Mayo Clinic Hospital - Jacksonville Florida Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Mayo Clinic Hospital - Jacksonville Florida, Jacksonville, FL in 2024, from traditional Medicare claims. Back to the Mayo Clinic Hospital - Jacksonville Florida profile, with quality ratings, finances and negotiated rates.
8,373
Medicare inpatient discharges
In 211 published DRGs
2.57
Case mix index
IPPS FY 2027
35%
Surgical stays
76%
Stays with complications
In DRGs with a CC or MCC
14,638
Medicare outpatient services
In 60 service groups
Inpatient stays by major diagnostic category
Circulatory system1,453 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 | 367 | $46,673 | $9,817 | $13,955 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 107 | $110,854 | $39,199 | $33,145 | 4.88 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 73 | $127,285 | $50,942 | $38,058 | 6.25 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 71 | $27,679 | $4,619 | $8,276 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 66 | $74,061 | $16,723 | $22,144 | 2.09 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 59 | $42,473 | $8,814 | $12,699 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 48 | $98,890 | $25,697 | $29,568 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 47 | $116,127 | $19,434 | $34,722 | 2.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 42 | $193,811 | $35,463 | $57,949 | 5.24 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 42 | $163,009 | $26,481 | $48,740 | 4.04 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 39 | $18,531 | $2,467 | $5,541 | 0.55 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 34 | $55,479 | $11,567 | $16,588 | 1.59 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 33 | $46,311 | $6,539 | $13,847 | 0.97 |
| Other vascular procedures with CCMS-DRG 253, surgical | 32 | $104,404 | $19,361 | $31,217 | 2.55 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 30 | $86,130 | $12,947 | $25,753 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 29 | $44,902 | $7,087 | $13,426 | 1.08 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 29 | $58,208 | $11,977 | $17,404 | 1.58 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 28 | $249,337 | $48,848 | $74,552 | 5.06 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 26 | $148,827 | $29,147 | $44,499 | 3.35 |
| Syncope and collapseMS-DRG 312, medical | 23 | $34,601 | $6,032 | $10,346 | 0.86 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 22 | $301,947 | $74,039 | $90,282 | 7.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 21 | $104,565 | $31,217 | $31,265 | 4.16 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 20 | $36,598 | $6,169 | $10,943 | 0.91 |
| Hypertension without MCCMS-DRG 305, medical | 19 | $27,521 | $5,400 | $8,229 | 0.75 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 18 | $114,505 | $26,494 | $34,237 | 3.27 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 17 | $98,065 | $16,158 | $29,321 | 2.28 |
| Heart failure and shock with CCMS-DRG 292, medical | 17 | $32,572 | $5,746 | $9,739 | 0.86 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 16 | $146,846 | $24,389 | $43,907 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 14 | $200,261 | $37,889 | $59,878 | 5.20 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 14 | $55,336 | $8,059 | $16,545 | 1.07 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 13 | $195,329 | $40,933 | $58,403 | 5.88 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 13 | $109,616 | $21,910 | $32,775 | 2.87 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 12 | $121,823 | $28,319 | $36,425 | 3.46 |
| Hypertension with MCCMS-DRG 304, medical | 12 | $34,467 | $8,964 | $10,306 | 1.15 |
Digestive system1,118 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 141 | $93,385 | $17,364 | $27,922 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 106 | $34,548 | $5,197 | $10,330 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 88 | $39,424 | $6,973 | $11,788 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 68 | $50,970 | $10,415 | $15,240 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 67 | $39,307 | $6,002 | $11,753 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 64 | $31,264 | $5,781 | $9,348 | 0.80 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 60 | $68,670 | $13,852 | $20,532 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 60 | $62,163 | $12,786 | $18,587 | 1.62 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 59 | $104,513 | $19,275 | $31,249 | 2.50 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 50 | $186,324 | $35,994 | $55,711 | 4.52 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 40 | $69,238 | $13,686 | $20,702 | 1.75 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 40 | $38,218 | $6,997 | $11,427 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 36 | $64,090 | $15,325 | $19,163 | 2.10 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 33 | $60,933 | $12,254 | $18,219 | 1.67 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 31 | $169,785 | $42,650 | $50,766 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 30 | $59,250 | $11,698 | $17,716 | 1.45 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 29 | $47,591 | $4,779 | $14,230 | 0.97 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 20 | $78,219 | $11,001 | $23,387 | 1.60 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 20 | $64,731 | $10,782 | $19,355 | 1.72 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 19 | $75,087 | $16,385 | $22,451 | 2.11 |
| Digestive malignancy with CCMS-DRG 375, medical | 17 | $40,156 | $6,970 | $12,007 | 1.20 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 15 | $150,064 | $34,456 | $44,869 | 3.58 |
| Peritoneal adhesiolysis without cc/mccMS-DRG 337, surgical | 13 | $63,016 | $10,509 | $18,842 | 1.50 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 12 | $59,109 | $13,024 | $17,674 | 2.20 |
Respiratory system1,026 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 261 | $57,374 | $12,162 | $17,155 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 94 | $51,338 | $9,428 | $15,350 | 1.33 |
| Major chest procedures with CCMS-DRG 164, surgical | 87 | $86,539 | $16,964 | $25,875 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 80 | $40,925 | $7,216 | $12,237 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 66 | $32,074 | $5,344 | $9,590 | 0.82 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 54 | $76,756 | $12,167 | $22,950 | 1.81 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 48 | $51,389 | $10,526 | $15,365 | 1.40 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 45 | $51,098 | $8,911 | $15,278 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 36 | $43,214 | $7,217 | $12,921 | 1.10 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 34 | $68,011 | $14,005 | $20,335 | 1.90 |
| Major chest procedures with MCCMS-DRG 163, surgical | 30 | $133,507 | $38,407 | $39,919 | 4.71 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 30 | $70,054 | $12,702 | $20,946 | 1.88 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 21 | $27,906 | $5,516 | $8,344 | 0.85 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 21 | $71,467 | $7,161 | $21,369 | 0.91 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 21 | $140,622 | $21,602 | $42,046 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 19 | $31,978 | $4,606 | $9,561 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 19 | $60,853 | $14,150 | $18,195 | 1.74 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 18 | $74,120 | $11,143 | $22,162 | 1.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 17 | $122,910 | $28,693 | $36,750 | 4.06 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 14 | $33,775 | $6,419 | $10,099 | 0.96 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $54,243 | $11,614 | $16,219 | 1.55 |
Kidney and urinary tract852 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 121 | $66,029 | $13,133 | $19,743 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 98 | $44,154 | $11,077 | $13,202 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 87 | $30,876 | $6,186 | $9,232 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 86 | $26,932 | $5,451 | $8,053 | 0.81 |
| Kidney transplantMS-DRG 652, surgical | 85 | $250,653 | $18,555 | $74,945 | 3.00 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 81 | $39,139 | $6,723 | $11,703 | 1.02 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 80 | $37,451 | $8,704 | $11,198 | 1.17 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 54 | $89,766 | $11,781 | $26,840 | 1.84 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 38 | $68,776 | $9,511 | $20,564 | 1.35 |
| Major bladder procedures with CCMS-DRG 654, surgical | 31 | $148,348 | $20,575 | $44,356 | 2.74 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 26 | $114,203 | $31,379 | $34,147 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 19 | $85,462 | $16,510 | $25,553 | 2.59 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 18 | $141,766 | $19,921 | $42,388 | 3.14 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 17 | $359,421 | $31,317 | $107,467 | 3.46 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 11 | $455,659 | $47,057 | $136,242 | 4.50 |
Nervous system809 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 90 | $174,162 | $35,552 | $52,075 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 87 | $80,341 | $15,138 | $24,022 | 2.00 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 59 | $84,244 | $22,686 | $25,189 | 2.95 |
| Seizures without MCCMS-DRG 101, medical | 51 | $34,864 | $5,305 | $10,424 | 0.91 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 46 | $84,331 | $16,873 | $25,215 | 2.43 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 45 | $47,893 | $6,651 | $14,320 | 1.02 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 34 | $71,120 | $14,783 | $21,265 | 1.79 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 31 | $37,518 | $9,236 | $11,218 | 1.47 |
| Seizures with MCCMS-DRG 100, medical | 31 | $57,817 | $14,194 | $17,287 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 29 | $55,964 | $6,715 | $16,733 | 1.03 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 28 | $199,921 | $48,756 | $59,777 | 5.67 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 27 | $43,808 | $9,456 | $13,099 | 1.36 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 26 | $41,183 | $12,176 | $12,314 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 23 | $81,187 | $20,501 | $24,275 | 2.39 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 21 | $54,416 | $8,014 | $16,270 | 1.14 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 20 | $85,727 | $13,721 | $25,632 | 1.87 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 20 | $34,576 | $5,750 | $10,338 | 0.80 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 19 | $43,385 | $6,905 | $12,972 | 1.03 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 18 | $72,071 | $18,401 | $21,549 | 2.30 |
| Extracranial procedures with CCMS-DRG 038, surgical | 17 | $72,249 | $10,258 | $21,602 | 1.60 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 15 | $52,994 | $12,208 | $15,845 | 1.62 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $32,833 | $9,381 | $9,817 | 1.32 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 12 | $47,353 | $13,058 | $14,159 | 1.81 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 12 | $35,889 | $8,089 | $10,731 | 1.06 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 12 | $56,654 | $17,894 | $16,940 | 2.28 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 11 | $56,380 | $13,557 | $16,858 | 2.15 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 11 | $49,013 | $14,796 | $14,655 | 2.27 |
Infectious and parasitic diseases794 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 | 516 | $78,600 | $15,558 | $23,501 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 102 | $36,836 | $7,470 | $11,014 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 64 | $175,268 | $39,525 | $52,405 | 5.00 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 46 | $49,492 | $12,375 | $14,798 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 22 | $123,539 | $29,538 | $36,938 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 17 | $29,625 | $7,172 | $8,858 | 1.01 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 14 | $35,898 | $6,424 | $10,733 | 0.88 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 13 | $78,315 | $12,824 | $23,416 | 2.14 |
Musculoskeletal system and connective tissue591 discharges in 24 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 | 59 | $156,433 | $47,766 | $46,773 | 6.12 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 58 | $75,920 | $15,142 | $22,700 | 2.07 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 52 | $100,078 | $21,145 | $29,923 | 2.96 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 48 | $95,038 | $25,539 | $28,416 | 3.49 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 44 | $71,180 | $16,076 | $21,283 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 36 | $109,086 | $27,136 | $32,617 | 3.66 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 32 | $119,099 | $32,194 | $35,611 | 4.61 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 26 | $72,440 | $13,587 | $21,659 | 1.88 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 24 | $68,293 | $14,652 | $20,420 | 1.97 |
| Medical back problems without MCCMS-DRG 552, medical | 23 | $32,040 | $6,884 | $9,580 | 0.97 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 22 | $117,549 | $23,253 | $35,147 | 3.00 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 16 | $193,199 | $45,588 | $57,766 | 6.08 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 16 | $92,852 | $19,824 | $27,763 | 2.48 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 16 | $58,396 | $12,625 | $17,460 | 1.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 14 | $95,316 | $20,966 | $28,499 | 2.95 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 13 | $70,508 | $14,975 | $21,082 | 2.04 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 12 | $208,158 | $73,817 | $62,239 | 8.86 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 12 | $73,010 | $18,024 | $21,830 | 2.67 |
| Knee procedures with principal diagnosis of infection with CCMS-DRG 486, surgical | 12 | $75,979 | $15,146 | $22,718 | 2.01 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 12 | $38,900 | $7,450 | $11,631 | 1.09 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 11 | $101,242 | $13,933 | $30,271 | 1.74 |
| Back and neck procedures except spinal fusion with MCC or disc device or neurostimulatorMS-DRG 518, surgical | 11 | $105,112 | $27,432 | $31,429 | 3.65 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 11 | $101,947 | $22,573 | $30,482 | 2.99 |
| Osteomyelitis with CCMS-DRG 540, medical | 11 | $42,052 | $9,966 | $12,574 | 1.30 |
Liver, gallbladder and pancreas328 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 52 | $130,171 | $20,729 | $38,921 | 2.89 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 47 | $72,351 | $15,121 | $21,633 | 1.83 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 34 | $30,966 | $4,508 | $9,259 | 0.86 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 32 | $194,731 | $45,298 | $58,224 | 5.51 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 31 | $47,061 | $7,149 | $14,071 | 1.67 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 28 | $86,693 | $14,090 | $25,921 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 27 | $85,186 | $16,588 | $25,471 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 26 | $55,354 | $6,858 | $16,551 | 0.95 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 20 | $61,316 | $13,690 | $18,333 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 18 | $58,980 | $9,900 | $17,635 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 13 | $65,570 | $12,855 | $19,605 | 1.63 |
Endocrine, nutritional and metabolic314 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 | 90 | $46,849 | $9,269 | $14,008 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 71 | $33,502 | $4,839 | $10,017 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 34 | $49,665 | $9,547 | $14,850 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 30 | $49,795 | $12,990 | $14,889 | 1.65 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 27 | $78,437 | $16,648 | $23,453 | 2.25 |
| Diabetes with CCMS-DRG 638, medical | 27 | $34,242 | $6,134 | $10,238 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 23 | $30,205 | $7,736 | $9,031 | 1.06 |
| O.r. procedures for obesity with CCMS-DRG 620, surgical | 12 | $82,325 | $10,191 | $24,615 | 1.62 |
Transplants, ECMO and tracheostomy (pre-MDC)254 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 49 | $410,484 | $84,619 | $122,735 | 10.35 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 39 | $858,624 | $196,201 | $256,729 | 21.32 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 34 | $106,314 | $46,427 | $31,788 | 6.18 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 31 | $2,055,428 | $459,233 | $614,573 | 36.84 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 26 | $1,406,732 | $285,856 | $420,613 | 27.10 |
| Lung transplantMS-DRG 007, surgical | 22 | $805,404 | $90,997 | $240,816 | 12.27 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 19 | $182,314 | $33,244 | $54,512 | 4.00 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 19 | $382,898 | $104,440 | $114,487 | 11.46 |
| Liver transplant without MCCMS-DRG 006, surgical | 15 | $352,172 | $40,669 | $105,299 | 4.84 |
Blood cancers and poorly differentiated neoplasms223 discharges in 8 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 | 47 | $36,826 | $6,990 | $11,011 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 36 | $152,314 | $28,068 | $45,542 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 33 | $77,987 | $22,128 | $23,318 | 2.44 |
| Acute leukemia with MCCMS-DRG 834, medical | 30 | $172,507 | $51,755 | $51,579 | 5.60 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 29 | $72,514 | $41,593 | $21,682 | 4.84 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 20 | $65,916 | $10,874 | $19,709 | 1.57 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 15 | $84,214 | $15,871 | $25,180 | 2.32 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 13 | $37,563 | $14,339 | $11,231 | 2.00 |
Injuries, poisonings and toxic effects of drugs157 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 55 | $88,054 | $15,568 | $26,328 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 45 | $32,053 | $7,290 | $9,584 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 21 | $70,463 | $12,186 | $21,068 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 20 | $99,651 | $17,500 | $29,796 | 2.00 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 16 | $176,502 | $38,151 | $52,774 | 3.72 |
Skin, subcutaneous tissue and breast146 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 87 | $29,019 | $6,045 | $8,677 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 38 | $49,426 | $10,764 | $14,778 | 1.49 |
| Skin graft except for skin ulcer or cellulitis with CCMS-DRG 577, surgical | 21 | $106,685 | $22,586 | $31,899 | 2.65 |
Blood and immune system132 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 37 | $50,068 | $13,216 | $14,970 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 30 | $43,306 | $8,480 | $12,949 | 1.20 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 27 | $78,394 | $10,801 | $23,440 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 22 | $32,386 | $6,083 | $9,683 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 16 | $81,828 | $17,252 | $24,467 | 2.19 |
Other112 discharges in 5 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 | 40 | $175,928 | $41,599 | $52,602 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 30 | $94,368 | $15,296 | $28,216 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 16 | $139,891 | $24,079 | $41,827 | 3.38 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 14 | $242,509 | $60,918 | $72,510 | |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 12 | $155,277 | $44,174 | $46,428 |
Ear, nose, mouth and throat29 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 | 29 | $97,677 | $13,311 | $29,206 | 2.07 |
Factors influencing health status24 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms with MCCMS-DRG 947, medical | 13 | $69,386 | $13,114 | $20,746 | 1.25 |
| Signs and symptoms without MCCMS-DRG 948, medical | 11 | $29,680 | $5,485 | $8,874 | 0.80 |
Alcohol and drug use11 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 with MCCMS-DRG 896, medical | 11 | $41,224 | $12,740 | $12,326 | 1.78 |
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 | 1,436 | 1,276 | $15,713 | $1,933 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 1,128 | 992 | $7,036 | $1,123 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 970 | 823 | $14,006 | $1,333 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 862 | 824 | $47,154 | $10,190 | $10,772 |
| Level 1 Nerve ProceduresAPC 5431 | 724 | 608 | $8,685 | $1,377 | $1,407 |
| Level 1 Intraocular ProceduresAPC 5491 | 671 | 416 | $16,906 | $1,667 | $1,752 |
| Level 3 Vascular ProceduresAPC 5183 | 624 | 479 | $15,408 | $2,187 | $2,405 |
| Level 3 Urology and Related ServicesAPC 5373 | 589 | 384 | $12,075 | $1,350 | $1,516 |
| Level 1 Endovascular ProceduresAPC 5191 | 547 | 539 | $19,804 | $2,044 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 544 | 512 | $28,473 | $3,659 | $3,918 |
| Level 4 Airway EndoscopyAPC 5154 | 487 | 343 | $23,016 | $2,531 | $2,833 |
| Level 4 Urology and Related ServicesAPC 5374 | 454 | 384 | $19,483 | $2,460 | $2,629 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 423 | 405 | $33,205 | $5,023 | $5,339 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 362 | 289 | $20,385 | $1,960 | $2,141 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 333 | 328 | $33,356 | $4,039 | $4,358 |
| Level 5 Airway EndoscopyAPC 5155 | 293 | 276 | $53,989 | $4,821 | $5,183 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 283 | 282 | $67,438 | $7,524 | $8,164 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 254 | 246 | $109,830 | $19,516 | $21,117 |
| Level 4 Vascular ProceduresAPC 5184 | 230 | 193 | $34,655 | $3,241 | $3,946 |
| Level 3 Endovascular ProceduresAPC 5193 | 217 | 189 | $56,521 | $8,284 | $8,874 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 202 | 189 | $21,268 | $2,232 | $2,373 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 193 | 141 | $17,119 | $2,335 | $2,636 |
| Level 3 Airway EndoscopyAPC 5153 | 191 | 169 | $12,509 | $1,173 | $1,264 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 172 | 163 | $23,079 | $2,735 | $2,930 |
| Level 5 ENT ProceduresAPC 5165 | 168 | 168 | $33,903 | $4,151 | $4,436 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 167 | 164 | $54,034 | $15,031 | $15,763 |
| Level 2 Vascular ProceduresAPC 5182 | 153 | 149 | $4,922 | $1,119 | $1,204 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 151 | 142 | $9,738 | $1,137 | $1,196 |
| Level 2 Intraocular ProceduresAPC 5492 | 147 | 120 | $25,838 | $2,855 | $3,116 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 145 | 140 | $31,986 | $4,563 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 129 | 118 | $29,928 | $3,885 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 129 | 124 | $17,520 | $2,003 | $2,176 |
| Complex GI ProceduresAPC 5331 | 110 | 78 | $32,758 | $4,076 | $4,263 |
| Level 3 Upper GI ProceduresAPC 5303 | 99 | 91 | $22,199 | $2,570 | $2,888 |
| Level 7 Radiation TherapyAPC 5627 | 87 | 76 | $22,917 | $5,556 | $6,121 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 83 | 75 | $19,374 | $1,625 | $1,780 |
| Level 4 Gynecologic ProceduresAPC 5414 | 76 | 75 | $20,427 | $2,167 | $2,389 |
| Level 6 Urology and Related ServicesAPC 5376 | 65 | 64 | $38,849 | $6,603 | $7,291 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 64 | 64 | $55,152 | $8,034 | $8,569 |
| Level 4 Endovascular ProceduresAPC 5194 | 63 | 61 | $77,761 | $13,535 | $14,606 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 56 | 51 | $70,331 | $25,471 | $26,719 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 51 | 47 | $28,167 | $4,839 | $4,524 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 50 | 50 | $137,754 | $27,519 | $29,375 |
| Level 4 ENT ProceduresAPC 5164 | 46 | 46 | $23,881 | $2,273 | $2,217 |
| Level 5 Gynecologic ProceduresAPC 5415 | 45 | 44 | $27,778 | $3,430 | $3,792 |
| Level 6 Gynecologic ProceduresAPC 5416 | 42 | 42 | $39,872 | $5,454 | $5,836 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 37 | 37 | $30,697 | $6,131 | $6,514 |
| Level 8 Urology and Related ServicesAPC 5378 | 37 | 36 | $51,534 | $16,586 | $17,428 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 34 | 33 | $53,425 | $17,602 | $18,465 |
| Level 2 Urology and Related ServicesAPC 5372 | 30 | 27 | $4,413 | $477 | $502 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 28 | 28 | $93,542 | $15,979 | $17,052 |
| Cochlear Implant ProcedureAPC 5166 | 25 | 25 | $89,161 | $28,653 | $29,489 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 23 | 22 | $38,313 | $6,905 | $7,546 |
| Level 3 Intraocular ProceduresAPC 5493 | 23 | 19 | $31,326 | $3,772 | $4,004 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 17 | 15 | $27,447 | $2,790 | $2,969 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 16 | 15 | $46,451 | $5,390 | $5,682 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 15 | 15 | $69,663 | $14,298 | $15,549 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 14 | 14 | $115,322 | $19,665 | $21,011 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 13 | 13 | $25,024 | $2,456 | $2,547 |
| Level 7 Urology and Related ServicesAPC 5377 | 11 | 11 | $41,308 | $9,981 | $10,388 |
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.