Missouri Baptist Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Missouri Baptist Medical Center, Saint Louis, MO in 2024, from traditional Medicare claims. Back to the Missouri Baptist Medical Center profile, with quality ratings, finances and negotiated rates.
5,188
Medicare inpatient discharges
In 148 published DRGs
1.94
Case mix index
IPPS FY 2027
24%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
4,620
Medicare outpatient services
In 44 service groups
Inpatient stays by major diagnostic category
Circulatory system1,382 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 | 361 | $42,717 | $7,045 | $11,704 | 1.28 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 99 | $91,725 | $19,331 | $25,133 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 66 | $169,420 | $30,495 | $46,421 | 4.88 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 66 | $28,045 | $3,369 | $7,684 | 0.74 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 46 | $192,127 | $32,041 | $52,643 | 5.24 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 46 | $73,506 | $13,726 | $20,141 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 46 | $30,229 | $4,457 | $8,283 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 43 | $43,288 | $6,505 | $11,861 | 1.20 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 42 | $257,330 | $50,575 | $70,508 | 7.71 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 42 | $38,107 | $5,614 | $10,441 | 1.08 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 41 | $203,722 | $39,026 | $55,820 | 6.25 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 35 | $74,491 | $9,514 | $20,411 | 1.82 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 30 | $22,536 | $2,190 | $6,175 | 0.55 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 29 | $104,662 | $15,771 | $28,677 | 2.87 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 27 | $52,908 | $9,524 | $14,497 | 1.59 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 26 | $140,014 | $20,108 | $38,364 | 4.04 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 25 | $63,724 | $12,964 | $17,460 | 2.09 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 24 | $108,734 | $19,399 | $29,793 | 3.18 |
| Hypertension without MCCMS-DRG 305, medical | 24 | $25,985 | $3,386 | $7,120 | 0.75 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 21 | $35,604 | $4,817 | $9,756 | 0.91 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 20 | $28,808 | $5,920 | $7,893 | 1.07 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $62,422 | $13,755 | $17,104 | 2.28 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 18 | $97,631 | $19,549 | $26,751 | 3.35 |
| Other vascular procedures with CCMS-DRG 253, surgical | 18 | $94,487 | $15,614 | $25,889 | 2.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $115,296 | $19,265 | $31,591 | 3.46 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 16 | $187,981 | $37,078 | $51,507 | 5.06 |
| Chest painMS-DRG 313, medical | 16 | $24,804 | $3,292 | $6,796 | 0.72 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 15 | $332,144 | $60,902 | $91,008 | 9.71 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 15 | $140,689 | $23,730 | $38,549 | 4.16 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 15 | $38,941 | $9,352 | $10,670 | 1.58 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 14 | $166,878 | $32,392 | $45,725 | 5.04 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 14 | $29,756 | $3,937 | $8,153 | 0.97 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 13 | $163,481 | $21,508 | $44,794 | 5.20 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 12 | $186,099 | $32,534 | $50,991 | 5.88 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 11 | $107,698 | $23,320 | $29,509 | 3.46 |
| Heart failure and shock with CCMS-DRG 292, medical | 11 | $30,521 | $4,485 | $8,363 | 0.86 |
Digestive system673 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 130 | $26,004 | $3,606 | $7,125 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 118 | $31,212 | $5,037 | $8,552 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 63 | $53,297 | $10,595 | $14,603 | 1.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 49 | $88,869 | $13,167 | $24,350 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 49 | $36,478 | $6,972 | $9,995 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 40 | $27,478 | $4,024 | $7,529 | 0.80 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 39 | $131,068 | $30,914 | $35,913 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 34 | $28,908 | $4,444 | $7,921 | 0.94 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 31 | $41,223 | $9,497 | $11,295 | 1.62 |
| Digestive malignancy with MCCMS-DRG 374, medical | 20 | $64,331 | $11,643 | $17,627 | 2.10 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 17 | $29,729 | $5,541 | $8,146 | 1.04 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 17 | $30,403 | $4,916 | $8,330 | 0.97 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 16 | $17,221 | $2,214 | $4,718 | 0.56 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 15 | $51,363 | $7,431 | $14,073 | 1.45 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 13 | $135,341 | $26,579 | $37,083 | 4.28 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 11 | $54,874 | $13,946 | $15,035 | 2.50 |
| Major esophageal disorders with CCMS-DRG 369, medical | 11 | $20,582 | $5,658 | $5,640 | 0.99 |
Respiratory system584 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 149 | $49,141 | $9,255 | $13,465 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 68 | $41,516 | $7,267 | $11,375 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 57 | $30,377 | $4,784 | $8,323 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 54 | $27,429 | $3,931 | $7,515 | 0.82 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 32 | $37,498 | $3,930 | $10,274 | 0.96 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 31 | $43,786 | $7,188 | $11,997 | 1.23 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 30 | $35,140 | $5,770 | $9,628 | 1.10 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 24 | $46,690 | $8,273 | $12,793 | 1.40 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 20 | $28,871 | $4,085 | $7,911 | 0.82 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 18 | $28,509 | $4,332 | $7,811 | 0.85 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 18 | $50,070 | $9,295 | $13,719 | 1.81 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 16 | $59,425 | $10,377 | $16,282 | 1.74 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 15 | $30,582 | $3,543 | $8,380 | 0.76 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 14 | $56,986 | $11,424 | $15,614 | 1.90 |
| Major chest procedures with CCMS-DRG 164, surgical | 13 | $94,202 | $14,059 | $25,811 | 2.55 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 13 | $44,310 | $6,756 | $12,141 | 1.10 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 12 | $72,276 | $16,501 | $19,804 | 2.70 |
Infectious and parasitic diseases546 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 351 | $62,475 | $11,092 | $17,118 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 79 | $33,940 | $5,019 | $9,300 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 49 | $126,086 | $28,626 | $34,548 | 5.00 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 23 | $74,482 | $11,945 | $20,408 | 2.04 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 17 | $194,532 | $35,700 | $53,302 | 6.96 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 14 | $57,766 | $10,081 | $15,828 | 1.84 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 13 | $24,987 | $4,093 | $6,846 | 1.01 |
Kidney and urinary tract485 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 119 | $23,967 | $4,206 | $6,567 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 86 | $30,245 | $4,571 | $8,287 | 0.90 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 59 | $35,900 | $6,595 | $9,837 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 47 | $56,810 | $10,359 | $15,566 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 46 | $43,165 | $8,482 | $11,827 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 39 | $27,724 | $5,406 | $7,596 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 34 | $40,540 | $7,288 | $11,108 | 1.35 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 16 | $55,536 | $7,772 | $15,217 | 1.48 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $79,926 | $15,813 | $21,900 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 13 | $64,053 | $10,335 | $17,551 | 1.84 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 12 | $41,349 | $5,479 | $11,330 | 1.05 |
Musculoskeletal system and connective tissue421 discharges in 16 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Medical back problems without MCCMS-DRG 552, medical | 79 | $30,192 | $4,795 | $8,273 | 0.97 |
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 59 | $56,388 | $10,024 | $15,450 | 1.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 34 | $31,285 | $5,659 | $8,572 | 1.09 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 34 | $26,081 | $4,676 | $7,146 | 0.90 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 28 | $68,091 | $12,034 | $18,657 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 24 | $63,115 | $12,081 | $17,294 | 2.11 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 22 | $57,169 | $11,735 | $15,664 | 2.04 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 19 | $158,584 | $34,841 | $43,452 | 6.12 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 19 | $26,099 | $3,607 | $7,151 | 0.79 |
| Medical back problems with MCCMS-DRG 551, medical | 19 | $37,666 | $9,971 | $10,320 | 1.70 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 16 | $121,334 | $20,830 | $33,245 | 3.66 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 16 | $51,130 | $10,318 | $14,010 | 1.82 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 14 | $96,709 | $17,841 | $26,498 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 14 | $66,639 | $14,080 | $18,259 | 2.40 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 13 | $88,178 | $16,577 | $24,161 | 2.96 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 11 | $20,737 | $3,748 | $5,682 | 0.82 |
Nervous system352 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 63 | $28,303 | $7,169 | $7,755 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 62 | $37,478 | $5,045 | $10,269 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 41 | $56,693 | $10,715 | $15,534 | 2.00 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 41 | $32,452 | $3,732 | $8,892 | 0.80 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 26 | $28,248 | $2,883 | $7,740 | 0.69 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 22 | $30,102 | $5,492 | $8,248 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 22 | $27,969 | $4,461 | $7,663 | 0.91 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 21 | $45,153 | $5,954 | $12,372 | 1.14 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 16 | $51,469 | $14,037 | $14,103 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 15 | $40,706 | $4,694 | $11,153 | 1.03 |
| Seizures with MCCMS-DRG 100, medical | 12 | $51,259 | $11,927 | $14,045 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 11 | $83,192 | $23,752 | $22,795 | 4.42 |
Liver, gallbladder and pancreas253 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 47 | $39,707 | $5,546 | $10,880 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 36 | $41,599 | $10,555 | $11,398 | 1.76 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 34 | $53,974 | $7,951 | $14,789 | 1.63 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 31 | $44,717 | $9,467 | $12,252 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 19 | $28,974 | $3,340 | $7,939 | 0.86 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 19 | $34,622 | $3,211 | $9,486 | 0.80 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 16 | $103,513 | $12,191 | $28,363 | 2.89 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 15 | $76,337 | $13,445 | $20,916 | 2.32 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 14 | $92,169 | $11,107 | $25,254 | 1.67 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 11 | $52,036 | $11,086 | $14,258 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 11 | $35,544 | $5,987 | $9,739 | 1.10 |
Endocrine, nutritional and metabolic182 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 60 | $39,523 | $6,989 | $10,829 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 52 | $26,125 | $4,041 | $7,158 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 27 | $30,168 | $4,315 | $8,266 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $35,252 | $6,120 | $9,659 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 14 | $41,695 | $5,872 | $11,424 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 14 | $50,623 | $11,082 | $13,871 | 1.65 |
Skin, subcutaneous tissue and breast95 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 62 | $23,112 | $4,339 | $6,333 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 19 | $32,252 | $4,231 | $8,837 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 14 | $37,219 | $7,602 | $10,198 | 1.49 |
Injuries, poisonings and toxic effects of drugs61 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 33 | $49,456 | $10,065 | $13,551 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 15 | $30,787 | $5,555 | $8,436 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 13 | $114,406 | $16,271 | $31,347 | 3.72 |
Blood and immune system41 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 23 | $33,238 | $4,250 | $9,107 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 18 | $33,873 | $7,849 | $9,281 | 1.40 |
Transplants, ECMO and tracheostomy (pre-MDC)27 discharges in 2 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 | 16 | $589,932 | $148,691 | $161,641 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 11 | $221,914 | $74,019 | $60,804 | 14.70 |
Mental diseases and disorders25 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 | 25 | $29,030 | $9,148 | $7,954 | 1.76 |
Ear, nose, mouth and throat19 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 19 | $23,839 | $3,717 | $6,532 | 0.74 |
Factors influencing health status15 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 | 15 | $24,701 | $3,806 | $6,768 | 0.80 |
Other15 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 | 15 | $192,725 | $33,623 | $52,807 | 4.74 |
Blood cancers and poorly differentiated neoplasms12 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 12 | $65,440 | $9,167 | $17,930 | 1.57 |
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 Upper GI ProceduresAPC 5302 | 516 | 463 | $5,530 | $1,307 | $1,445 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 397 | 373 | $45,029 | $9,707 | $10,772 |
| Level 1 Endovascular ProceduresAPC 5191 | 279 | 277 | $12,650 | $1,989 | $2,208 |
| Level 1 Nerve ProceduresAPC 5431 | 254 | 212 | $15,706 | $1,330 | $1,407 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 251 | 228 | $8,807 | $1,110 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 238 | 231 | $16,481 | $1,842 | $2,090 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 177 | 173 | $132,649 | $18,437 | $21,117 |
| Level 3 Urology and Related ServicesAPC 5373 | 167 | 90 | $11,252 | $1,370 | $1,516 |
| Level 3 Vascular ProceduresAPC 5183 | 164 | 150 | $14,107 | $2,190 | $2,405 |
| Complex GI ProceduresAPC 5331 | 147 | 99 | $14,944 | $3,319 | $4,263 |
| Level 3 Upper GI ProceduresAPC 5303 | 133 | 130 | $10,684 | $2,643 | $2,888 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 131 | 109 | $15,154 | $2,390 | $2,636 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 127 | 124 | $26,012 | $3,923 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 119 | 96 | $18,001 | $2,324 | $2,629 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 113 | 113 | $45,213 | $7,174 | $8,164 |
| Level 3 Endovascular ProceduresAPC 5193 | 109 | 104 | $51,354 | $7,904 | $8,874 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 107 | 106 | $13,484 | $1,941 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 89 | 86 | $36,083 | $4,813 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 87 | 82 | $16,206 | $2,607 | $2,833 |
| Level 5 Urology and Related ServicesAPC 5375 | 78 | 71 | $22,868 | $3,554 | $3,918 |
| Level 4 Gynecologic ProceduresAPC 5414 | 77 | 77 | $12,003 | $2,177 | $2,389 |
| Level 2 Vascular ProceduresAPC 5182 | 63 | 46 | $5,663 | $1,092 | $1,204 |
| Level 4 Endovascular ProceduresAPC 5194 | 63 | 61 | $69,145 | $13,666 | $14,606 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 57 | 56 | $66,552 | $15,092 | $17,052 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 56 | 56 | $29,855 | $7,697 | $8,569 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 54 | 53 | $80,689 | $14,351 | $15,763 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 52 | 52 | $101,627 | $27,036 | $29,375 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 50 | 45 | $18,307 | $2,655 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 44 | 43 | $16,116 | $2,203 | $2,373 |
| Level 3 Airway EndoscopyAPC 5153 | 43 | 43 | $10,189 | $1,182 | $1,264 |
| Level 5 Airway EndoscopyAPC 5155 | 36 | 36 | $30,766 | $4,634 | $5,183 |
| Level 3 Lower GI ProceduresAPC 5313 | 36 | 34 | $11,764 | $1,917 | $2,176 |
| Level 5 ENT ProceduresAPC 5165 | 33 | 33 | $27,904 | $4,078 | $4,436 |
| Level 6 Gynecologic ProceduresAPC 5416 | 33 | 32 | $29,139 | $5,263 | $5,836 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 31 | 31 | $8,555 | $1,119 | $1,196 |
| Level 2 Endovascular ProceduresAPC 5192 | 29 | 27 | $25,011 | $3,981 | $4,338 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 28 | 28 | $26,424 | $4,542 | $4,982 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 28 | 28 | $27,711 | $5,903 | $6,514 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 28 | 19 | $19,651 | $3,742 | $4,524 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 25 | 25 | $113,226 | $25,433 | $26,719 |
| Level 8 Urology and Related ServicesAPC 5378 | 22 | 22 | $59,185 | $15,961 | $17,428 |
| Level 5 Gynecologic ProceduresAPC 5415 | 22 | 22 | $26,298 | $3,455 | $3,792 |
| Level 4 ENT ProceduresAPC 5164 | 15 | 15 | $17,284 | $2,242 | $2,217 |
| Level 4 Vascular ProceduresAPC 5184 | 12 | 12 | $31,579 | $3,827 | $3,946 |
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.