Michigan Medicine University Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Michigan Medicine University Hospital, Ann Arbor, MI in 2024, from traditional Medicare claims. Back to the Michigan Medicine University Hospital profile, with quality ratings, finances and negotiated rates.
6,691
Medicare inpatient discharges
In 201 published DRGs
2.59
Case mix index
IPPS FY 2027
32%
Surgical stays
65%
Stays with complications
In DRGs with a CC or MCC
14,384
Medicare outpatient services
In 58 service groups
Inpatient stays by major diagnostic category
Circulatory system1,700 discharges in 35 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 309 | $56,703 | $11,982 | $17,918 | 1.28 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 148 | $213,002 | $48,095 | $67,309 | 5.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 121 | $168,959 | $44,161 | $53,391 | 4.88 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 117 | $281,127 | $77,729 | $88,836 | 7.71 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 76 | $110,350 | $21,810 | $34,871 | 2.16 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 75 | $32,529 | $6,429 | $10,279 | 0.74 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 73 | $123,932 | $27,418 | $39,162 | 2.09 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 68 | $118,498 | $28,308 | $37,445 | 3.24 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 52 | $70,758 | $9,715 | $22,360 | 1.08 |
| Syncope and collapseMS-DRG 312, medical | 50 | $42,098 | $7,882 | $13,303 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 48 | $52,762 | $11,154 | $16,673 | 1.20 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 44 | $110,425 | $14,991 | $34,894 | 1.82 |
| Heart failure and shock with CCMS-DRG 292, medical | 38 | $37,112 | $6,986 | $11,727 | 0.86 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 35 | $42,135 | $7,720 | $13,315 | 0.97 |
| Other vascular procedures with CCMS-DRG 253, surgical | 34 | $138,686 | $28,046 | $43,825 | 2.55 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 33 | $250,666 | $63,573 | $79,211 | 6.25 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 30 | $100,617 | $16,780 | $31,795 | 1.59 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 28 | $174,870 | $40,857 | $55,259 | 3.35 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 25 | $174,538 | $37,692 | $55,154 | 4.04 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 23 | $168,562 | $30,691 | $53,265 | 3.46 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 22 | $284,758 | $63,313 | $89,984 | 5.06 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 22 | $24,659 | $4,261 | $7,792 | 0.55 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 21 | $186,374 | $42,855 | $58,894 | 4.16 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 20 | $247,333 | $43,013 | $78,157 | 4.78 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 19 | $40,272 | $8,051 | $12,726 | 0.91 |
| Hypertension without MCCMS-DRG 305, medical | 19 | $29,867 | $6,800 | $9,438 | 0.75 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 19 | $155,210 | $27,980 | $49,046 | 2.87 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 18 | $475,230 | $107,282 | $150,173 | 9.71 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 18 | $100,697 | $30,275 | $31,820 | 3.46 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 18 | $71,769 | $14,466 | $22,679 | 1.58 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 17 | $90,086 | $20,914 | $28,467 | 2.28 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 17 | $44,975 | $8,230 | $14,212 | 1.07 |
| Chest painMS-DRG 313, medical | 17 | $33,512 | $5,804 | $10,590 | 0.72 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $186,493 | $32,786 | $58,932 | 3.90 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 11 | $262,767 | $54,947 | $83,034 | 5.88 |
Digestive system819 discharges in 23 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 | 102 | $36,473 | $6,832 | $11,526 | 0.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 80 | $67,253 | $13,811 | $21,252 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 71 | $91,200 | $19,552 | $28,819 | 2.37 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 57 | $49,010 | $8,780 | $15,487 | 0.98 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 51 | $53,860 | $11,030 | $17,020 | 0.94 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 48 | $104,881 | $22,510 | $33,143 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 44 | $167,595 | $40,305 | $52,960 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 40 | $71,200 | $13,670 | $22,499 | 1.62 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 39 | $41,773 | $6,484 | $13,200 | 0.80 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 36 | $34,105 | $8,465 | $10,777 | 1.04 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 35 | $73,470 | $13,239 | $23,217 | 1.60 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 27 | $118,946 | $20,960 | $37,587 | 2.50 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 26 | $60,854 | $13,176 | $19,230 | 1.45 |
| Digestive malignancy with CCMS-DRG 375, medical | 21 | $40,971 | $10,988 | $12,947 | 1.20 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 20 | $61,235 | $14,336 | $19,350 | 1.75 |
| Digestive malignancy with MCCMS-DRG 374, medical | 19 | $76,312 | $18,745 | $24,114 | 2.10 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 18 | $25,760 | $4,797 | $8,140 | 0.56 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 17 | $314,829 | $40,891 | $99,486 | 5.08 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 16 | $47,715 | $12,238 | $15,078 | 1.67 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 15 | $215,861 | $42,037 | $68,212 | 4.28 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 14 | $49,808 | $7,607 | $15,739 | 0.97 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 12 | $81,367 | $14,561 | $25,712 | 1.72 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 11 | $91,515 | $18,054 | $28,919 | 2.20 |
Respiratory system703 discharges in 19 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 127 | $78,494 | $12,640 | $24,804 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 108 | $67,499 | $15,182 | $21,330 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 59 | $55,514 | $11,304 | $17,542 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 50 | $38,268 | $7,133 | $12,093 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 45 | $103,538 | $22,536 | $32,718 | 2.55 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 37 | $48,384 | $8,536 | $15,289 | 0.99 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 35 | $49,872 | $12,598 | $15,760 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 31 | $63,051 | $10,606 | $19,924 | 1.10 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 30 | $69,948 | $16,177 | $22,104 | 1.81 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 27 | $90,291 | $13,367 | $28,532 | 1.88 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 26 | $258,477 | $57,154 | $81,679 | 6.91 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 24 | $133,982 | $29,921 | $42,338 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 21 | $87,157 | $14,138 | $27,542 | 1.74 |
| Major chest procedures with MCCMS-DRG 163, surgical | 17 | $133,544 | $41,863 | $42,200 | 4.71 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 16 | $40,250 | $7,709 | $12,719 | 0.85 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 15 | $39,099 | $6,945 | $12,355 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 12 | $32,778 | $8,076 | $10,358 | 0.96 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $54,534 | $8,269 | $17,233 | 0.91 |
| Pleural effusion with MCCMS-DRG 186, medical | 11 | $52,469 | $10,133 | $16,580 | 1.55 |
Kidney and urinary tract654 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 91 | $38,095 | $8,585 | $12,038 | 1.02 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 84 | $58,112 | $14,245 | $18,363 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 69 | $35,846 | $7,260 | $11,327 | 0.81 |
| Kidney transplantMS-DRG 652, surgical | 59 | $237,370 | $26,746 | $75,009 | 3.00 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 58 | $44,420 | $10,254 | $14,037 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 49 | $32,584 | $7,382 | $10,297 | 0.90 |
| Major bladder procedures with CCMS-DRG 654, surgical | 39 | $133,221 | $25,328 | $42,098 | 2.74 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 39 | $83,511 | $16,281 | $26,389 | 1.84 |
| Renal failure with MCCMS-DRG 682, medical | 34 | $61,255 | $12,931 | $19,357 | 1.50 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 25 | $301,179 | $36,139 | $95,173 | 4.50 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 23 | $64,669 | $10,815 | $20,435 | 1.35 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 18 | $76,674 | $12,024 | $24,229 | 1.48 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 16 | $259,419 | $42,845 | $81,976 | 3.70 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 15 | $253,950 | $25,881 | $80,248 | 3.46 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 12 | $79,611 | $20,790 | $25,157 | 2.38 |
| Urinary stones without MCCMS-DRG 694, medical | 12 | $37,082 | $6,724 | $11,718 | 0.78 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 11 | $67,541 | $6,030 | $21,343 | 1.05 |
Infectious and parasitic diseases565 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 | 298 | $93,319 | $18,019 | $29,489 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 76 | $47,922 | $8,977 | $15,143 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 61 | $256,395 | $54,335 | $81,021 | 5.00 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 27 | $252,350 | $63,727 | $79,743 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 22 | $80,520 | $19,236 | $25,444 | 1.84 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 18 | $72,341 | $16,212 | $22,860 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 18 | $46,758 | $8,415 | $14,775 | 0.88 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 17 | $38,950 | $8,476 | $12,308 | 1.01 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 16 | $91,365 | $16,565 | $28,871 | 2.04 |
| Viral illness without MCCMS-DRG 866, medical | 12 | $28,388 | $7,368 | $8,971 | 0.92 |
Musculoskeletal system and connective tissue518 discharges in 25 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 46 | $39,076 | $8,017 | $12,348 | 0.97 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 44 | $127,354 | $27,540 | $40,244 | 2.96 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 42 | $90,447 | $17,466 | $28,581 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 37 | $122,725 | $28,447 | $38,781 | 3.49 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 30 | $86,185 | $16,225 | $27,235 | 1.88 |
| Connective tissue disorders with CCMS-DRG 546, medical | 29 | $52,996 | $10,773 | $16,747 | 1.20 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 23 | $157,537 | $30,558 | $49,782 | 3.66 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 21 | $280,820 | $61,493 | $88,739 | 6.12 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 20 | $45,172 | $10,182 | $14,274 | 1.09 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 18 | $81,280 | $19,713 | $25,684 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 18 | $32,835 | $7,751 | $10,376 | 0.90 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 17 | $31,920 | $5,707 | $10,087 | 0.82 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 16 | $108,941 | $25,314 | $34,425 | 3.00 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 16 | $148,660 | $35,752 | $46,977 | 2.49 |
| Medical back problems with MCCMS-DRG 551, medical | 15 | $68,107 | $17,063 | $21,522 | 1.70 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 15 | $35,985 | $7,783 | $11,371 | 0.82 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 14 | $283,638 | $54,410 | $89,630 | 6.08 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 14 | $101,679 | $18,277 | $32,131 | 1.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 13 | $109,117 | $23,153 | $34,481 | 2.48 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 13 | $84,313 | $14,531 | $26,643 | 1.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 12 | $95,199 | $26,504 | $30,083 | 2.95 |
| Osteomyelitis with MCCMS-DRG 539, medical | 12 | $57,335 | $17,200 | $18,118 | 1.98 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 11 | $101,990 | $20,392 | $32,229 | 2.38 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 11 | $68,455 | $18,665 | $21,632 | 2.04 |
| Connective tissue disorders without cc/mccMS-DRG 547, medical | 11 | $39,458 | $5,663 | $12,469 | 0.82 |
Nervous system483 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 49 | $48,343 | $8,565 | $15,276 | 1.02 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 39 | $55,398 | $10,938 | $17,506 | 1.36 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 38 | $192,237 | $41,951 | $60,747 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 35 | $98,506 | $21,602 | $31,128 | 2.00 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 30 | $132,644 | $19,631 | $41,916 | 2.43 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 30 | $46,618 | $9,752 | $14,731 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 30 | $48,189 | $6,775 | $15,228 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 28 | $81,547 | $14,797 | $25,769 | 1.79 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 25 | $42,251 | $7,563 | $13,351 | 1.03 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 23 | $66,828 | $12,009 | $21,118 | 1.47 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 21 | $214,646 | $50,412 | $67,828 | 5.67 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 20 | $147,986 | $24,114 | $46,763 | 2.95 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 18 | $76,059 | $17,721 | $24,035 | 1.79 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 16 | $71,767 | $15,850 | $22,678 | 2.39 |
| Headaches without MCCMS-DRG 103, medical | 16 | $39,794 | $6,481 | $12,575 | 0.84 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 15 | $177,311 | $36,656 | $56,030 | 3.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 14 | $44,060 | $9,649 | $13,923 | 1.06 |
| Seizures with MCCMS-DRG 100, medical | 14 | $95,485 | $23,862 | $30,173 | 1.98 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 11 | $70,817 | $17,064 | $22,378 | 1.87 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 11 | $38,126 | $4,372 | $12,048 | 0.69 |
Liver, gallbladder and pancreas258 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 42 | $78,542 | $17,402 | $24,819 | 1.83 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 38 | $64,282 | $10,173 | $20,313 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 33 | $86,045 | $16,865 | $27,190 | 1.76 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 27 | $42,247 | $8,108 | $13,350 | 0.95 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 26 | $80,698 | $13,317 | $25,501 | 1.63 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 22 | $137,172 | $23,963 | $43,346 | 2.89 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 22 | $54,294 | $5,373 | $17,157 | 0.86 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 18 | $90,998 | $17,572 | $28,755 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 17 | $87,786 | $16,481 | $27,740 | 1.92 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 13 | $44,398 | $8,261 | $14,030 | 1.03 |
Endocrine, nutritional and metabolic219 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 64 | $37,444 | $6,273 | $11,832 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 50 | $53,209 | $11,134 | $16,814 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 33 | $40,255 | $7,018 | $12,721 | 0.90 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 18 | $75,931 | $12,790 | $23,994 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 17 | $36,358 | $9,175 | $11,489 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 15 | $113,599 | $21,471 | $35,897 | 1.45 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 11 | $95,096 | $14,629 | $30,050 | 2.25 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 11 | $51,619 | $12,782 | $16,312 | 1.86 |
Injuries, poisonings and toxic effects of drugs131 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 51 | $109,136 | $22,923 | $34,487 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 35 | $48,671 | $9,556 | $15,380 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 24 | $160,705 | $33,027 | $50,783 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 21 | $83,821 | $16,056 | $26,487 | 2.00 |
Blood and immune system127 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 48 | $43,522 | $8,023 | $13,753 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 23 | $75,571 | $15,342 | $23,880 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 22 | $60,466 | $13,074 | $19,107 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 22 | $55,948 | $14,293 | $17,680 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 12 | $87,274 | $16,941 | $27,579 | 2.19 |
Transplants, ECMO and tracheostomy (pre-MDC)124 discharges in 6 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 | 28 | $1,095,670 | $287,460 | $346,232 | 21.32 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCMS-DRG 012, surgical | 24 | $207,845 | $37,946 | $65,679 | 4.00 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 23 | $1,754,881 | $460,814 | $554,542 | 36.84 |
| Autologous bone marrow transplant with cc/mccMS-DRG 016, medical | 18 | $386,306 | $55,318 | $122,073 | 6.18 |
| Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCCMS-DRG 011, surgical | 16 | $204,968 | $46,991 | $64,770 | 5.16 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 15 | $451,756 | $134,715 | $142,755 | 11.46 |
Blood cancers and poorly differentiated neoplasms111 discharges in 6 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 | 34 | $42,369 | $9,478 | $13,388 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 26 | $112,155 | $29,836 | $35,441 | 3.13 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 16 | $221,422 | $61,895 | $69,969 | 4.84 |
| Acute leukemia with MCCMS-DRG 834, medical | 12 | $231,472 | $57,695 | $73,145 | 5.60 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 12 | $81,132 | $19,903 | $25,638 | 2.44 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 11 | $124,462 | $22,659 | $39,330 | 1.57 |
Skin, subcutaneous tissue and breast86 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 45 | $26,609 | $7,336 | $8,408 | 0.88 |
| Minor skin disorders without MCCMS-DRG 607, medical | 16 | $30,836 | $6,911 | $9,744 | 0.89 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 14 | $103,239 | $15,543 | $32,624 | 1.75 |
| Cellulitis with MCCMS-DRG 602, medical | 11 | $55,612 | $13,591 | $17,573 | 1.49 |
Factors influencing health status62 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 47 | $42,840 | $6,870 | $13,537 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 15 | $69,548 | $12,385 | $21,977 | 1.25 |
Ear, nose, mouth and throat46 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major head and neck procedures with CCMS-DRG 141, surgical | 22 | $123,601 | $18,226 | $39,058 | 2.07 |
| Dental and oral diseases with CCMS-DRG 158, medical | 13 | $33,778 | $8,764 | $10,674 | 0.94 |
| Major head and neck procedures without cc/mccMS-DRG 142, surgical | 11 | $77,319 | $11,779 | $24,433 | 1.54 |
Mental diseases and disorders37 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 24 | $92,157 | $18,871 | $29,121 | 1.76 |
| PsychosesMS-DRG 885, medical | 13 | $64,663 | $17,094 | $20,434 | 1.37 |
Alcohol and drug use24 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 | 24 | $26,332 | $7,904 | $8,321 | 0.86 |
Other24 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 24 | $195,787 | $49,339 | $61,869 | 4.74 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 2 Urology and Related ServicesAPC 5372 | 2,369 | 1,326 | $2,721 | $424 | $502 |
| Level 1 Intraocular ProceduresAPC 5491 | 1,412 | 942 | $22,808 | $1,710 | $1,752 |
| Level 3 Urology and Related ServicesAPC 5373 | 1,169 | 810 | $10,758 | $1,303 | $1,516 |
| Comprehensive Observation ServicesAPC 8011 | 1,091 | 940 | $15,959 | $1,968 | $2,090 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 1,041 | 926 | $9,721 | $1,170 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 487 | 412 | $13,650 | $1,376 | $1,445 |
| Level 1 Endovascular ProceduresAPC 5191 | 412 | 402 | $21,223 | $2,125 | $2,208 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 378 | 331 | $20,198 | $2,077 | $2,141 |
| Level 3 Vascular ProceduresAPC 5183 | 373 | 313 | $19,763 | $2,330 | $2,405 |
| Level 2 Intraocular ProceduresAPC 5492 | 312 | 281 | $29,205 | $2,987 | $3,116 |
| Level 4 Urology and Related ServicesAPC 5374 | 293 | 248 | $18,701 | $2,496 | $2,629 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 293 | 265 | $17,349 | $1,716 | $1,780 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 290 | 284 | $120,591 | $20,212 | $21,117 |
| Level 5 Urology and Related ServicesAPC 5375 | 259 | 238 | $28,701 | $3,693 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 253 | 242 | $55,592 | $10,411 | $10,772 |
| Level 5 ENT ProceduresAPC 5165 | 242 | 235 | $38,174 | $4,227 | $4,436 |
| Level 1 Nerve ProceduresAPC 5431 | 219 | 197 | $13,459 | $1,399 | $1,407 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 201 | 197 | $35,711 | $4,252 | $4,358 |
| Level 3 Airway EndoscopyAPC 5153 | 182 | 135 | $10,768 | $1,228 | $1,264 |
| Level 4 Airway EndoscopyAPC 5154 | 181 | 153 | $23,294 | $2,699 | $2,833 |
| Level 3 Endovascular ProceduresAPC 5193 | 173 | 160 | $76,793 | $8,487 | $8,874 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 171 | 170 | $34,478 | $4,806 | $4,982 |
| Level 4 ENT ProceduresAPC 5164 | 160 | 157 | $21,459 | $2,332 | $2,217 |
| Complex GI ProceduresAPC 5331 | 157 | 79 | $42,154 | $3,933 | $4,263 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 132 | 109 | $23,720 | $2,634 | $2,969 |
| Level 4 Vascular ProceduresAPC 5184 | 131 | 99 | $39,280 | $3,119 | $3,946 |
| Level 2 Endovascular ProceduresAPC 5192 | 130 | 115 | $34,976 | $4,180 | $4,338 |
| Level 2 Vascular ProceduresAPC 5182 | 121 | 118 | $9,315 | $1,169 | $1,204 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 117 | 103 | $23,985 | $2,592 | $2,930 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 117 | 115 | $42,715 | $5,231 | $5,339 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 116 | 61 | $15,580 | $2,515 | $2,636 |
| Level 3 Lower GI ProceduresAPC 5313 | 107 | 97 | $16,657 | $2,068 | $2,176 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 102 | 90 | $8,070 | $1,092 | $1,196 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 95 | 93 | $69,402 | $7,842 | $8,164 |
| Level 4 Gynecologic ProceduresAPC 5414 | 91 | 80 | $18,032 | $2,276 | $2,389 |
| Level 5 Airway EndoscopyAPC 5155 | 81 | 74 | $51,582 | $4,951 | $5,183 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 77 | 77 | $62,429 | $8,237 | $8,569 |
| Level 3 Upper GI ProceduresAPC 5303 | 77 | 69 | $27,404 | $2,752 | $2,888 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 75 | 74 | $86,802 | $15,567 | $15,763 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 71 | 69 | $22,427 | $2,347 | $2,373 |
| Level 3 ENT ProceduresAPC 5163 | 70 | 59 | $8,777 | $1,124 | $1,106 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 70 | 69 | $173,756 | $28,300 | $29,375 |
| Level 4 Endovascular ProceduresAPC 5194 | 58 | 55 | $111,984 | $14,556 | $14,606 |
| Level 3 Intraocular ProceduresAPC 5493 | 58 | 46 | $46,528 | $3,850 | $4,004 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 51 | 51 | $43,669 | $6,252 | $6,514 |
| Level 5 Gynecologic ProceduresAPC 5415 | 44 | 44 | $30,242 | $3,666 | $3,792 |
| Level 6 Urology and Related ServicesAPC 5376 | 42 | 39 | $48,294 | $6,888 | $7,291 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 37 | 32 | $35,197 | $4,305 | $4,524 |
| Level 7 Radiation TherapyAPC 5627 | 36 | 30 | $33,540 | $5,740 | $6,121 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 28 | 28 | $76,598 | $17,930 | $18,465 |
| Level 6 Gynecologic ProceduresAPC 5416 | 27 | 26 | $39,749 | $5,362 | $5,836 |
| Level 8 Urology and Related ServicesAPC 5378 | 23 | 23 | $74,734 | $16,985 | $17,428 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 21 | 21 | $101,488 | $27,009 | $26,719 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 14 | 14 | $115,880 | $16,352 | $17,052 |
| Cochlear Implant ProcedureAPC 5166 | 13 | 13 | $109,612 | $29,296 | $29,489 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 12 | 12 | $142,595 | $20,117 | $21,011 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 11 | 11 | $50,733 | $14,636 | $15,549 |
| Level 2 Nerve ProceduresAPC 5432 | 11 | 11 | $57,608 | $4,687 | $4,674 |
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.