Methodist Hospital Northeast Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Methodist Hospital Northeast, San Antonio, TX in 2024, from traditional Medicare claims. Back to the Methodist Hospital Northeast profile, with quality ratings, finances and negotiated rates.
17,711
Medicare inpatient discharges
In 279 published DRGs
2.11
Case mix index
IPPS FY 2027
25%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
6,106
Medicare outpatient services
In 49 service groups
Inpatient stays by major diagnostic category
Circulatory system4,561 discharges in 55 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 831 | $96,092 | $8,500 | $8,937 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 437 | $334,085 | $19,827 | $31,070 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 239 | $132,822 | $10,441 | $12,352 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 188 | $59,503 | $4,838 | $5,534 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 173 | $68,229 | $5,552 | $6,345 | 0.86 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 164 | $191,952 | $11,624 | $17,852 | 1.82 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 155 | $202,411 | $13,731 | $18,824 | 2.16 |
| Hypertension without MCCMS-DRG 305, medical | 151 | $65,919 | $4,793 | $6,130 | 0.75 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 148 | $650,003 | $43,118 | $60,450 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 147 | $114,428 | $6,445 | $10,642 | 1.08 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 139 | $43,436 | $3,442 | $4,040 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 123 | $254,731 | $17,918 | $23,690 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 98 | $146,352 | $13,545 | $13,611 | 2.09 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 92 | $89,737 | $8,224 | $8,346 | 1.20 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 82 | $619,624 | $32,089 | $57,625 | 4.88 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 77 | $88,243 | $5,455 | $8,207 | 0.91 |
| Chest painMS-DRG 313, medical | 72 | $59,293 | $4,290 | $5,514 | 0.72 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 69 | $159,478 | $14,695 | $14,831 | 2.28 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 69 | $470,634 | $36,233 | $43,769 | 5.06 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 68 | $251,487 | $21,671 | $23,388 | 3.46 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 68 | $67,052 | $6,749 | $6,236 | 1.07 |
| Hypertension with MCCMS-DRG 304, medical | 61 | $89,119 | $7,452 | $8,288 | 1.15 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 59 | $250,618 | $21,986 | $23,307 | 3.35 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 52 | $131,700 | $10,030 | $12,248 | 1.58 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 46 | $137,120 | $11,849 | $12,752 | 1.83 |
| Other vascular procedures with CCMS-DRG 253, surgical | 43 | $199,658 | $16,165 | $18,568 | 2.55 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 43 | $423,107 | $27,843 | $39,349 | 3.90 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 39 | $570,617 | $35,024 | $53,067 | 5.24 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 39 | $554,324 | $42,279 | $51,552 | 7.80 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 37 | $712,905 | $54,706 | $66,300 | 7.71 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 36 | $79,042 | $5,750 | $7,351 | 0.97 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 34 | $328,384 | $24,151 | $30,540 | 4.04 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 34 | $298,675 | $27,931 | $27,777 | 4.81 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 34 | $385,438 | $27,761 | $35,846 | 4.14 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 32 | $275,830 | $23,349 | $25,652 | 3.46 |
| Atherosclerosis without MCCMS-DRG 303, medical | 32 | $53,368 | $3,750 | $4,963 | 0.66 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 31 | $70,659 | $4,473 | $6,571 | 0.72 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 27 | $347,998 | $23,586 | $32,364 | 3.18 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 27 | $178,421 | $12,907 | $16,593 | 1.97 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 25 | $403,444 | $35,801 | $37,520 | 5.88 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 25 | $210,612 | $17,715 | $19,587 | 2.81 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 22 | $289,920 | $18,572 | $26,963 | 2.97 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 20 | $481,477 | $29,628 | $44,777 | 5.20 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 20 | $113,873 | $11,386 | $10,590 | 1.74 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 18 | $251,068 | $17,707 | $23,349 | 3.27 |
| Other heart assist system implantMS-DRG 215, surgical | 17 | $799,716 | $69,605 | $74,374 | 10.21 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 17 | $860,091 | $56,655 | $79,988 | 9.71 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 15 | $507,296 | $47,372 | $47,178 | 7.04 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 14 | $321,439 | $29,217 | $29,894 | 4.78 |
| Peripheral vascular disorders without cc/mccMS-DRG 301, medical | 14 | $38,468 | $4,312 | $3,577 | 0.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 13 | $339,947 | $25,824 | $31,615 | 4.16 |
| Cardiac congenital and valvular disorders without MCCMS-DRG 307, medical | 12 | $81,553 | $5,341 | $7,584 | 0.94 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 11 | $410,543 | $34,320 | $38,180 | 5.04 |
| Cardiac pacemaker revision except device replacement with CCMS-DRG 261, surgical | 11 | $114,163 | $12,652 | $10,617 | 1.88 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 11 | $567,792 | $52,514 | $52,805 | 6.85 |
Infectious and parasitic diseases2,445 discharges in 10 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 | 1,615 | $141,255 | $12,319 | $13,137 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 350 | $71,454 | $6,466 | $6,645 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 205 | $367,558 | $31,363 | $34,183 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 106 | $535,293 | $40,546 | $49,782 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 56 | $169,588 | $12,857 | $15,772 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 40 | $102,677 | $11,614 | $9,549 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 26 | $42,909 | $6,694 | $3,991 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 17 | $398,729 | $27,373 | $37,082 | 4.43 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 16 | $61,091 | $5,964 | $5,681 | 0.88 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $150,221 | $13,537 | $13,971 | 2.14 |
Digestive system1,715 discharges in 32 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 | 261 | $57,200 | $4,698 | $5,320 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 165 | $120,978 | $11,569 | $11,251 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 120 | $64,395 | $6,305 | $5,989 | 0.98 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 119 | $60,974 | $5,240 | $5,671 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 109 | $230,202 | $26,989 | $21,409 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 100 | $65,301 | $5,975 | $6,073 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 93 | $132,430 | $13,817 | $12,316 | 2.37 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 67 | $102,117 | $10,627 | $9,497 | 1.62 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 65 | $100,911 | $9,541 | $9,385 | 1.45 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 61 | $89,375 | $8,493 | $8,312 | 1.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 58 | $43,677 | $3,417 | $4,062 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 50 | $74,315 | $6,533 | $6,911 | 1.04 |
| Digestive malignancy with CCMS-DRG 375, medical | 44 | $75,993 | $7,556 | $7,067 | 1.20 |
| Digestive malignancy with MCCMS-DRG 374, medical | 39 | $116,572 | $12,841 | $10,841 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 35 | $115,188 | $10,938 | $10,712 | 1.75 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 29 | $138,830 | $13,970 | $12,911 | 2.50 |
| Appendix procedures with CCMS-DRG 398, surgical | 26 | $89,136 | $9,428 | $8,290 | 1.51 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 25 | $286,773 | $28,664 | $26,670 | 5.08 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 23 | $72,128 | $6,389 | $6,708 | 1.07 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 22 | $92,886 | $11,025 | $8,638 | 1.67 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 21 | $364,979 | $31,416 | $33,943 | 4.28 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 20 | $41,084 | $3,942 | $3,821 | 0.63 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 19 | $97,400 | $10,190 | $9,058 | 1.60 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 19 | $180,367 | $14,435 | $16,774 | 2.20 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 19 | $46,403 | $3,754 | $4,315 | 0.65 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 18 | $156,543 | $12,974 | $14,559 | 2.11 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 18 | $83,875 | $12,991 | $7,800 | 1.95 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 17 | $99,758 | $9,247 | $9,277 | 1.72 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 17 | $63,192 | $6,186 | $5,877 | 0.97 |
| Major esophageal disorders with MCCMS-DRG 368, medical | 14 | $78,342 | $11,354 | $7,286 | 1.65 |
| Inguinal and femoral hernia procedures with CCMS-DRG 351, surgical | 11 | $83,565 | $9,941 | $7,772 | 1.46 |
| Appendix procedures without cc/mccMS-DRG 399, surgical | 11 | $65,715 | $6,492 | $6,111 | 1.11 |
Kidney and urinary tract1,636 discharges in 18 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 | 329 | $110,749 | $10,603 | $10,300 | 1.65 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 229 | $69,075 | $6,858 | $6,424 | 1.02 |
| Renal failure with MCCMS-DRG 682, medical | 220 | $102,304 | $9,459 | $9,514 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 216 | $57,776 | $5,842 | $5,373 | 0.90 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 178 | $52,991 | $5,051 | $4,928 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 116 | $72,347 | $7,220 | $6,728 | 1.17 |
| Kidney transplantMS-DRG 652, surgical | 59 | $602,478 | $18,614 | $56,030 | 3.00 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 54 | $249,479 | $23,493 | $23,202 | 3.70 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 37 | $62,631 | $6,235 | $5,825 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 36 | $81,187 | $7,525 | $7,550 | 1.35 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 32 | $138,556 | $14,438 | $12,886 | 2.38 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 29 | $726,925 | $31,556 | $67,604 | 4.50 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 24 | $295,790 | $23,546 | $27,508 | 2.59 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 19 | $63,249 | $9,844 | $5,882 | 1.48 |
| Renal failure without cc/mccMS-DRG 684, medical | 19 | $44,235 | $4,039 | $4,114 | 0.61 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 14 | $115,332 | $10,368 | $10,726 | 1.84 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 14 | $41,735 | $5,198 | $3,881 | 0.69 |
| Transurethral procedures with CCMS-DRG 669, surgical | 11 | $93,723 | $10,775 | $8,716 | 1.53 |
Respiratory system1,566 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 314 | $103,634 | $8,419 | $9,638 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 228 | $120,875 | $10,762 | $11,241 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 157 | $110,331 | $8,074 | $10,261 | 1.23 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 134 | $253,849 | $18,168 | $23,608 | 2.70 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 75 | $66,780 | $4,974 | $6,211 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 51 | $141,092 | $11,262 | $13,122 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 50 | $281,083 | $28,611 | $26,141 | 4.71 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 49 | $116,587 | $11,669 | $10,843 | 1.90 |
| Major chest procedures with CCMS-DRG 164, surgical | 45 | $166,324 | $16,036 | $15,468 | 2.55 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 45 | $129,115 | $9,064 | $12,008 | 1.40 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 42 | $73,174 | $5,976 | $6,805 | 0.96 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 38 | $63,884 | $5,396 | $5,941 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 38 | $69,585 | $6,404 | $6,471 | 0.99 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 38 | $125,851 | $11,441 | $11,704 | 1.81 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 33 | $469,176 | $34,568 | $43,633 | 6.91 |
| Major chest trauma with CCMS-DRG 184, medical | 26 | $70,601 | $6,551 | $6,566 | 1.05 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 23 | $90,955 | $6,307 | $8,459 | 0.91 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 22 | $185,815 | $24,222 | $17,281 | 4.06 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 21 | $50,998 | $3,539 | $4,743 | 0.63 |
| Pneumothorax with MCCMS-DRG 199, medical | 21 | $123,605 | $12,071 | $11,495 | 1.77 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 20 | $95,249 | $7,036 | $8,858 | 1.10 |
| Pleural effusion with MCCMS-DRG 186, medical | 19 | $107,811 | $10,018 | $10,026 | 1.55 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 19 | $64,422 | $5,929 | $5,991 | 0.85 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 16 | $75,396 | $6,808 | $7,012 | 1.10 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 15 | $137,674 | $11,709 | $12,804 | 1.88 |
| Respiratory signs and symptomsMS-DRG 204, medical | 14 | $62,476 | $4,839 | $5,810 | 0.82 |
| Major chest trauma with MCCMS-DRG 183, medical | 13 | $106,857 | $10,461 | $9,938 | 1.57 |
Nervous system1,561 discharges in 32 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 216 | $163,803 | $12,605 | $15,234 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 167 | $95,091 | $6,326 | $8,843 | 1.02 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 155 | $80,057 | $5,137 | $7,445 | 0.80 |
| Seizures without MCCMS-DRG 101, medical | 140 | $77,079 | $5,869 | $7,168 | 0.91 |
| Seizures with MCCMS-DRG 100, medical | 125 | $136,716 | $13,073 | $12,715 | 1.98 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 63 | $78,428 | $6,845 | $7,294 | 1.03 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 61 | $82,297 | $7,944 | $7,654 | 1.36 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 56 | $80,961 | $6,194 | $7,529 | 1.03 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 46 | $101,112 | $11,211 | $9,403 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 44 | $81,178 | $6,552 | $7,550 | 1.06 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 39 | $341,919 | $28,165 | $31,799 | 4.42 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 37 | $79,901 | $4,291 | $7,431 | 0.69 |
| Headaches without MCCMS-DRG 103, medical | 37 | $72,102 | $5,008 | $6,705 | 0.84 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 27 | $147,203 | $11,397 | $13,690 | 1.87 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 26 | $82,533 | $5,544 | $7,676 | 0.87 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 25 | $490,373 | $34,783 | $45,605 | 5.67 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 25 | $69,242 | $7,436 | $6,440 | 1.14 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 24 | $89,987 | $8,253 | $8,369 | 1.32 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 23 | $88,317 | $10,046 | $8,213 | 1.47 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 22 | $91,969 | $8,391 | $8,553 | 1.36 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 21 | $185,530 | $14,222 | $17,254 | 2.30 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 21 | $185,291 | $12,661 | $17,232 | 2.39 |
| Extracranial procedures with CCMS-DRG 038, surgical | 18 | $115,037 | $10,107 | $10,698 | 1.60 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 18 | $114,487 | $11,191 | $10,647 | 1.79 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 18 | $118,288 | $10,177 | $11,001 | 1.51 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 18 | $71,941 | $5,072 | $6,690 | 0.77 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 17 | $165,431 | $14,644 | $15,385 | 2.28 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 16 | $561,500 | $20,121 | $52,219 | 3.79 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 16 | $179,578 | $15,206 | $16,701 | 2.27 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 15 | $58,790 | $5,949 | $5,467 | 0.89 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 14 | $207,322 | $18,400 | $19,281 | 2.80 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 11 | $141,945 | $10,715 | $13,201 | 1.81 |
Musculoskeletal system and connective tissue1,229 discharges in 36 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 162 | $146,742 | $11,904 | $13,647 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 135 | $66,988 | $6,158 | $6,230 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 103 | $143,985 | $12,950 | $13,391 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 86 | $154,391 | $13,195 | $14,358 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 47 | $57,187 | $5,505 | $5,318 | 0.90 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 46 | $44,683 | $5,029 | $4,156 | 0.79 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 45 | $136,882 | $14,460 | $12,730 | 2.40 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 43 | $180,212 | $19,030 | $16,760 | 2.95 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 41 | $236,935 | $21,694 | $22,035 | 3.49 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 40 | $121,046 | $10,092 | $11,257 | 1.59 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 29 | $117,401 | $13,220 | $10,918 | 2.04 |
| Medical back problems with MCCMS-DRG 551, medical | 28 | $120,420 | $10,986 | $11,199 | 1.70 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 26 | $198,435 | $16,799 | $18,454 | 2.48 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 26 | $207,130 | $17,957 | $19,263 | 2.99 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 23 | $48,597 | $5,648 | $4,519 | 0.82 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 23 | $104,969 | $10,398 | $9,762 | 1.56 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 21 | $64,437 | $6,300 | $5,993 | 1.00 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 20 | $181,964 | $16,869 | $16,923 | 2.67 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 20 | $190,432 | $17,157 | $17,710 | 2.49 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 19 | $230,345 | $21,108 | $21,422 | 3.33 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 19 | $202,419 | $16,486 | $18,825 | 2.38 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 18 | $186,754 | $15,862 | $17,368 | 3.00 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 18 | $123,813 | $11,447 | $11,515 | 1.87 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 18 | $84,300 | $6,181 | $7,840 | 1.09 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 17 | $114,593 | $8,582 | $10,657 | 1.82 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 16 | $101,517 | $9,899 | $9,441 | 1.56 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 16 | $137,060 | $9,146 | $12,747 | 1.52 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 15 | $197,241 | $15,735 | $18,343 | 2.96 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 15 | $110,357 | $9,199 | $10,263 | 1.49 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 15 | $54,443 | $5,402 | $5,063 | 0.88 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 14 | $538,086 | $42,262 | $50,042 | 6.08 |
| Amputation for musculoskeletal system and connective tissue disorders with MCCMS-DRG 474, surgical | 14 | $227,884 | $24,827 | $21,193 | 4.30 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 14 | $203,678 | $21,167 | $18,942 | 3.16 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 14 | $52,716 | $5,444 | $4,903 | 0.82 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 12 | $284,049 | $30,202 | $26,417 | 5.66 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 11 | $265,563 | $24,274 | $24,697 | 3.46 |
Endocrine, nutritional and metabolic758 discharges in 11 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 | 269 | $90,447 | $8,559 | $8,412 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 149 | $57,551 | $5,064 | $5,352 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 84 | $55,797 | $5,687 | $5,189 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 73 | $84,808 | $9,044 | $7,887 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 44 | $161,917 | $12,923 | $15,058 | 1.98 |
| Endocrine disorders with MCCMS-DRG 643, medical | 41 | $110,084 | $10,359 | $10,238 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 37 | $67,694 | $7,009 | $6,296 | 1.06 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 16 | $187,189 | $10,565 | $17,409 | 1.86 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 16 | $153,475 | $14,272 | $14,273 | 2.26 |
| Diabetes without cc/mccMS-DRG 639, medical | 15 | $47,768 | $3,880 | $4,442 | 0.62 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 14 | $99,020 | $9,725 | $9,209 | 1.52 |
Liver, gallbladder and pancreas727 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 104 | $121,503 | $12,870 | $11,300 | 1.92 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 65 | $90,748 | $6,628 | $8,440 | 1.03 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 62 | $115,844 | $11,346 | $10,773 | 1.83 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 59 | $122,215 | $11,792 | $11,366 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 57 | $77,814 | $7,252 | $7,237 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 55 | $104,303 | $10,057 | $9,700 | 1.63 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 48 | $66,259 | $5,950 | $6,162 | 0.95 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 46 | $109,921 | $10,189 | $10,223 | 1.63 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 45 | $165,472 | $16,733 | $15,389 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 45 | $151,640 | $13,285 | $14,102 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 38 | $86,089 | $6,620 | $8,006 | 1.31 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 26 | $86,482 | $7,206 | $8,043 | 1.10 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 22 | $139,508 | $10,536 | $12,974 | 1.67 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 21 | $56,520 | $4,941 | $5,256 | 0.80 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 19 | $76,180 | $4,750 | $7,085 | 0.86 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 15 | $426,809 | $34,553 | $39,693 | 5.51 |
Blood and immune system356 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 117 | $79,833 | $9,474 | $7,424 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 83 | $57,005 | $5,781 | $5,301 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 66 | $174,138 | $14,793 | $16,195 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 49 | $67,931 | $7,754 | $6,318 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 41 | $103,033 | $11,253 | $9,582 | 1.56 |
Injuries, poisonings and toxic effects of drugs212 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 77 | $133,646 | $13,543 | $12,429 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 40 | $67,200 | $6,773 | $6,250 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 31 | $90,954 | $9,985 | $8,459 | 1.60 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 27 | $316,549 | $23,831 | $29,439 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 23 | $159,191 | $12,942 | $14,805 | 2.00 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 14 | $35,181 | $5,451 | $3,272 | 0.86 |
Mental diseases and disorders207 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 101 | $52,929 | $9,100 | $4,922 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 84 | $76,386 | $11,002 | $7,104 | 1.76 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 22 | $58,359 | $6,471 | $5,427 | 0.95 |
Skin, subcutaneous tissue and breast204 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 83 | $46,041 | $5,451 | $4,282 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 43 | $100,436 | $9,736 | $9,341 | 1.49 |
| Other skin, subcutaneous tissue and breast procedures without cc/mccMS-DRG 581, surgical | 31 | $123,371 | $7,134 | $11,474 | 1.35 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 29 | $153,451 | $10,698 | $14,271 | 1.75 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 18 | $54,680 | $6,292 | $5,085 | 0.91 |
Blood cancers and poorly differentiated neoplasms117 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute leukemia with MCCMS-DRG 834, medical | 32 | $462,195 | $35,981 | $42,984 | 5.60 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 28 | $313,651 | $22,769 | $29,170 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 20 | $136,347 | $10,606 | $12,680 | 1.57 |
| Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wiMS-DRG 829, surgical | 14 | $335,059 | $23,913 | $31,161 | 3.15 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 12 | $107,768 | $8,698 | $10,022 | 1.21 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 11 | $477,362 | $32,241 | $44,395 | 4.84 |
Transplants, ECMO and tracheostomy (pre-MDC)114 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 41 | $900,669 | $68,981 | $83,762 | 14.70 |
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 33 | $1,447,914 | $124,179 | $134,656 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 22 | $2,545,241 | $159,386 | $236,707 | 27.10 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 18 | $330,797 | $36,507 | $30,764 | 6.18 |
Ear, nose, mouth and throat102 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 75 | $65,556 | $4,529 | $6,097 | 0.74 |
| Epistaxis without MCCMS-DRG 151, medical | 15 | $43,784 | $4,557 | $4,072 | 0.77 |
| Otitis media and uri without MCCMS-DRG 153, medical | 12 | $49,639 | $4,925 | $4,616 | 0.73 |
Other60 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Concomitant left atrial appendage closure and cardiac ablationMS-DRG 317 | 44 | $601,123 | $42,741 | $55,904 | |
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 16 | $333,622 | $32,767 | $31,027 | 4.74 |
Factors influencing health status55 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 21 | $44,637 | $5,010 | $4,151 | 0.80 |
| Rehabilitation with cc/mccMS-DRG 945, medical | 20 | $80,998 | $8,904 | $7,533 | 1.51 |
| Signs and symptoms with MCCMS-DRG 947, medical | 14 | $82,323 | $8,004 | $7,656 | 1.25 |
Alcohol and drug use50 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 25 | $78,900 | $11,779 | $7,338 | 1.78 |
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 25 | $67,556 | $5,685 | $6,283 | 0.86 |
Female reproductive system25 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 14 | $100,091 | $12,812 | $9,308 | 1.85 |
| Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with CCMS-DRG 740, surgical | 11 | $108,929 | $8,701 | $10,130 | 1.79 |
Male reproductive system11 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Inflammation of the male reproductive system without MCCMS-DRG 728, medical | 11 | $44,257 | $4,313 | $4,116 | 0.80 |
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 1 Endovascular ProceduresAPC 5191 | 712 | 708 | $56,622 | $2,008 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 369 | 363 | $264,805 | $18,819 | $21,117 |
| Level 3 Endovascular ProceduresAPC 5193 | 344 | 327 | $130,489 | $7,766 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 332 | 329 | $43,229 | $3,985 | $4,358 |
| Comprehensive Observation ServicesAPC 8011 | 313 | 307 | $37,035 | $1,878 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 288 | 283 | $129,574 | $9,677 | $10,772 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 268 | 267 | $82,028 | $7,359 | $8,569 |
| Level 3 Vascular ProceduresAPC 5183 | 254 | 192 | $42,760 | $2,130 | $2,405 |
| Level 2 Upper GI ProceduresAPC 5302 | 247 | 221 | $13,207 | $1,293 | $1,445 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 221 | 219 | $59,484 | $7,205 | $8,164 |
| Level 3 Urology and Related ServicesAPC 5373 | 212 | 172 | $13,855 | $1,386 | $1,516 |
| Level 2 Endovascular ProceduresAPC 5192 | 203 | 201 | $75,156 | $3,894 | $4,338 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 192 | 188 | $23,767 | $1,115 | $1,220 |
| Level 5 Urology and Related ServicesAPC 5375 | 176 | 172 | $37,227 | $3,555 | $3,918 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 140 | 127 | $35,611 | $1,942 | $2,141 |
| Level 4 Endovascular ProceduresAPC 5194 | 130 | 123 | $185,415 | $13,353 | $14,606 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 107 | 106 | $79,493 | $5,829 | $6,514 |
| Level 5 Airway EndoscopyAPC 5155 | 92 | 92 | $53,954 | $4,732 | $5,183 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 92 | 91 | $210,830 | $24,365 | $29,375 |
| Level 4 Airway EndoscopyAPC 5154 | 89 | 87 | $41,582 | $2,589 | $2,833 |
| Level 4 Urology and Related ServicesAPC 5374 | 89 | 77 | $31,437 | $2,410 | $2,629 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 87 | 82 | $34,396 | $2,392 | $2,636 |
| Level 2 Urology and Related ServicesAPC 5372 | 74 | 73 | $22,501 | $454 | $502 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 72 | 71 | $49,283 | $4,508 | $4,982 |
| Level 4 Vascular ProceduresAPC 5184 | 69 | 67 | $49,970 | $3,744 | $3,946 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 67 | 64 | $165,835 | $14,505 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 65 | 59 | $25,589 | $1,152 | $1,264 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 64 | 64 | $78,025 | $4,791 | $5,339 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 60 | 59 | $18,086 | $1,099 | $1,196 |
| Complex GI ProceduresAPC 5331 | 58 | 50 | $45,235 | $3,940 | $4,263 |
| Level 5 ENT ProceduresAPC 5165 | 57 | 57 | $52,812 | $3,977 | $4,436 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 55 | 53 | $32,560 | $2,197 | $2,373 |
| Level 3 Upper GI ProceduresAPC 5303 | 55 | 54 | $24,783 | $2,644 | $2,888 |
| Level 6 Urology and Related ServicesAPC 5376 | 55 | 53 | $77,505 | $6,160 | $7,291 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 45 | 43 | $43,111 | $2,633 | $2,930 |
| Level 2 Intraocular ProceduresAPC 5492 | 41 | 38 | $45,067 | $2,811 | $3,116 |
| Level 2 Vascular ProceduresAPC 5182 | 40 | 40 | $15,516 | $1,102 | $1,204 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 40 | 40 | $143,674 | $14,744 | $17,052 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 30 | 30 | $142,029 | $18,739 | $21,011 |
| Level 5 Gynecologic ProceduresAPC 5415 | 28 | 26 | $45,558 | $3,439 | $3,792 |
| Level 3 Lower GI ProceduresAPC 5313 | 25 | 23 | $27,332 | $1,941 | $2,176 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 24 | 24 | $81,127 | $5,163 | $5,682 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 24 | 24 | $350,216 | $25,235 | $26,719 |
| Level 4 Gynecologic ProceduresAPC 5414 | 22 | 22 | $30,830 | $2,161 | $2,389 |
| Level 8 Urology and Related ServicesAPC 5378 | 20 | 20 | $145,933 | $14,236 | $17,428 |
| Level 1 Nerve ProceduresAPC 5431 | 17 | 15 | $36,245 | $1,256 | $1,407 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 15 | 15 | $151,076 | $6,547 | $7,546 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 14 | 14 | $326,691 | $17,304 | $18,465 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 13 | 13 | $101,788 | $23,517 | $26,955 |
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.