Mercyone Des Moines Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Mercyone Des Moines Medical Center, Des Moines, IA in 2024, from traditional Medicare claims. Back to the Mercyone Des Moines Medical Center profile, with quality ratings, finances and negotiated rates.
5,130
Medicare inpatient discharges
In 142 published DRGs
2.30
Case mix index
IPPS FY 2027
35%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
5,308
Medicare outpatient services
In 46 service groups
Inpatient stays by major diagnostic category
Circulatory system1,558 discharges in 36 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 241 | $53,687 | $7,988 | $11,221 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 169 | $78,695 | $20,415 | $16,447 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 101 | $142,690 | $31,058 | $29,822 | 4.88 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 82 | $96,030 | $10,694 | $20,070 | 1.82 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 64 | $195,506 | $35,837 | $40,861 | 5.88 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 63 | $272,872 | $51,451 | $57,030 | 7.71 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 55 | $73,237 | $9,664 | $15,307 | 1.59 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 53 | $274,388 | $50,826 | $57,347 | 7.80 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 52 | $29,194 | $3,821 | $6,102 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 51 | $49,326 | $7,055 | $10,309 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 45 | $181,350 | $38,716 | $37,902 | 6.25 |
| Syncope and collapseMS-DRG 312, medical | 45 | $44,841 | $4,985 | $9,372 | 0.86 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 43 | $105,836 | $13,433 | $22,120 | 2.16 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 40 | $161,232 | $26,198 | $33,697 | 4.04 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 36 | $46,177 | $5,171 | $9,651 | 0.91 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 36 | $116,100 | $16,883 | $24,265 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 28 | $185,808 | $32,869 | $38,834 | 5.24 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 27 | $20,305 | $2,554 | $4,244 | 0.55 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 26 | $56,121 | $6,181 | $11,729 | 1.08 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 26 | $61,009 | $13,035 | $12,751 | 2.09 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 24 | $80,640 | $14,152 | $16,854 | 2.28 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 24 | $96,751 | $25,772 | $20,221 | 4.16 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 23 | $207,183 | $32,971 | $43,301 | 5.06 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 22 | $134,965 | $24,978 | $28,208 | 3.46 |
| Other vascular procedures with CCMS-DRG 253, surgical | 21 | $115,861 | $15,170 | $24,215 | 2.55 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 21 | $42,700 | $3,639 | $8,924 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 20 | $50,952 | $5,798 | $10,649 | 0.97 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $62,041 | $6,129 | $12,967 | 1.07 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 14 | $113,981 | $20,432 | $23,822 | 3.18 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 221, surgical | 13 | $163,142 | $30,734 | $34,097 | 4.65 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 13 | $69,184 | $11,028 | $14,459 | 1.83 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 13 | $189,095 | $26,115 | $39,521 | 3.35 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 13 | $69,903 | $9,893 | $14,610 | 1.74 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $102,335 | $18,903 | $21,388 | 3.46 |
| Other major cardiovascular procedures without cc/mccMS-DRG 272, surgical | 13 | $115,055 | $14,330 | $24,047 | 2.44 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 11 | $327,895 | $51,973 | $68,530 | 9.71 |
Infectious and parasitic diseases732 discharges in 5 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 | 529 | $75,365 | $12,073 | $15,751 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 88 | $194,653 | $32,317 | $40,682 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 68 | $46,913 | $6,061 | $9,805 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 26 | $70,914 | $11,669 | $14,821 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 21 | $295,072 | $49,122 | $61,670 | 6.96 |
Respiratory system606 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 | 114 | $50,306 | $7,702 | $10,514 | 1.33 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 85 | $54,129 | $7,615 | $11,313 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 79 | $71,686 | $9,410 | $14,982 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 41 | $49,057 | $6,066 | $10,253 | 1.10 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 39 | $114,149 | $17,785 | $23,857 | 2.70 |
| Major chest procedures with MCCMS-DRG 163, surgical | 37 | $116,179 | $29,509 | $24,281 | 4.71 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 28 | $35,433 | $4,599 | $7,406 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 24 | $53,840 | $7,949 | $11,253 | 1.40 |
| Major chest trauma with CCMS-DRG 184, medical | 23 | $73,563 | $5,434 | $15,375 | 1.05 |
| Major chest trauma with MCCMS-DRG 183, medical | 20 | $85,220 | $9,726 | $17,811 | 1.57 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 19 | $68,009 | $10,236 | $14,214 | 1.88 |
| Pleural effusion with MCCMS-DRG 186, medical | 17 | $85,609 | $9,716 | $17,892 | 1.55 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 16 | $83,824 | $10,926 | $17,519 | 1.74 |
| Major chest procedures with CCMS-DRG 164, surgical | 14 | $81,745 | $14,926 | $17,085 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 14 | $38,818 | $5,523 | $8,113 | 0.99 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $42,681 | $4,460 | $8,920 | 0.82 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 12 | $119,047 | $26,692 | $24,881 | 4.06 |
| Pneumothorax with MCCMS-DRG 199, medical | 11 | $63,667 | $8,874 | $13,306 | 1.77 |
Nervous system555 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 101 | $77,001 | $11,941 | $16,093 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 88 | $51,450 | $5,306 | $10,753 | 1.02 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 39 | $48,808 | $6,792 | $10,201 | 1.14 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 35 | $132,315 | $34,114 | $27,654 | 5.67 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 34 | $46,149 | $6,047 | $9,645 | 1.03 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 29 | $186,244 | $29,095 | $38,925 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 26 | $78,097 | $9,832 | $16,322 | 1.79 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 24 | $41,294 | $4,461 | $8,630 | 0.80 |
| Seizures with MCCMS-DRG 100, medical | 23 | $58,570 | $12,141 | $12,241 | 1.98 |
| Extracranial procedures with CCMS-DRG 038, surgical | 21 | $51,566 | $9,006 | $10,777 | 1.60 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 21 | $43,463 | $3,423 | $9,084 | 0.69 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 17 | $60,971 | $8,007 | $12,743 | 1.36 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 17 | $48,556 | $7,805 | $10,148 | 1.32 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 16 | $82,454 | $13,442 | $17,233 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 14 | $91,080 | $22,473 | $19,036 | 3.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 14 | $94,269 | $16,437 | $19,702 | 2.39 |
| Seizures without MCCMS-DRG 101, medical | 13 | $44,202 | $5,468 | $9,238 | 0.91 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 12 | $39,456 | $4,541 | $8,246 | 0.89 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 11 | $60,177 | $8,549 | $12,577 | 1.47 |
Musculoskeletal system and connective tissue506 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 | 73 | $84,293 | $12,591 | $17,617 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 51 | $76,349 | $12,862 | $15,957 | 2.11 |
| Medical back problems without MCCMS-DRG 552, medical | 50 | $37,422 | $5,285 | $7,821 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 42 | $109,964 | $19,748 | $22,982 | 2.95 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 36 | $60,835 | $11,229 | $12,714 | 1.88 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 31 | $75,388 | $15,700 | $15,756 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 28 | $72,791 | $17,964 | $15,213 | 2.99 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 26 | $148,313 | $23,097 | $30,997 | 3.66 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 26 | $94,500 | $14,941 | $19,751 | 2.40 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 23 | $85,535 | $21,084 | $17,877 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 22 | $110,474 | $17,788 | $23,089 | 2.96 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 21 | $44,866 | $4,236 | $9,377 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 20 | $60,841 | $9,248 | $12,716 | 1.70 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 19 | $44,631 | $5,150 | $9,328 | 0.90 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 15 | $68,525 | $10,493 | $14,322 | 1.87 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 12 | $172,968 | $39,778 | $36,150 | 6.12 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $142,700 | $20,422 | $29,824 | 3.46 |
Digestive system436 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 73 | $51,357 | $5,785 | $10,734 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 55 | $38,856 | $4,146 | $8,121 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 45 | $79,546 | $11,316 | $16,625 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 31 | $75,239 | $14,291 | $15,725 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 30 | $51,242 | $6,905 | $10,710 | 1.28 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 29 | $59,418 | $8,835 | $12,418 | 1.67 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 27 | $219,463 | $30,489 | $45,868 | 4.52 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 23 | $32,831 | $4,301 | $6,862 | 0.80 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 18 | $64,930 | $10,889 | $13,570 | 1.75 |
| Digestive malignancy with MCCMS-DRG 374, medical | 18 | $77,470 | $11,618 | $16,191 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 17 | $41,300 | $6,400 | $8,632 | 1.04 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 17 | $68,742 | $8,087 | $14,367 | 1.45 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 17 | $22,681 | $2,862 | $4,740 | 0.56 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 13 | $33,301 | $5,416 | $6,960 | 0.94 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $45,067 | $7,112 | $9,419 | 1.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $224,021 | $35,898 | $46,820 | 5.08 |
Kidney and urinary tract239 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 64 | $38,059 | $4,210 | $7,954 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 47 | $63,769 | $8,698 | $13,328 | 1.50 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 42 | $44,859 | $6,595 | $9,376 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 37 | $76,700 | $10,255 | $16,030 | 1.65 |
| Renal failure with CCMS-DRG 683, medical | 36 | $41,715 | $4,576 | $8,718 | 0.90 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 13 | $53,661 | $6,575 | $11,215 | 1.35 |
Endocrine, nutritional and metabolic122 discharges in 4 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 | 56 | $64,552 | $8,428 | $13,491 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 33 | $40,105 | $4,251 | $8,382 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 17 | $45,986 | $4,923 | $9,611 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 16 | $52,525 | $8,785 | $10,978 | 1.45 |
Skin, subcutaneous tissue and breast85 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 44 | $33,013 | $4,978 | $6,900 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 25 | $37,603 | $4,860 | $7,859 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 16 | $51,071 | $8,136 | $10,674 | 1.49 |
Liver, gallbladder and pancreas72 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 24 | $81,243 | $9,953 | $16,980 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $66,846 | $9,371 | $13,971 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 12 | $69,570 | $6,412 | $14,540 | 1.09 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 11 | $73,478 | $9,714 | $15,357 | 1.67 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 11 | $61,116 | $3,877 | $12,773 | 0.80 |
Blood and immune system54 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 | 21 | $62,535 | $8,336 | $13,070 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 18 | $47,720 | $4,983 | $9,973 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 15 | $74,679 | $9,822 | $15,608 | 1.56 |
Blood cancers and poorly differentiated neoplasms49 discharges in 2 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 | 36 | $36,964 | $7,302 | $7,726 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 13 | $141,219 | $19,095 | $29,515 | 3.13 |
Other33 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 | 21 | $234,295 | $27,822 | $48,968 | 4.74 |
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 12 | $125,415 | $41,244 | $26,212 |
Factors influencing health status16 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 | 16 | $36,633 | $4,167 | $7,656 | 0.80 |
Transplants, ECMO and tracheostomy (pre-MDC)15 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 | 15 | $585,398 | $131,281 | $122,348 | 21.32 |
Alcohol and drug use15 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 | 15 | $36,513 | $5,019 | $7,631 | 0.86 |
Mental diseases and disorders13 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 | 13 | $58,521 | $9,802 | $12,231 | 1.76 |
Injuries, poisonings and toxic effects of drugs12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 12 | $76,241 | $10,686 | $15,934 | 1.82 |
Multiple significant trauma12 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 | 12 | $132,859 | $21,799 | $27,767 | 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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 701 | 649 | $26,390 | $1,839 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 499 | 477 | $47,350 | $9,536 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 408 | 408 | $24,124 | $1,978 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 303 | 300 | $82,511 | $18,388 | $21,117 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 249 | 239 | $10,086 | $1,091 | $1,220 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 195 | 189 | $118,786 | $14,071 | $15,763 |
| Level 3 Vascular ProceduresAPC 5183 | 193 | 176 | $19,778 | $2,159 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 186 | 171 | $25,925 | $3,447 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 176 | 137 | $25,052 | $2,349 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 171 | 164 | $30,808 | $3,841 | $4,358 |
| Level 1 Nerve ProceduresAPC 5431 | 153 | 98 | $16,340 | $1,310 | $1,407 |
| Level 2 Upper GI ProceduresAPC 5302 | 151 | 135 | $18,263 | $1,290 | $1,445 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 142 | 140 | $38,321 | $4,842 | $5,339 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 137 | 137 | $46,938 | $7,496 | $8,569 |
| Level 3 Endovascular ProceduresAPC 5193 | 125 | 117 | $56,319 | $7,711 | $8,874 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 123 | 112 | $21,148 | $1,884 | $2,141 |
| Level 5 Airway EndoscopyAPC 5155 | 113 | 112 | $48,951 | $4,582 | $5,183 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 88 | 86 | $44,009 | $4,393 | $4,982 |
| Level 4 Endovascular ProceduresAPC 5194 | 88 | 87 | $70,594 | $13,340 | $14,606 |
| Level 3 Urology and Related ServicesAPC 5373 | 88 | 50 | $12,075 | $1,386 | $1,516 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 87 | 70 | $17,730 | $2,303 | $2,636 |
| Level 2 Endovascular ProceduresAPC 5192 | 83 | 62 | $32,200 | $3,797 | $4,338 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 75 | 74 | $58,040 | $7,168 | $8,164 |
| Level 5 ENT ProceduresAPC 5165 | 74 | 72 | $31,216 | $3,907 | $4,436 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 68 | 68 | $33,020 | $5,788 | $6,514 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 67 | 62 | $28,092 | $2,559 | $2,930 |
| Level 2 Vascular ProceduresAPC 5182 | 62 | 59 | $7,143 | $1,056 | $1,204 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 60 | 60 | $96,562 | $25,107 | $29,375 |
| Level 4 Vascular ProceduresAPC 5184 | 59 | 51 | $14,311 | $3,682 | $3,946 |
| Level 4 Airway EndoscopyAPC 5154 | 56 | 54 | $21,120 | $2,507 | $2,833 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 52 | 49 | $13,536 | $1,957 | $2,373 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 34 | 34 | $66,475 | $15,001 | $17,052 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 27 | 25 | $11,905 | $1,095 | $1,196 |
| Level 3 Upper GI ProceduresAPC 5303 | 24 | 24 | $25,783 | $2,602 | $2,888 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 20 | 20 | $76,740 | $17,037 | $18,465 |
| Level 3 ENT ProceduresAPC 5163 | 19 | 19 | $11,120 | $930 | $1,106 |
| Level 5 Gynecologic ProceduresAPC 5415 | 19 | 19 | $35,779 | $3,390 | $3,792 |
| Level 4 Gynecologic ProceduresAPC 5414 | 18 | 18 | $17,131 | $2,131 | $2,389 |
| Cochlear Implant ProcedureAPC 5166 | 17 | 17 | $105,676 | $26,968 | $29,489 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 17 | 17 | $96,504 | $18,482 | $21,011 |
| Level 3 Lower GI ProceduresAPC 5313 | 17 | 16 | $16,992 | $1,914 | $2,176 |
| Level 3 Airway EndoscopyAPC 5153 | 14 | 13 | $12,644 | $1,157 | $1,264 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $18,132 | $2,194 | $2,217 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 13 | 13 | $152,699 | $23,159 | $26,955 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 12 | 12 | $96,462 | $24,257 | $26,719 |
| Level 6 Gynecologic ProceduresAPC 5416 | 11 | 11 | $50,756 | $5,150 | $5,836 |
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.