431 | 9.71 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 11 | $39,127 | $8,692 | $8,803 | 0.91 |
Kidney and urinary tract417 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with CCMS-DRG 683, medical | 68 | $40,765 | $8,159 | $9,172 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 58 | $49,478 | $9,432 | $11,133 | 1.02 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 54 | $76,522 | $15,431 | $17,217 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 39 | $67,304 | $14,600 | $15,143 | 1.50 |
| Kidney transplantMS-DRG 652, surgical | 36 | $284,926 | $29,078 | $64,108 | 3.00 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 35 | $36,024 | $7,593 | $8,105 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 33 | $58,733 | $10,702 | $13,215 | 1.17 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 16 | $344,966 | $45,966 | $77,617 | 4.50 |
| Major bladder procedures with CCMS-DRG 654, surgical | 14 | $116,125 | $26,033 | $26,128 | 2.74 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 14 | $66,060 | $12,158 | $14,863 | 1.35 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 14 | $84,145 | $23,652 | $18,933 | 2.38 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 13 | $166,591 | $28,858 | $37,483 | 3.70 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 12 | $308,165 | $34,234 | $69,337 | 3.46 |
| Major bladder procedures with MCCMS-DRG 653, surgical | 11 | $199,141 | $43,125 | $44,807 | 5.41 |
Digestive system353 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 60 | $50,533 | $8,574 | $11,370 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 45 | $76,217 | $16,136 | $17,149 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 37 | $39,703 | $7,091 | $8,933 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 31 | $100,479 | $22,008 | $22,608 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 25 | $50,647 | $11,662 | $11,396 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 22 | $39,045 | $7,100 | $8,785 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 22 | $56,415 | $8,205 | $12,693 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 21 | $86,095 | $12,971 | $19,371 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 19 | $64,124 | $10,542 | $14,428 | 1.04 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 18 | $242,880 | $42,470 | $54,648 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 16 | $59,527 | $16,458 | $13,394 | 1.62 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 13 | $78,644 | $13,862 | $17,695 | 1.67 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $42,505 | $11,432 | $9,564 | 1.20 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 12 | $77,404 | $14,110 | $17,416 | 1.45 |
Respiratory system334 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 47 | $81,944 | $16,133 | $18,437 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 41 | $77,730 | $11,393 | $17,489 | 1.33 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 34 | $94,144 | $17,940 | $21,182 | 1.81 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 33 | $58,874 | $11,830 | $13,247 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 26 | $47,693 | $7,340 | $10,731 | 0.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 23 | $152,814 | $41,339 | $34,383 | 4.06 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 21 | $43,487 | $10,188 | $9,785 | 1.10 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 17 | $83,141 | $19,389 | $18,707 | 1.90 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 17 | $113,348 | $23,479 | $25,503 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 14 | $98,034 | $24,964 | $22,058 | 2.55 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $275,190 | $59,336 | $61,918 | 6.91 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 12 | $74,187 | $18,044 | $16,692 | 1.88 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 12 | $119,885 | $14,629 | $26,974 | 1.40 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 12 | $69,135 | $13,369 | $15,555 | 1.74 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 11 | $43,374 | $9,617 | $9,759 | 0.99 |
Nervous system318 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 42 | $95,846 | $18,720 | $21,565 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 36 | $56,832 | $9,245 | $12,787 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 29 | $187,379 | $42,847 | $42,160 | 4.42 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 25 | $218,852 | $47,703 | $49,242 | 5.67 |
| Seizures with MCCMS-DRG 100, medical | 22 | $78,566 | $17,780 | $17,677 | 1.98 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 19 | $79,111 | $12,522 | $17,800 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 18 | $75,389 | $9,786 | $16,963 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 17 | $48,744 | $10,158 | $10,967 | 1.36 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 17 | $162,890 | $22,753 | $36,650 | 2.28 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 17 | $105,697 | $18,169 | $23,782 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $67,936 | $14,491 | $15,286 | 1.47 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $63,340 | $10,987 | $14,252 | 1.32 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 12 | $86,825 | $27,281 | $19,536 | 2.95 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 12 | $52,340 | $9,616 | $11,776 | 1.03 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $135,512 | $22,481 | $30,490 | 2.27 |
| Seizures without MCCMS-DRG 101, medical | 12 | $45,591 | $8,389 | $10,258 | 0.91 |
Musculoskeletal system and connective tissue290 discharges in 14 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 | 45 | $56,457 | $17,766 | $12,703 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 43 | $97,568 | $20,067 | $21,953 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 34 | $50,312 | $9,211 | $11,320 | 0.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 27 | $83,069 | $22,759 | $18,690 | 2.48 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 22 | $105,945 | $33,957 | $23,838 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 15 | $112,528 | $22,843 | $25,319 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 15 | $73,899 | $9,714 | $16,627 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 14 | $100,080 | $15,792 | $22,518 | 1.70 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $111,783 | $27,194 | $25,151 | 2.96 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 13 | $85,808 | $20,744 | $19,307 | 2.11 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $38,541 | $6,949 | $8,672 | 0.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 12 | $145,400 | $26,968 | $32,715 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 12 | $148,353 | $34,498 | $33,379 | 3.46 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 12 | $83,431 | $19,947 | $18,772 | 2.04 |
Infectious and parasitic diseases273 discharges in 5 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 | 160 | $100,457 | $18,425 | $22,603 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 47 | $55,312 | $9,397 | $12,445 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 40 | $231,300 | $50,151 | $52,042 | 5.00 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 13 | $149,660 | $37,974 | $33,674 | 4.43 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 13 | $276,786 | $69,080 | $62,277 | 6.96 |
Endocrine, nutritional and metabolic145 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 | 53 | $78,792 | $13,450 | $17,728 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 44 | $50,765 | $6,989 | $11,422 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 23 | $55,508 | $7,397 | $12,489 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 13 | $59,776 | $12,629 | $13,450 | 1.45 |
| Endocrine disorders with CCMS-DRG 644, medical | 12 | $54,144 | $9,731 | $12,182 | 1.06 |
Transplants, ECMO and tracheostomy (pre-MDC)91 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 | 40 | $630,172 | $196,635 | $141,789 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 17 | $565,823 | $132,492 | $127,310 | 14.70 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 12 | $237,030 | $56,662 | $53,332 | 6.18 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 11 | $157,966 | $37,396 | $35,542 | 4.00 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 11 | $2,833,228 | $383,946 | $637,476 | 36.84 |
Liver, gallbladder and pancreas89 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 22 | $109,589 | $20,356 | $24,657 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 22 | $101,967 | $16,404 | $22,943 | 1.83 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 19 | $45,027 | $8,577 | $10,131 | 0.95 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 15 | $81,059 | $16,702 | $18,238 | 1.76 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $49,204 | $9,479 | $11,071 | 1.03 |
Blood and immune system56 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 | 24 | $38,670 | $8,914 | $8,701 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 19 | $48,589 | $14,160 | $10,933 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 13 | $96,630 | $17,116 | $21,742 | 1.20 |
Blood cancers and poorly differentiated neoplasms52 discharges in 3 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 | 22 | $52,835 | $9,789 | $11,888 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 17 | $176,079 | $29,866 | $39,618 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 13 | $87,240 | $14,611 | $19,629 | 1.57 |
Other40 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 | 29 | $206,868 | $46,064 | $46,545 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 11 | $93,104 | $23,578 | $20,948 | 2.49 |
Skin, subcutaneous tissue and breast37 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 37 | $40,583 | $7,571 | $9,131 | 0.88 |
Burns31 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Non-extensive burnsMS-DRG 935, medical | 16 | $47,568 | $18,810 | $10,703 | 2.04 |
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 15 | $146,224 | $57,730 | $32,900 | 6.92 |
Injuries, poisonings and toxic effects of drugs26 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 | 13 | $77,551 | $14,269 | $17,449 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $55,480 | $8,626 | $12,483 | 1.03 |
Ear, nose, mouth and throat17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 17 | $72,047 | $20,378 | $16,211 | 2.07 |
Factors influencing health status15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 15 | $34,588 | $7,284 | $7,782 | 0.80 |
Multiple significant trauma11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with MCCMS-DRG 963, medical | 11 | $114,410 | $23,505 | $25,742 | 2.73 |
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 | 671 | 479 | $4,623 | $523 | $502 |
| Comprehensive Observation ServicesAPC 8011 | 436 | 408 | $18,201 | $2,077 | $2,090 |
| Level 3 Urology and Related ServicesAPC 5373 | 391 | 279 | $7,470 | $1,552 | $1,516 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 359 | 319 | $9,307 | $1,216 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 351 | 331 | $17,365 | $2,167 | $2,208 |
| Level 3 Endovascular ProceduresAPC 5193 | 256 | 233 | $46,676 | $8,879 | $8,874 |
| Level 1 Intraocular ProceduresAPC 5491 | 254 | 164 | $9,148 | $1,777 | $1,752 |
| Level 4 Airway EndoscopyAPC 5154 | 178 | 123 | $19,290 | $2,769 | $2,833 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 173 | 150 | $21,378 | $2,151 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 171 | 156 | $15,029 | $2,425 | $2,405 |
| Level 2 Upper GI ProceduresAPC 5302 | 168 | 139 | $11,752 | $1,469 | $1,445 |
| Level 5 Urology and Related ServicesAPC 5375 | 168 | 146 | $25,296 | $3,938 | $3,918 |
| Level 5 ENT ProceduresAPC 5165 | 154 | 150 | $32,555 | $4,361 | $4,436 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 148 | 146 | $85,487 | $20,683 | $21,117 |
| Level 4 Urology and Related ServicesAPC 5374 | 148 | 123 | $18,582 | $2,655 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 128 | 112 | $7,948 | $1,471 | $1,407 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 104 | 102 | $38,595 | $10,825 | $10,772 |
| Level 4 Vascular ProceduresAPC 5184 | 100 | 73 | $23,073 | $3,192 | $3,946 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 97 | 96 | $30,556 | $4,376 | $4,358 |
| Level 2 Endovascular ProceduresAPC 5192 | 85 | 77 | $26,763 | $4,224 | $4,338 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 78 | 77 | $29,436 | $5,188 | $5,339 |
| Level 3 Airway EndoscopyAPC 5153 | 78 | 60 | $6,987 | $1,315 | $1,264 |
| Level 2 Vascular ProceduresAPC 5182 | 68 | 65 | $5,939 | $1,205 | $1,204 |
| Level 4 Endovascular ProceduresAPC 5194 | 64 | 57 | $61,390 | $14,179 | $14,606 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 54 | 53 | $10,170 | $1,222 | $1,196 |
| Level 4 Gynecologic ProceduresAPC 5414 | 54 | 52 | $11,878 | $2,423 | $2,389 |
| Level 5 Airway EndoscopyAPC 5155 | 53 | 52 | $35,154 | $5,104 | $5,183 |
| Complex GI ProceduresAPC 5331 | 53 | 25 | $27,171 | $3,715 | $4,263 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 49 | 49 | $45,411 | $15,445 | $15,763 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 48 | 46 | $22,914 | $2,513 | $2,636 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 47 | 43 | $16,155 | $2,348 | $2,373 |
| Level 3 ENT ProceduresAPC 5163 | 47 | 24 | $4,459 | $1,181 | $1,106 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 46 | 42 | $23,830 | $2,954 | $2,930 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 46 | 46 | $40,472 | $8,372 | $8,164 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 44 | 43 | $42,888 | $8,744 | $8,569 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 43 | 43 | $40,233 | $5,053 | $4,982 |
| Level 2 Intraocular ProceduresAPC 5492 | 41 | 33 | $15,251 | $3,151 | $3,116 |
| Level 4 ENT ProceduresAPC 5164 | 37 | 36 | $19,642 | $2,419 | $2,217 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 37 | 37 | $136,959 | $29,450 | $29,375 |
| Level 3 Lower GI ProceduresAPC 5313 | 34 | 34 | $15,216 | $2,182 | $2,176 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 33 | 32 | $13,417 | $1,811 | $1,780 |
| Level 3 Upper GI ProceduresAPC 5303 | 27 | 27 | $20,059 | $2,858 | $2,888 |
| Cochlear Implant ProcedureAPC 5166 | 25 | 23 | $86,027 | $29,648 | $29,489 |
| Level 5 Gynecologic ProceduresAPC 5415 | 25 | 23 | $33,928 | $3,854 | $3,792 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 17 | 17 | $59,215 | $17,275 | $17,052 |
| Level 8 Urology and Related ServicesAPC 5378 | 15 | 15 | $57,675 | $17,940 | $17,428 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 14 | 14 | $24,874 | $6,630 | $6,514 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 13 | 13 | $84,409 | $28,461 | $26,719 |
| Level 7 Radiation TherapyAPC 5627 | 13 | 11 | $32,862 | $6,034 | $6,121 |
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.