Memorial Hermann Texas Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Memorial Hermann Texas Medical Center, Houston, TX in 2024, from traditional Medicare claims. Back to the Memorial Hermann Texas Medical Center profile, with quality ratings, finances and negotiated rates.
4,729
Medicare inpatient discharges
In 143 published DRGs
2.74
Case mix index
IPPS FY 2027
39%
Surgical stays
77%
Stays with complications
In DRGs with a CC or MCC
3,350
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,067 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 | 182 | $75,110 | $13,104 | $16,074 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 78 | $169,028 | $29,544 | $36,172 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 64 | $167,452 | $21,469 | $35,835 | 2.16 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 63 | $290,150 | $58,182 | $62,092 | 6.25 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 62 | $522,453 | $78,385 | $111,805 | 7.71 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 54 | $186,125 | $42,852 | $39,831 | 4.88 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 48 | $422,052 | $59,561 | $90,319 | 5.06 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 45 | $102,091 | $17,109 | $21,847 | 1.82 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 43 | $75,557 | $15,764 | $16,169 | 1.59 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 39 | $125,799 | $26,584 | $26,921 | 2.87 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 36 | $50,527 | $8,357 | $10,813 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 29 | $179,097 | $21,084 | $38,327 | 2.09 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 26 | $323,043 | $46,337 | $69,131 | 3.35 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 26 | $72,144 | $9,995 | $15,439 | 1.08 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 26 | $74,545 | $11,696 | $15,953 | 1.07 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 26 | $91,048 | $11,752 | $19,484 | 1.20 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 23 | $335,134 | $39,790 | $71,719 | 3.90 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 22 | $410,428 | $53,025 | $87,832 | 5.88 |
| Syncope and collapseMS-DRG 312, medical | 19 | $51,591 | $9,972 | $11,041 | 0.86 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 18 | $219,792 | $32,295 | $47,035 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 17 | $95,623 | $18,550 | $20,463 | 2.28 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 16 | $456,383 | $79,691 | $97,666 | 6.85 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 16 | $58,257 | $8,064 | $12,467 | 0.97 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 15 | $615,093 | $105,303 | $131,630 | 9.71 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 15 | $187,492 | $27,614 | $40,123 | 3.27 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 13 | $57,312 | $10,859 | $12,265 | 0.91 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 12 | $465,109 | $62,218 | $99,533 | 7.80 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 12 | $319,120 | $35,744 | $68,292 | 4.04 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $180,124 | $38,756 | $38,546 | 4.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 11 | $105,448 | $15,354 | $22,566 | 1.58 |
Nervous system915 discharges in 26 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 133 | $128,566 | $19,279 | $27,513 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 108 | $258,330 | $37,485 | $55,283 | 4.42 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 78 | $106,352 | $20,717 | $22,759 | 2.27 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 66 | $66,036 | $11,113 | $14,132 | 1.02 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 61 | $59,598 | $13,283 | $12,754 | 1.32 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 57 | $138,511 | $23,627 | $29,641 | 2.28 |
| Seizures with MCCMS-DRG 100, medical | 43 | $163,009 | $23,220 | $34,884 | 1.98 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 40 | $272,323 | $51,020 | $58,277 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 37 | $54,777 | $10,556 | $11,722 | 0.91 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 32 | $64,909 | $13,670 | $13,891 | 1.36 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 28 | $93,509 | $12,816 | $20,011 | 1.47 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 27 | $173,340 | $20,695 | $37,095 | 2.43 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 24 | $175,440 | $28,500 | $37,544 | 2.95 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 19 | $64,255 | $9,845 | $13,750 | 1.03 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 18 | $46,067 | $10,393 | $9,858 | 0.89 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 16 | $105,948 | $18,301 | $22,673 | 2.39 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 15 | $194,236 | $26,295 | $41,567 | 3.85 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 15 | $98,904 | $20,692 | $21,166 | 2.23 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 15 | $122,803 | $13,728 | $26,280 | 1.79 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 14 | $497,612 | $72,008 | $106,489 | 8.45 |
| Spinal procedures with MCCMS-DRG 028, surgical | 13 | $286,095 | $44,627 | $61,224 | 6.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 12 | $35,200 | $8,687 | $7,533 | 0.69 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 11 | $47,397 | $13,700 | $10,143 | 1.36 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 11 | $87,645 | $18,717 | $18,756 | 1.87 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 11 | $76,118 | $9,145 | $16,289 | 0.80 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 11 | $99,391 | $13,287 | $21,270 | 1.79 |
Musculoskeletal system and connective tissue664 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 125 | $144,374 | $19,281 | $30,896 | 2.07 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 77 | $176,032 | $25,948 | $37,671 | 2.95 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 60 | $156,920 | $19,841 | $33,581 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 43 | $54,094 | $10,556 | $11,576 | 0.97 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 36 | $168,669 | $29,001 | $36,095 | 3.49 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 33 | $148,740 | $22,319 | $31,830 | 2.40 |
| Medical back problems with MCCMS-DRG 551, medical | 33 | $100,216 | $16,641 | $21,446 | 1.70 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 31 | $253,995 | $34,413 | $54,355 | 3.66 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 27 | $205,871 | $26,939 | $44,056 | 2.99 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 22 | $336,105 | $57,498 | $71,926 | 6.12 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 20 | $124,730 | $19,987 | $26,692 | 2.04 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 18 | $81,162 | $13,546 | $17,369 | 1.30 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 17 | $728,067 | $111,733 | $155,806 | 8.86 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 16 | $158,065 | $18,735 | $33,826 | 1.97 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $187,617 | $24,790 | $40,150 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 15 | $166,440 | $30,323 | $35,618 | 3.46 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 15 | $60,336 | $9,030 | $12,912 | 0.79 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 13 | $117,827 | $13,551 | $25,215 | 1.49 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 12 | $371,341 | $58,001 | $79,467 | 6.08 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 12 | $149,546 | $17,430 | $32,003 | 2.67 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 12 | $106,630 | $11,832 | $22,819 | 1.52 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 12 | $57,259 | $9,199 | $12,253 | 0.90 |
Infectious and parasitic diseases634 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 | 409 | $114,869 | $19,682 | $24,582 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 69 | $341,990 | $49,094 | $73,186 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 58 | $64,251 | $11,246 | $13,750 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 38 | $378,016 | $62,547 | $80,895 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 18 | $172,418 | $20,148 | $36,898 | 2.14 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 15 | $104,934 | $19,588 | $22,456 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 15 | $280,672 | $36,425 | $60,064 | 4.43 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $100,789 | $13,118 | $21,569 | 1.84 |
Respiratory system361 discharges in 14 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 77 | $76,753 | $16,686 | $16,425 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 51 | $56,245 | $13,235 | $12,036 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 47 | $72,018 | $13,284 | $15,412 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 26 | $151,240 | $24,008 | $32,365 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 24 | $241,697 | $44,634 | $51,723 | 4.71 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 20 | $98,042 | $14,781 | $20,981 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 20 | $63,158 | $11,645 | $13,516 | 1.05 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 16 | $54,441 | $8,952 | $11,650 | 0.99 |
| Major chest trauma with MCCMS-DRG 183, medical | 15 | $67,856 | $16,410 | $14,521 | 1.57 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 14 | $36,519 | $11,530 | $7,815 | 1.10 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 14 | $48,178 | $9,750 | $10,310 | 0.82 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 14 | $65,428 | $16,564 | $14,002 | 1.90 |
| Pneumothorax with MCCMS-DRG 199, medical | 12 | $107,620 | $18,325 | $23,031 | 1.77 |
| Pneumothorax with CCMS-DRG 200, medical | 11 | $52,007 | $11,897 | $11,129 | 1.08 |
Kidney and urinary tract264 discharges in 7 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 | 60 | $93,414 | $16,291 | $19,991 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 45 | $58,373 | $11,565 | $12,492 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 42 | $58,382 | $10,123 | $12,494 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 38 | $40,322 | $9,233 | $8,629 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 36 | $78,108 | $14,600 | $16,715 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 32 | $86,751 | $11,334 | $18,565 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 11 | $168,831 | $38,206 | $36,130 | 3.70 |
Digestive system242 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 46 | $72,050 | $10,522 | $15,419 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 45 | $91,426 | $17,466 | $19,565 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 25 | $46,125 | $6,993 | $9,871 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 22 | $198,503 | $22,292 | $42,480 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 22 | $66,968 | $12,808 | $14,331 | 1.28 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 21 | $260,349 | $43,921 | $55,715 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 19 | $50,078 | $9,818 | $10,717 | 0.94 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 17 | $50,613 | $9,821 | $10,831 | 0.80 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 13 | $96,668 | $14,530 | $20,687 | 1.45 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $374,997 | $51,711 | $80,249 | 5.08 |
Endocrine, nutritional and metabolic136 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 | 58 | $75,509 | $15,584 | $16,159 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 25 | $47,218 | $9,150 | $10,105 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 21 | $49,678 | $10,204 | $10,631 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 20 | $64,926 | $14,353 | $13,894 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $103,039 | $15,341 | $22,050 | 1.65 |
Multiple significant trauma99 discharges in 5 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 | 34 | $246,226 | $38,083 | $52,692 | 3.88 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 20 | $112,235 | $25,358 | $24,018 | 2.73 |
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 17 | $651,742 | $71,134 | $139,473 | 7.23 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 16 | $73,519 | $15,359 | $15,733 | 1.50 |
| Other o.r. procedures for multiple significant trauma with CCMS-DRG 958, surgical | 12 | $254,611 | $37,682 | $54,487 | 4.04 |
Transplants, ECMO and tracheostomy (pre-MDC)97 discharges in 3 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 | 48 | $1,115,422 | $207,886 | $238,700 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 26 | $606,773 | $118,415 | $129,849 | 14.70 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 23 | $1,842,229 | $266,039 | $394,237 | 27.10 |
Other73 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 29 | $158,992 | $23,101 | $34,024 | 2.49 |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 28 | $310,494 | $50,515 | $66,446 | 4.74 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 16 | $176,307 | $24,179 | $37,730 | 3.38 |
Liver, gallbladder and pancreas47 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 26 | $98,543 | $16,630 | $21,088 | 1.92 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 21 | $128,498 | $20,356 | $27,499 | 1.83 |
Injuries, poisonings and toxic effects of drugs43 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 16 | $100,933 | $15,511 | $21,600 | 1.60 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 14 | $122,982 | $19,604 | $26,318 | 2.00 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $231,839 | $29,554 | $49,614 | 3.72 |
Blood and immune system40 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 22 | $86,081 | $14,021 | $18,421 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 18 | $53,897 | $9,669 | $11,534 | 0.90 |
Skin, subcutaneous tissue and breast25 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 25 | $37,077 | $10,192 | $7,934 | 0.88 |
Ear, nose, mouth and throat11 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 | 11 | $220,524 | $24,732 | $47,192 | 2.07 |
Burns11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 11 | $261,632 | $53,649 | $55,989 | 6.92 |
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 | 628 | 586 | $36,819 | $2,003 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 355 | 339 | $93,379 | $10,414 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 207 | 204 | $25,587 | $1,951 | $2,208 |
| Level 2 Upper GI ProceduresAPC 5302 | 201 | 167 | $19,306 | $1,391 | $1,445 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 170 | 168 | $171,392 | $19,854 | $21,117 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 144 | 141 | $82,508 | $5,212 | $5,339 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 105 | 100 | $19,491 | $1,185 | $1,220 |
| Level 3 Vascular ProceduresAPC 5183 | 102 | 90 | $34,603 | $2,326 | $2,405 |
| Level 3 Endovascular ProceduresAPC 5193 | 95 | 90 | $64,709 | $8,108 | $8,874 |
| Level 4 Airway EndoscopyAPC 5154 | 86 | 64 | $46,654 | $2,701 | $2,833 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 86 | 85 | $65,315 | $4,166 | $4,358 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 80 | 71 | $31,309 | $2,096 | $2,141 |
| Level 5 Urology and Related ServicesAPC 5375 | 72 | 64 | $60,107 | $3,770 | $3,918 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 69 | 68 | $47,531 | $2,193 | $2,373 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 64 | 64 | $98,583 | $15,123 | $15,763 |
| Level 4 Endovascular ProceduresAPC 5194 | 63 | 59 | $99,739 | $13,899 | $14,606 |
| Level 7 Radiation TherapyAPC 5627 | 58 | 47 | $235,710 | $5,753 | $6,121 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 52 | 51 | $28,020 | $1,161 | $1,196 |
| Level 4 Urology and Related ServicesAPC 5374 | 52 | 45 | $46,468 | $2,377 | $2,629 |
| Level 5 ENT ProceduresAPC 5165 | 49 | 46 | $77,257 | $4,326 | $4,436 |
| Level 3 Urology and Related ServicesAPC 5373 | 44 | 40 | $27,543 | $1,431 | $1,516 |
| Level 5 Airway EndoscopyAPC 5155 | 42 | 42 | $73,043 | $5,056 | $5,183 |
| Level 4 Vascular ProceduresAPC 5184 | 42 | 37 | $54,804 | $3,686 | $3,946 |
| Complex GI ProceduresAPC 5331 | 41 | 28 | $40,453 | $4,005 | $4,263 |
| Level 3 Lower GI ProceduresAPC 5313 | 38 | 36 | $23,809 | $2,132 | $2,176 |
| Level 1 Nerve ProceduresAPC 5431 | 38 | 38 | $27,921 | $1,341 | $1,407 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 35 | 35 | $39,532 | $8,026 | $8,569 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 31 | 31 | $29,643 | $6,074 | $6,514 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 30 | 30 | $104,766 | $28,782 | $29,375 |
| Level 2 Endovascular ProceduresAPC 5192 | 29 | 28 | $45,685 | $4,216 | $4,338 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 24 | 24 | $141,061 | $27,077 | $26,719 |
| Level 3 Upper GI ProceduresAPC 5303 | 22 | 21 | $33,101 | $2,435 | $2,888 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 22 | 20 | $70,276 | $2,856 | $2,969 |
| Level 1 Intraocular ProceduresAPC 5491 | 21 | 17 | $43,506 | $1,640 | $1,752 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 19 | 19 | $99,497 | $7,904 | $8,164 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 19 | 18 | $62,612 | $1,726 | $1,780 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 18 | 18 | $57,706 | $2,146 | $2,636 |
| Level 4 Gynecologic ProceduresAPC 5414 | 18 | 18 | $37,809 | $2,299 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 16 | 16 | $12,598 | $1,183 | $1,204 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $61,729 | $2,379 | $2,217 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 13 | 13 | $76,027 | $4,447 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 13 | 13 | $28,351 | $1,248 | $1,264 |
| Level 2 Intraocular ProceduresAPC 5492 | 12 | 11 | $66,297 | $3,004 | $3,116 |
| Implantation of Drug Infusion DeviceAPC 5471 | 11 | 11 | $82,219 | $13,518 | $14,829 |
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.