Memorial Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Memorial Medical Center, Springfield, IL in 2024, from traditional Medicare claims. Back to the Memorial Medical Center profile, with quality ratings, finances and negotiated rates.
4,765
Medicare inpatient discharges
In 147 published DRGs
1.93
Case mix index
IPPS FY 2027
28%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
4,137
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,047 discharges in 32 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 190 | $41,261 | $8,881 | $8,582 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 74 | $94,492 | $11,480 | $19,654 | 1.82 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 70 | $57,206 | $10,613 | $11,899 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 64 | $34,162 | $4,404 | $7,106 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 43 | $53,310 | $7,826 | $11,089 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 43 | $136,081 | $20,268 | $28,305 | 2.87 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 40 | $143,542 | $24,214 | $29,857 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 40 | $47,107 | $7,270 | $9,798 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 39 | $187,678 | $37,069 | $39,037 | 4.88 |
| Syncope and collapseMS-DRG 312, medical | 37 | $34,017 | $5,411 | $7,075 | 0.86 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 35 | $41,342 | $5,981 | $8,599 | 0.91 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 33 | $183,153 | $24,414 | $38,096 | 4.04 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 33 | $23,193 | $3,237 | $4,824 | 0.55 |
| Other vascular procedures with CCMS-DRG 253, surgical | 28 | $111,876 | $15,430 | $23,270 | 2.55 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 28 | $107,345 | $15,912 | $22,328 | 2.16 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 23 | $154,682 | $25,686 | $32,174 | 3.35 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 20 | $73,219 | $15,426 | $15,230 | 2.09 |
| Hypertension with MCCMS-DRG 304, medical | 19 | $37,431 | $8,226 | $7,786 | 1.15 |
| Hypertension without MCCMS-DRG 305, medical | 18 | $29,305 | $4,620 | $6,096 | 0.75 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 16 | $91,297 | $10,054 | $18,990 | 1.74 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 15 | $207,421 | $29,572 | $43,144 | 4.16 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 15 | $31,453 | $4,527 | $6,542 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 13 | $312,568 | $42,215 | $65,014 | 5.24 |
| Heart failure and shock with CCMS-DRG 292, medical | 13 | $29,720 | $5,890 | $6,182 | 0.86 |
| Chest painMS-DRG 313, medical | 13 | $28,068 | $4,462 | $5,838 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 13 | $32,089 | $6,647 | $6,675 | 0.97 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 13 | $164,992 | $21,145 | $34,318 | 2.97 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 12 | $123,748 | $25,636 | $25,740 | 3.46 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 12 | $102,090 | $13,234 | $21,235 | 1.97 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 12 | $52,703 | $9,370 | $10,962 | 1.58 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 12 | $195,862 | $29,824 | $40,739 | 4.14 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 11 | $239,173 | $36,802 | $49,748 | 5.20 |
Respiratory system750 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 118 | $48,107 | $8,892 | $10,006 | 1.33 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 108 | $48,301 | $7,929 | $10,047 | 1.10 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 102 | $60,805 | $11,820 | $12,647 | 1.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 83 | $39,726 | $5,124 | $8,263 | 0.82 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 53 | $57,711 | $8,297 | $12,004 | 1.23 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 42 | $75,366 | $13,060 | $15,676 | 1.88 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 34 | $43,231 | $6,377 | $8,992 | 0.99 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 30 | $37,257 | $5,652 | $7,749 | 0.85 |
| Major chest procedures with CCMS-DRG 164, surgical | 29 | $84,825 | $18,767 | $17,644 | 2.55 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 29 | $115,521 | $19,027 | $24,028 | 2.70 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 24 | $41,295 | $5,000 | $8,589 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 23 | $46,312 | $9,827 | $9,633 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 14 | $48,674 | $5,407 | $10,124 | 1.05 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 14 | $334,318 | $60,107 | $69,538 | 6.91 |
| Major chest procedures with MCCMS-DRG 163, surgical | 13 | $131,359 | $36,104 | $27,323 | 4.71 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 12 | $63,515 | $10,820 | $13,211 | 1.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 11 | $59,008 | $11,120 | $12,274 | 1.74 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $60,774 | $9,972 | $12,641 | 1.55 |
Infectious and parasitic diseases605 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 358 | $72,916 | $13,969 | $15,167 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 121 | $39,630 | $6,970 | $8,243 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 51 | $152,289 | $34,965 | $31,676 | 5.00 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 17 | $120,296 | $18,206 | $25,022 | 2.14 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 13 | $92,895 | $13,949 | $19,322 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 12 | $75,389 | $13,923 | $15,681 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $152,048 | $31,258 | $31,626 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 11 | $39,862 | $7,711 | $8,291 | 1.01 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 11 | $345,271 | $62,067 | $71,816 | 6.96 |
Nervous system518 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 108 | $43,676 | $6,536 | $9,085 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 56 | $92,224 | $14,926 | $19,183 | 2.00 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 38 | $31,174 | $4,114 | $6,484 | 0.69 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 35 | $193,639 | $34,583 | $40,277 | 4.42 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 29 | $36,859 | $4,892 | $7,667 | 0.80 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 24 | $121,857 | $14,362 | $25,346 | 2.43 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 24 | $46,740 | $9,601 | $9,722 | 1.36 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 23 | $61,490 | $7,427 | $12,790 | 1.14 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 22 | $215,710 | $38,700 | $44,868 | 5.67 |
| Seizures without MCCMS-DRG 101, medical | 22 | $31,530 | $5,734 | $6,558 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 19 | $81,693 | $15,597 | $16,992 | 1.98 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 15 | $101,047 | $17,389 | $21,018 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 14 | $109,593 | $24,947 | $22,795 | 3.79 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 14 | $50,862 | $8,893 | $10,579 | 1.36 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 14 | $74,160 | $12,809 | $15,425 | 1.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 13 | $156,257 | $20,464 | $32,501 | 2.95 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 12 | $47,357 | $10,519 | $9,850 | 1.47 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 12 | $40,783 | $8,834 | $8,483 | 1.32 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 12 | $33,965 | $5,875 | $7,065 | 0.89 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 12 | $34,776 | $7,007 | $7,233 | 1.03 |
Digestive system496 discharges in 16 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 | 66 | $28,936 | $5,005 | $6,019 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 58 | $44,882 | $6,617 | $9,335 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 51 | $68,916 | $12,981 | $14,335 | 1.79 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 51 | $32,628 | $5,288 | $6,787 | 0.80 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 46 | $82,020 | $16,801 | $17,060 | 2.37 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 37 | $69,879 | $10,333 | $14,535 | 1.67 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 26 | $174,955 | $32,449 | $36,391 | 4.52 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 26 | $50,700 | $7,686 | $10,546 | 1.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 25 | $21,553 | $3,024 | $4,483 | 0.56 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 25 | $34,602 | $6,188 | $7,197 | 0.94 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 18 | $95,392 | $17,421 | $19,842 | 2.50 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 18 | $60,371 | $11,627 | $12,557 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $63,862 | $10,099 | $13,283 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 13 | $37,089 | $7,650 | $7,715 | 1.04 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $219,932 | $43,937 | $45,746 | 5.08 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 11 | $77,666 | $15,787 | $16,154 | 2.11 |
Kidney and urinary tract415 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 92 | $32,324 | $5,227 | $6,723 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 67 | $32,631 | $6,019 | $6,787 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 54 | $44,343 | $8,129 | $9,223 | 1.17 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 41 | $46,310 | $9,265 | $9,633 | 1.35 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 37 | $56,244 | $12,803 | $11,699 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 31 | $42,137 | $10,510 | $8,764 | 1.50 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 23 | $37,719 | $6,528 | $7,846 | 1.05 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 22 | $31,822 | $6,599 | $6,619 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 21 | $92,824 | $19,767 | $19,307 | 2.59 |
| Kidney transplantMS-DRG 652, surgical | 15 | $288,434 | $21,227 | $59,994 | 3.00 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $77,843 | $11,120 | $16,191 | 1.84 |
Musculoskeletal system and connective tissue388 discharges in 17 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 | 71 | $91,521 | $14,599 | $19,036 | 2.07 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 38 | $188,810 | $25,423 | $39,273 | 3.66 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 37 | $85,992 | $14,512 | $17,886 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 33 | $46,867 | $6,396 | $9,748 | 0.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 22 | $124,266 | $18,481 | $25,847 | 2.48 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 21 | $125,190 | $21,732 | $26,040 | 2.95 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 20 | $85,575 | $17,949 | $17,799 | 2.46 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 20 | $70,116 | $11,288 | $14,584 | 1.59 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 20 | $41,312 | $5,554 | $8,593 | 0.90 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 19 | $142,892 | $21,613 | $29,721 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 17 | $94,017 | $13,207 | $19,555 | 2.04 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 14 | $30,010 | $4,669 | $6,242 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 12 | $100,165 | $18,066 | $20,834 | 2.40 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 11 | $273,302 | $41,686 | $56,847 | 6.12 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 11 | $154,815 | $26,766 | $32,201 | 3.49 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 11 | $127,922 | $19,676 | $26,608 | 2.67 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 11 | $121,271 | $14,902 | $25,224 | 1.97 |
Endocrine, nutritional and metabolic190 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 56 | $32,464 | $4,880 | $6,753 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 49 | $47,408 | $8,434 | $9,861 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 39 | $42,653 | $5,980 | $8,872 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 18 | $78,135 | $14,490 | $16,252 | 1.98 |
| Diabetes with MCCMS-DRG 637, medical | 15 | $55,620 | $9,855 | $11,569 | 1.45 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 13 | $69,431 | $9,500 | $14,442 | 1.52 |
Liver, gallbladder and pancreas109 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 16 | $54,922 | $12,189 | $11,424 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 16 | $42,142 | $6,825 | $8,766 | 1.09 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 15 | $53,130 | $12,421 | $11,051 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $33,733 | $5,863 | $7,017 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 13 | $70,811 | $11,863 | $14,729 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 13 | $72,256 | $13,359 | $15,029 | 1.83 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $37,093 | $6,994 | $7,715 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $35,507 | $6,087 | $7,386 | 0.95 |
Skin, subcutaneous tissue and breast83 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 69 | $39,775 | $5,896 | $8,273 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $49,115 | $11,390 | $10,216 | 1.49 |
Blood and immune system57 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 30 | $35,772 | $6,412 | $7,441 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 27 | $63,794 | $10,032 | $13,269 | 1.40 |
Factors influencing health status27 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 | 27 | $26,328 | $5,515 | $5,476 | 0.80 |
Injuries, poisonings and toxic effects of drugs25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 13 | $34,045 | $7,389 | $7,081 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 12 | $66,022 | $11,771 | $13,733 | 1.82 |
Blood cancers and poorly differentiated neoplasms22 discharges in 1 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 | $37,367 | $9,425 | $7,772 | 1.21 |
Other22 discharges in 1 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 | 22 | $193,680 | $33,562 | $40,285 | 4.74 |
Transplants, ECMO and tracheostomy (pre-MDC)11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 11 | $585,840 | $124,634 | $121,855 | 21.32 |
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 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 357 | 339 | $11,981 | $1,153 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 342 | 341 | $19,489 | $2,138 | $2,208 |
| Level 3 Vascular ProceduresAPC 5183 | 296 | 230 | $15,964 | $2,191 | $2,405 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 250 | 238 | $67,540 | $10,492 | $10,772 |
| Level 3 Endovascular ProceduresAPC 5193 | 181 | 166 | $59,233 | $8,522 | $8,874 |
| Level 2 Upper GI ProceduresAPC 5302 | 170 | 152 | $12,196 | $1,401 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 166 | 164 | $30,109 | $4,189 | $4,358 |
| Level 2 Endovascular ProceduresAPC 5192 | 161 | 134 | $29,696 | $4,156 | $4,338 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 160 | 156 | $36,456 | $5,267 | $5,339 |
| Level 5 Urology and Related ServicesAPC 5375 | 148 | 140 | $28,723 | $3,808 | $3,918 |
| Comprehensive Observation ServicesAPC 8011 | 146 | 143 | $16,753 | $1,974 | $2,090 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 145 | 141 | $20,832 | $2,090 | $2,141 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 142 | 140 | $53,501 | $7,820 | $8,164 |
| Level 4 Urology and Related ServicesAPC 5374 | 141 | 128 | $18,473 | $2,563 | $2,629 |
| Level 3 Urology and Related ServicesAPC 5373 | 131 | 89 | $10,873 | $1,497 | $1,516 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 118 | 116 | $109,343 | $15,422 | $15,763 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 99 | 95 | $18,816 | $2,337 | $2,373 |
| Level 4 Vascular ProceduresAPC 5184 | 79 | 62 | $37,300 | $3,734 | $3,946 |
| Level 2 Vascular ProceduresAPC 5182 | 69 | 62 | $7,198 | $1,179 | $1,204 |
| Level 4 Airway EndoscopyAPC 5154 | 68 | 62 | $19,457 | $2,756 | $2,833 |
| Level 4 Endovascular ProceduresAPC 5194 | 64 | 61 | $104,394 | $14,533 | $14,606 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 56 | 45 | $14,754 | $2,545 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 53 | 51 | $10,217 | $1,157 | $1,196 |
| Level 1 Nerve ProceduresAPC 5431 | 53 | 47 | $15,011 | $1,364 | $1,407 |
| Level 5 ENT ProceduresAPC 5165 | 46 | 46 | $37,652 | $4,311 | $4,436 |
| Level 5 Gynecologic ProceduresAPC 5415 | 43 | 31 | $41,406 | $3,570 | $3,792 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 41 | 39 | $10,486 | $1,717 | $1,780 |
| Level 3 Airway EndoscopyAPC 5153 | 40 | 39 | $13,796 | $1,249 | $1,264 |
| Level 4 Gynecologic ProceduresAPC 5414 | 38 | 38 | $20,691 | $2,241 | $2,389 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 34 | 32 | $23,594 | $2,803 | $2,930 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 34 | 34 | $117,618 | $26,981 | $26,719 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 31 | 31 | $45,828 | $6,248 | $6,514 |
| Level 3 Upper GI ProceduresAPC 5303 | 30 | 29 | $18,442 | $2,816 | $2,888 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 28 | 26 | $178,571 | $20,253 | $21,117 |
| Level 3 Lower GI ProceduresAPC 5313 | 28 | 28 | $18,273 | $2,097 | $2,176 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 25 | 25 | $37,601 | $4,798 | $4,982 |
| Complex GI ProceduresAPC 5331 | 25 | 22 | $38,864 | $4,196 | $4,263 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 22 | 22 | $55,955 | $8,228 | $8,569 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 16 | 15 | $82,348 | $18,535 | $18,465 |
| Level 2 Urology and Related ServicesAPC 5372 | 15 | 15 | $6,541 | $503 | $502 |
| Level 6 Urology and Related ServicesAPC 5376 | 12 | 11 | $44,477 | $6,880 | $7,291 |
| Level 7 Radiation TherapyAPC 5627 | 12 | $44,371 | $5,734 | $6,121 | |
| Level 2 ICD and Similar ProceduresAPC 5232 | 11 | 11 | $135,322 | $28,680 | $29,375 |
| Implantation of Drug Infusion DeviceAPC 5471 | 11 | 11 | $52,246 | $14,815 | $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.