Mercy Hospital St. Louis Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Mercy Hospital St. Louis, Saint Louis, MO in 2024, from traditional Medicare claims. Back to the Mercy Hospital St. Louis profile, with quality ratings, finances and negotiated rates.
6,014
Medicare inpatient discharges
In 164 published DRGs
1.95
Case mix index
IPPS FY 2027
22%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
5,082
Medicare outpatient services
In 46 service groups
Inpatient stays by major diagnostic category
Circulatory system1,212 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 332 | $44,868 | $8,815 | $10,634 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 59 | $87,337 | $21,540 | $20,699 | 3.24 |
| Syncope and collapseMS-DRG 312, medical | 59 | $30,732 | $5,825 | $7,283 | 0.86 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 53 | $137,506 | $33,322 | $32,589 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 53 | $28,462 | $4,808 | $6,746 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 51 | $78,164 | $14,934 | $18,525 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 44 | $43,328 | $6,789 | $10,269 | 1.08 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 42 | $45,093 | $8,233 | $10,687 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 40 | $73,801 | $11,507 | $17,491 | 1.82 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 36 | $119,399 | $24,525 | $28,297 | 4.04 |
| Hypertension without MCCMS-DRG 305, medical | 36 | $21,309 | $5,009 | $5,050 | 0.75 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 32 | $70,153 | $15,473 | $16,626 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 31 | $107,926 | $16,809 | $25,578 | 2.87 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 29 | $76,847 | $11,282 | $18,213 | 1.59 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 29 | $25,486 | $7,658 | $6,040 | 1.07 |
| Other vascular procedures with CCMS-DRG 253, surgical | 24 | $54,025 | $14,960 | $12,804 | 2.55 |
| Chest painMS-DRG 313, medical | 24 | $31,190 | $4,553 | $7,392 | 0.72 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 23 | $19,361 | $3,197 | $4,589 | 0.55 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 22 | $81,144 | $23,811 | $19,231 | 3.35 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 20 | $45,822 | $9,309 | $10,860 | 1.58 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 18 | $144,743 | $36,311 | $34,304 | 5.06 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 17 | $96,740 | $22,552 | $22,927 | 3.46 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 15 | $63,653 | $15,773 | $15,086 | 2.28 |
| Hypertension with MCCMS-DRG 304, medical | 15 | $44,333 | $6,528 | $10,507 | 1.15 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 14 | $151,112 | $32,697 | $35,814 | 5.20 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 14 | $132,982 | $26,804 | $31,517 | 4.81 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 12 | $334,583 | $61,454 | $79,296 | 7.71 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 12 | $136,992 | $30,699 | $32,467 | 5.24 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 12 | $95,546 | $20,611 | $22,644 | 3.18 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 11 | $116,923 | $24,328 | $27,711 | 3.46 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 11 | $97,784 | $24,104 | $23,175 | 3.27 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 11 | $196,610 | $44,282 | $46,597 | 6.25 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 11 | $101,203 | $29,023 | $23,985 | 4.16 |
Musculoskeletal system and connective tissue729 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 111 | $30,634 | $6,160 | $7,260 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 72 | $41,748 | $12,204 | $9,894 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 64 | $62,212 | $13,417 | $14,744 | 2.07 |
| Medical back problems with MCCMS-DRG 551, medical | 49 | $59,688 | $11,515 | $14,146 | 1.70 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 43 | $90,858 | $20,801 | $21,533 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 35 | $65,183 | $16,352 | $15,448 | 2.40 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 33 | $42,102 | $12,617 | $9,978 | 1.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 33 | $28,758 | $7,511 | $6,816 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 32 | $24,200 | $5,338 | $5,735 | 0.90 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 30 | $56,460 | $13,390 | $13,381 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 29 | $79,566 | $23,450 | $18,857 | 3.66 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 22 | $73,048 | $20,284 | $17,312 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 19 | $19,273 | $5,356 | $4,568 | 0.79 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 17 | $48,390 | $10,107 | $11,468 | 1.59 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 17 | $21,826 | $5,249 | $5,173 | 0.82 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 16 | $156,921 | $40,626 | $37,190 | 6.12 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 15 | $85,968 | $23,892 | $20,375 | 3.46 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 15 | $47,582 | $11,682 | $11,277 | 1.87 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 14 | $69,277 | $14,818 | $16,419 | 2.38 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 14 | $31,017 | $8,603 | $7,351 | 1.30 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 13 | $62,259 | $17,152 | $14,755 | 2.48 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 12 | $77,251 | $24,616 | $18,308 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 12 | $59,378 | $20,215 | $14,073 | 2.96 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 12 | $23,155 | $5,581 | $5,488 | 0.82 |
Respiratory system701 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 208 | $51,390 | $11,261 | $12,180 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 90 | $38,411 | $8,466 | $9,103 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 63 | $43,409 | $8,167 | $10,288 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 39 | $25,345 | $5,019 | $6,007 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 37 | $28,206 | $6,734 | $6,685 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 31 | $34,033 | $6,173 | $8,066 | 0.96 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 31 | $102,878 | $18,885 | $24,382 | 2.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 30 | $38,873 | $6,654 | $9,213 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 23 | $55,872 | $9,446 | $13,242 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 21 | $31,948 | $6,470 | $7,572 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 20 | $57,624 | $12,446 | $13,657 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 19 | $131,848 | $32,904 | $31,248 | 4.71 |
| Pneumothorax with CCMS-DRG 200, medical | 16 | $39,246 | $6,720 | $9,301 | 1.08 |
| Major chest procedures with CCMS-DRG 164, surgical | 13 | $85,180 | $17,495 | $20,188 | 2.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 13 | $34,834 | $6,244 | $8,256 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 12 | $33,659 | $5,265 | $7,977 | 0.82 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 12 | $58,629 | $10,744 | $13,895 | 1.90 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 12 | $197,135 | $44,373 | $46,721 | 6.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 11 | $77,716 | $25,668 | $18,419 | 4.06 |
Infectious and parasitic diseases628 discharges in 7 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 | 413 | $63,530 | $13,419 | $15,057 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 83 | $146,426 | $32,726 | $34,703 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 61 | $39,650 | $6,531 | $9,397 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 22 | $58,453 | $13,198 | $13,853 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 22 | $265,281 | $46,095 | $62,872 | 6.96 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 16 | $51,266 | $13,974 | $12,150 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $100,227 | $27,108 | $23,754 | 4.43 |
Kidney and urinary tract617 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 | 151 | $22,633 | $5,367 | $5,364 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 118 | $31,020 | $7,799 | $7,352 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 95 | $47,293 | $10,766 | $11,208 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 85 | $28,815 | $5,898 | $6,829 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 64 | $43,063 | $11,663 | $10,206 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 34 | $21,903 | $7,384 | $5,191 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 18 | $55,721 | $11,929 | $13,206 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 16 | $59,365 | $16,068 | $14,069 | 2.59 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 13 | $100,310 | $24,840 | $23,773 | 3.70 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $59,052 | $12,396 | $13,995 | 1.84 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 11 | $57,513 | $8,970 | $13,631 | 1.48 |
Nervous system601 discharges in 21 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 80 | $73,068 | $13,927 | $17,317 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 66 | $36,203 | $6,281 | $8,580 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 44 | $30,210 | $8,713 | $7,160 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 37 | $123,927 | $30,845 | $29,371 | 4.42 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 31 | $34,440 | $4,858 | $8,162 | 0.80 |
| Seizures with MCCMS-DRG 100, medical | 31 | $49,945 | $13,866 | $11,837 | 1.98 |
| Seizures without MCCMS-DRG 101, medical | 29 | $27,329 | $5,828 | $6,477 | 0.91 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 28 | $65,795 | $14,763 | $15,593 | 2.28 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 27 | $54,936 | $9,540 | $13,020 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 27 | $28,348 | $7,325 | $6,718 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 26 | $44,224 | $15,084 | $10,481 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 22 | $31,498 | $7,228 | $7,465 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 22 | $51,249 | $11,845 | $12,146 | 1.79 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 20 | $71,506 | $15,783 | $16,947 | 2.27 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 19 | $150,955 | $37,075 | $35,776 | 5.67 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 19 | $46,418 | $10,331 | $11,001 | 1.47 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 18 | $49,601 | $8,939 | $11,755 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 17 | $23,798 | $3,868 | $5,640 | 0.84 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 16 | $31,941 | $4,098 | $7,570 | 0.69 |
| Extracranial procedures with CCMS-DRG 038, surgical | 11 | $63,662 | $10,232 | $15,088 | 1.60 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 11 | $38,634 | $7,432 | $9,156 | 1.06 |
Digestive system569 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 | 130 | $25,389 | $5,114 | $6,017 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 59 | $38,788 | $7,076 | $9,193 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 51 | $42,030 | $9,036 | $9,961 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 44 | $58,474 | $15,847 | $13,858 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 44 | $58,662 | $12,188 | $13,903 | 1.79 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 40 | $40,948 | $11,308 | $9,705 | 1.75 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 32 | $145,144 | $28,183 | $34,399 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 26 | $40,955 | $11,591 | $9,706 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 26 | $26,357 | $6,237 | $6,247 | 0.94 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 24 | $24,805 | $7,280 | $5,879 | 1.04 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 21 | $27,405 | $5,560 | $6,495 | 0.80 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 19 | $35,206 | $9,922 | $8,344 | 1.45 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 18 | $54,750 | $10,046 | $12,976 | 1.67 |
| Digestive malignancy with MCCMS-DRG 374, medical | 12 | $43,046 | $12,933 | $10,202 | 2.10 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 12 | $18,908 | $3,419 | $4,481 | 0.56 |
| Digestive malignancy with CCMS-DRG 375, medical | 11 | $26,809 | $7,005 | $6,354 | 1.20 |
Endocrine, nutritional and metabolic242 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 with MCCMS-DRG 640, medical | 85 | $39,229 | $9,038 | $9,297 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 56 | $23,480 | $5,252 | $5,565 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 36 | $40,366 | $10,161 | $9,567 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 36 | $23,554 | $6,373 | $5,582 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 15 | $43,258 | $11,824 | $10,252 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $36,032 | $7,612 | $8,539 | 1.06 |
Mental diseases and disorders197 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 142 | $18,825 | $9,518 | $4,462 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 38 | $31,510 | $11,481 | $7,468 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 17 | $27,204 | $6,327 | $6,447 | 0.95 |
Skin, subcutaneous tissue and breast172 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 87 | $21,383 | $5,552 | $5,068 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 38 | $33,148 | $9,714 | $7,856 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 32 | $26,456 | $5,950 | $6,270 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 15 | $39,707 | $11,285 | $9,410 | 1.75 |
Liver, gallbladder and pancreas126 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 20 | $22,204 | $5,709 | $5,262 | 0.86 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 17 | $50,106 | $12,850 | $11,875 | 1.92 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 14 | $27,530 | $6,336 | $6,525 | 1.03 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $50,698 | $10,743 | $12,015 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 13 | $39,553 | $12,394 | $9,374 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 13 | $39,877 | $7,410 | $9,451 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 12 | $49,243 | $14,719 | $11,671 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 12 | $51,240 | $11,356 | $12,144 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $30,347 | $5,305 | $7,192 | 0.95 |
Blood and immune system66 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 | 35 | $35,129 | $5,385 | $8,325 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 31 | $46,886 | $9,735 | $11,112 | 1.40 |
Other37 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 20 | $160,113 | $33,544 | $37,947 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 17 | $60,537 | $15,549 | $14,347 | 2.49 |
Injuries, poisonings and toxic effects of drugs28 discharges in 2 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 | 15 | $69,429 | $12,967 | $16,455 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 13 | $25,186 | $7,498 | $5,969 | 1.03 |
Alcohol and drug use22 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 without MCCMS-DRG 897, medical | 22 | $31,551 | $5,561 | $7,478 | 0.86 |
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 | $28,970 | $4,404 | $6,866 | 0.74 |
Factors influencing health status17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other factors influencing health statusMS-DRG 951, medical | 17 | $18,568 | $3,891 | $4,401 | 0.59 |
Multiple significant trauma17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other multiple significant trauma with MCCMS-DRG 963, medical | 17 | $105,809 | $18,929 | $25,077 | 2.73 |
Burns14 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 | 14 | $198,714 | $52,667 | $47,095 | 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 | 568 | 551 | $16,702 | $1,886 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 340 | 325 | $31,586 | $9,800 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 326 | 314 | $6,322 | $1,121 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 292 | 268 | $7,720 | $1,338 | $1,445 |
| Level 1 Intraocular ProceduresAPC 5491 | 292 | 162 | $8,862 | $1,610 | $1,752 |
| Level 1 Endovascular ProceduresAPC 5191 | 285 | 282 | $18,353 | $2,047 | $2,208 |
| Level 3 Urology and Related ServicesAPC 5373 | 216 | 169 | $12,624 | $1,418 | $1,516 |
| Level 3 Vascular ProceduresAPC 5183 | 178 | 168 | $11,687 | $2,228 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 176 | 174 | $22,512 | $4,901 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 167 | 163 | $18,711 | $4,068 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 167 | 138 | $14,449 | $2,374 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 153 | 147 | $23,017 | $3,600 | $3,918 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 143 | 141 | $129,367 | $19,176 | $21,117 |
| Level 3 Endovascular ProceduresAPC 5193 | 113 | 111 | $41,291 | $8,020 | $8,874 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 94 | 94 | $10,517 | $1,970 | $2,141 |
| Level 1 Nerve ProceduresAPC 5431 | 94 | 85 | $6,432 | $1,340 | $1,407 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 93 | 92 | $12,733 | $2,170 | $2,373 |
| Level 4 Vascular ProceduresAPC 5184 | 91 | 65 | $17,697 | $3,048 | $3,946 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 82 | 73 | $14,447 | $2,637 | $2,930 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 81 | 80 | $35,415 | $7,148 | $8,164 |
| Level 5 ENT ProceduresAPC 5165 | 72 | 69 | $23,624 | $3,984 | $4,436 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 67 | 66 | $11,850 | $2,421 | $2,636 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 65 | 65 | $6,143 | $1,107 | $1,196 |
| Level 5 Airway EndoscopyAPC 5155 | 65 | 64 | $24,067 | $4,778 | $5,183 |
| Level 4 Gynecologic ProceduresAPC 5414 | 64 | 60 | $11,863 | $2,157 | $2,389 |
| Level 5 Gynecologic ProceduresAPC 5415 | 62 | 58 | $19,360 | $3,413 | $3,792 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 59 | 59 | $26,839 | $4,544 | $4,982 |
| Level 2 Endovascular ProceduresAPC 5192 | 59 | 55 | $16,517 | $4,053 | $4,338 |
| Level 3 Lower GI ProceduresAPC 5313 | 58 | 58 | $11,102 | $2,001 | $2,176 |
| Level 4 Airway EndoscopyAPC 5154 | 56 | 54 | $15,088 | $2,611 | $2,833 |
| Level 2 Vascular ProceduresAPC 5182 | 56 | 56 | $6,293 | $1,123 | $1,204 |
| Level 6 Urology and Related ServicesAPC 5376 | 50 | 50 | $29,207 | $6,566 | $7,291 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 49 | 48 | $45,708 | $14,646 | $15,763 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 46 | 46 | $28,288 | $7,865 | $8,569 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 44 | 44 | $20,779 | $5,966 | $6,514 |
| Level 6 Gynecologic ProceduresAPC 5416 | 42 | 42 | $23,144 | $5,358 | $5,836 |
| Level 4 Endovascular ProceduresAPC 5194 | 36 | 35 | $59,161 | $13,597 | $14,606 |
| Complex GI ProceduresAPC 5331 | 29 | 22 | $15,754 | $4,041 | $4,263 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 28 | 28 | $78,970 | $26,576 | $29,375 |
| Level 4 ENT ProceduresAPC 5164 | 24 | 24 | $13,550 | $2,282 | $2,217 |
| Level 3 Upper GI ProceduresAPC 5303 | 23 | 23 | $12,309 | $2,716 | $2,888 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 20 | 20 | $53,955 | $15,671 | $17,052 |
| Level 3 Airway EndoscopyAPC 5153 | 16 | 16 | $6,275 | $1,129 | $1,264 |
| Level 2 Intraocular ProceduresAPC 5492 | 16 | 12 | $19,464 | $2,883 | $3,116 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 13 | 13 | $71,981 | $23,929 | $26,719 |
| Level 3 Intraocular ProceduresAPC 5493 | 12 | $12,772 | $3,706 | $4,004 |
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.