Medical City Frisco Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Medical City Frisco, Frisco, TX in 2024, from traditional Medicare claims. Back to the Medical City Frisco profile, with quality ratings, finances and negotiated rates.
5,131
Medicare inpatient discharges
In 165 published DRGs
2.39
Case mix index
IPPS FY 2027
36%
Surgical stays
69%
Stays with complications
In DRGs with a CC or MCC
1,655
Medicare outpatient services
In 29 service groups
Inpatient stays by major diagnostic category
Musculoskeletal system and connective tissue1,295 discharges in 39 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 | 111 | $1,035,135 | $49,244 | $70,389 | 6.12 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 109 | $885,464 | $38,424 | $60,212 | 3.49 |
| Medical back problems without MCCMS-DRG 552, medical | 91 | $85,522 | $6,239 | $5,815 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 67 | $341,612 | $14,674 | $23,230 | 1.88 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 59 | $392,939 | $18,718 | $26,720 | 2.96 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 58 | $573,462 | $25,241 | $38,995 | 3.66 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 58 | $600,082 | $26,842 | $40,806 | 2.67 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 56 | $239,120 | $13,343 | $16,260 | 2.07 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 53 | $685,046 | $31,486 | $46,583 | 4.61 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 42 | $645,432 | $27,272 | $43,889 | 3.00 |
| Medical back problems with MCCMS-DRG 551, medical | 42 | $135,786 | $10,082 | $9,233 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 36 | $283,039 | $13,555 | $19,247 | 2.11 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 32 | $921,876 | $40,964 | $62,688 | 5.19 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 31 | $399,978 | $18,845 | $27,199 | 2.99 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 29 | $813,597 | $43,365 | $55,325 | 6.08 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 29 | $365,636 | $21,262 | $24,863 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 29 | $290,028 | $14,859 | $19,722 | 2.40 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 26 | $965,649 | $44,339 | $65,664 | 5.66 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 24 | $204,331 | $12,042 | $13,894 | 1.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 23 | $566,682 | $17,959 | $38,534 | 2.48 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 22 | $1,543,132 | $70,029 | $104,933 | 8.86 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 21 | $162,449 | $8,920 | $11,047 | 1.49 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 20 | $259,784 | $14,126 | $17,665 | 2.38 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 19 | $86,463 | $4,962 | $5,879 | 0.79 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 19 | $112,484 | $5,069 | $7,649 | 1.13 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $78,686 | $5,735 | $5,351 | 0.90 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 17 | $220,388 | $13,636 | $14,986 | 2.04 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 16 | $276,467 | $21,635 | $18,800 | 3.46 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 15 | $563,161 | $26,755 | $38,295 | 4.92 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 14 | $184,167 | $9,828 | $12,523 | 1.59 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 13 | $496,433 | $22,780 | $33,757 | 3.33 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 13 | $336,953 | $15,335 | $22,913 | 2.46 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 13 | $61,268 | $5,599 | $4,166 | 0.82 |
| Spinal fusion except cervical with MCCMS-DRG 459, surgical | 12 | $766,148 | $46,074 | $52,098 | 6.63 |
| Aftercare, musculoskeletal system and connective tissue with MCCMS-DRG 559, medical | 12 | $138,017 | $12,585 | $9,385 | 1.85 |
| Aftercare, musculoskeletal system and connective tissue without cc/mccMS-DRG 561, medical | 12 | $61,151 | $4,952 | $4,158 | 0.78 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 11 | $326,712 | $19,531 | $22,216 | 3.37 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $163,541 | $12,693 | $11,121 | 1.87 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 11 | $321,104 | $18,370 | $21,835 | 3.16 |
Nervous system740 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 147 | $175,062 | $13,013 | $11,904 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 57 | $103,562 | $5,924 | $7,042 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 51 | $602,527 | $30,943 | $40,972 | 4.42 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 50 | $96,979 | $4,827 | $6,595 | 0.80 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 45 | $123,044 | $8,350 | $8,367 | 1.32 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 39 | $179,770 | $14,583 | $12,224 | 2.27 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 39 | $134,099 | $11,611 | $9,119 | 1.79 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 36 | $219,668 | $15,320 | $14,937 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 34 | $685,120 | $37,642 | $46,588 | 5.67 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 27 | $144,775 | $8,631 | $9,845 | 1.36 |
| Seizures with MCCMS-DRG 100, medical | 24 | $143,801 | $13,409 | $9,778 | 1.98 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 21 | $77,011 | $5,747 | $5,237 | 0.89 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 21 | $100,858 | $7,063 | $6,858 | 1.03 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 20 | $104,537 | $5,732 | $7,109 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 17 | $84,139 | $5,626 | $5,721 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 16 | $113,766 | $7,293 | $7,736 | 1.14 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 16 | $98,315 | $8,666 | $6,685 | 1.36 |
| Headaches without MCCMS-DRG 103, medical | 15 | $87,757 | $5,160 | $5,967 | 0.84 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 14 | $112,818 | $9,912 | $7,672 | 1.47 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 13 | $123,805 | $14,105 | $8,419 | 2.39 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 13 | $88,252 | $4,376 | $6,001 | 0.69 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 13 | $102,147 | $4,866 | $6,946 | 0.87 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 12 | $273,481 | $14,757 | $18,597 | 2.23 |
Infectious and parasitic diseases640 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 | 419 | $168,430 | $12,884 | $11,453 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 82 | $570,532 | $33,108 | $38,796 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 55 | $111,279 | $6,710 | $7,567 | 1.03 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 20 | $423,126 | $28,987 | $28,773 | 4.43 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 17 | $279,492 | $14,574 | $19,005 | 2.14 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $581,735 | $41,463 | $39,558 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $215,173 | $13,970 | $14,632 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $108,238 | $10,473 | $7,360 | 1.84 |
Circulatory system627 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 124 | $116,862 | $8,610 | $7,947 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 53 | $587,901 | $23,235 | $39,977 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 44 | $91,036 | $5,618 | $6,190 | 0.86 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 40 | $363,972 | $23,458 | $24,750 | 3.35 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 37 | $152,650 | $10,317 | $10,380 | 1.59 |
| Hypertension without MCCMS-DRG 305, medical | 26 | $70,341 | $4,747 | $4,783 | 0.75 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 25 | $327,470 | $8,283 | $22,268 | 1.20 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 24 | $567,944 | $34,208 | $38,620 | 5.06 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 23 | $80,466 | $4,688 | $5,472 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 23 | $178,582 | $11,552 | $12,144 | 2.09 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 22 | $114,526 | $9,619 | $7,788 | 1.58 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $101,618 | $5,433 | $6,910 | 0.91 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 21 | $234,351 | $14,564 | $15,936 | 2.16 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 19 | $648,561 | $47,104 | $44,102 | 7.80 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 19 | $51,845 | $3,351 | $3,525 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 16 | $219,798 | $11,334 | $14,946 | 1.82 |
| Other vascular procedures with CCMS-DRG 253, surgical | 15 | $293,835 | $16,547 | $19,981 | 2.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 15 | $300,125 | $15,640 | $20,408 | 2.87 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $593,977 | $21,020 | $40,390 | 3.46 |
| Hypertension with MCCMS-DRG 304, medical | 13 | $97,252 | $7,770 | $6,613 | 1.15 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $636,480 | $26,070 | $43,281 | 3.90 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 11 | $597,790 | $40,629 | $40,650 | 5.88 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 11 | $75,318 | $6,101 | $5,122 | 0.97 |
Digestive system456 discharges in 17 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 | 79 | $65,114 | $4,741 | $4,428 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 67 | $176,402 | $12,111 | $11,995 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 48 | $109,287 | $6,333 | $7,432 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 31 | $63,188 | $4,551 | $4,297 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 28 | $382,600 | $29,053 | $26,017 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 27 | $101,494 | $6,068 | $6,902 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 26 | $113,508 | $10,575 | $7,719 | 1.62 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 22 | $96,561 | $8,650 | $6,566 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 18 | $347,410 | $12,355 | $23,624 | 2.37 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 17 | $493,621 | $31,170 | $33,566 | 5.08 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 16 | $115,616 | $7,403 | $7,862 | 1.45 |
| Digestive malignancy with MCCMS-DRG 374, medical | 15 | $147,850 | $13,120 | $10,054 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 14 | $290,184 | $14,552 | $19,733 | 2.50 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 13 | $53,672 | $3,429 | $3,650 | 0.56 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 12 | $206,018 | $8,010 | $14,009 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 12 | $117,426 | $11,981 | $7,985 | 1.75 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 11 | $200,464 | $10,334 | $13,632 | 1.67 |
Respiratory system416 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 96 | $106,392 | $8,251 | $7,235 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 77 | $106,907 | $10,244 | $7,270 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 53 | $85,161 | $8,589 | $5,791 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 44 | $230,499 | $17,358 | $15,674 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 27 | $432,132 | $29,640 | $29,385 | 4.71 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 18 | $136,631 | $8,287 | $9,291 | 1.40 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $596,378 | $42,439 | $40,554 | 6.91 |
| Major chest procedures with CCMS-DRG 164, surgical | 14 | $303,013 | $17,272 | $20,605 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 14 | $79,354 | $6,813 | $5,396 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 13 | $57,339 | $6,388 | $3,899 | 0.96 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $144,604 | $10,311 | $9,833 | 1.81 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 11 | $70,036 | $5,825 | $4,762 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 11 | $150,351 | $7,347 | $10,224 | 1.05 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 11 | $73,216 | $5,717 | $4,979 | 0.82 |
Kidney and urinary tract335 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 76 | $117,718 | $9,568 | $8,005 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 67 | $90,112 | $7,752 | $6,128 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 60 | $173,307 | $10,706 | $11,785 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 56 | $64,389 | $5,124 | $4,378 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 45 | $79,303 | $5,830 | $5,393 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 20 | $102,409 | $6,966 | $6,964 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 11 | $167,263 | $17,655 | $11,374 | 2.59 |
Liver, gallbladder and pancreas148 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 21 | $113,824 | $7,198 | $7,740 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $120,042 | $13,662 | $8,163 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 16 | $226,102 | $11,587 | $15,375 | 1.63 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 15 | $289,596 | $15,037 | $19,693 | 2.32 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $191,192 | $10,783 | $13,001 | 1.67 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $125,996 | $4,825 | $8,568 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 13 | $179,628 | $8,063 | $12,215 | 1.31 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $307,178 | $11,311 | $20,888 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 12 | $220,210 | $10,110 | $14,974 | 1.63 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 11 | $525,768 | $33,222 | $35,752 | 5.51 |
Endocrine, nutritional and metabolic120 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 | 46 | $92,551 | $8,331 | $6,293 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 25 | $72,778 | $4,913 | $4,949 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 21 | $161,825 | $7,900 | $11,004 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $113,959 | $10,077 | $7,749 | 1.65 |
| Diabetes with CCMS-DRG 638, medical | 12 | $66,453 | $6,120 | $4,519 | 0.90 |
Other94 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 30 | $686,365 | $25,610 | $46,673 | |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 26 | $1,222,347 | $48,182 | $83,120 | |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 16 | $596,968 | $34,019 | $40,594 | 4.74 |
| Multiple level combined anterior and posterior spinal fusion except cervical without CC/MS-DRG 428 | 11 | $990,845 | $38,036 | $67,377 | |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 11 | $727,296 | $31,803 | $49,456 |
Blood and immune system63 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 33 | $113,589 | $8,324 | $7,724 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 16 | $59,403 | $6,245 | $4,039 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 14 | $100,616 | $10,536 | $6,842 | 1.56 |
Skin, subcutaneous tissue and breast56 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 23 | $57,212 | $5,106 | $3,890 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 22 | $95,098 | $6,396 | $6,467 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 11 | $110,379 | $9,188 | $7,506 | 1.49 |
Mental diseases and disorders39 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 39 | $79,098 | $11,244 | $5,379 | 1.76 |
Transplants, ECMO and tracheostomy (pre-MDC)35 discharges in 2 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 | 22 | $1,637,487 | $128,952 | $111,349 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 13 | $978,263 | $74,906 | $66,522 | 14.70 |
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 | 15 | $123,652 | $12,195 | $8,408 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 11 | $78,350 | $7,724 | $5,328 | 1.03 |
Ear, nose, mouth and throat19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 19 | $80,284 | $4,929 | $5,459 | 0.74 |
Burns11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Non-extensive burnsMS-DRG 935, medical | 11 | $258,541 | $15,146 | $17,581 | 2.04 |
Multiple significant trauma11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 11 | $663,486 | $34,363 | $45,117 | 3.88 |
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 5 Musculoskeletal ProceduresAPC 5115 | 276 | 257 | $255,934 | $10,122 | $10,772 |
| Comprehensive Observation ServicesAPC 8011 | 208 | 198 | $42,496 | $1,934 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 177 | 168 | $19,974 | $1,149 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 134 | 108 | $31,793 | $1,365 | $1,445 |
| Level 3 Vascular ProceduresAPC 5183 | 88 | 88 | $54,482 | $2,278 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 77 | 76 | $138,864 | $5,063 | $5,339 |
| Level 1 Endovascular ProceduresAPC 5191 | 66 | 66 | $49,589 | $2,101 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 59 | 54 | $364,473 | $19,687 | $21,117 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 56 | 56 | $108,690 | $4,130 | $4,358 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 51 | 49 | $50,903 | $2,037 | $2,141 |
| Level 4 Vascular ProceduresAPC 5184 | 51 | 48 | $101,933 | $3,940 | $3,946 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 44 | 44 | $157,751 | $7,279 | $8,164 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 36 | 35 | $113,630 | $4,676 | $4,982 |
| Level 3 Upper GI ProceduresAPC 5303 | 35 | 35 | $75,991 | $2,743 | $2,888 |
| Level 3 Endovascular ProceduresAPC 5193 | 34 | 31 | $152,919 | $8,015 | $8,874 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 30 | 26 | $76,490 | $2,243 | $2,373 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 29 | 28 | $39,416 | $1,150 | $1,196 |
| Level 2 Endovascular ProceduresAPC 5192 | 26 | 24 | $89,576 | $4,094 | $4,338 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 24 | 22 | $465,920 | $26,231 | $26,719 |
| Level 2 Vascular ProceduresAPC 5182 | 21 | 21 | $21,159 | $1,148 | $1,204 |
| Complex GI ProceduresAPC 5331 | 20 | 17 | $112,542 | $3,881 | $4,263 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 19 | 18 | $65,199 | $2,732 | $2,930 |
| Level 4 Gynecologic ProceduresAPC 5414 | 17 | 17 | $45,517 | $2,242 | $2,389 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 16 | 16 | $490,937 | $15,103 | $15,763 |
| Level 4 Endovascular ProceduresAPC 5194 | 15 | 15 | $305,003 | $14,117 | $14,606 |
| Level 5 Airway EndoscopyAPC 5155 | 12 | 12 | $73,123 | $4,907 | $5,183 |
| Level 1 Nerve ProceduresAPC 5431 | 12 | 12 | $63,415 | $1,384 | $1,407 |
| Level 4 Airway EndoscopyAPC 5154 | 11 | 11 | $52,377 | $2,685 | $2,833 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 11 | $68,753 | $2,481 | $2,636 |
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.