Mount Sinai Morningside Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Mount Sinai Morningside, New York, NY in 2024, from traditional Medicare claims. Back to the Mount Sinai Morningside profile, with quality ratings, finances and negotiated rates.
4,907
Medicare inpatient discharges
In 138 published DRGs
2.05
Case mix index
IPPS FY 2027
23%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
3,231
Medicare outpatient services
In 45 service groups
Inpatient stays by major diagnostic category
Circulatory system1,064 discharges in 33 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 155 | $151,824 | $18,936 | $29,758 | 1.59 |
| Heart failure and shock with MCCMS-DRG 291, medical | 150 | $125,049 | $15,920 | $24,510 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 123 | $66,724 | $9,811 | $13,078 | 0.86 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 47 | $156,431 | $37,483 | $30,661 | 3.24 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 39 | $63,325 | $8,042 | $12,412 | 0.74 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 38 | $123,693 | $12,791 | $24,244 | 1.20 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 35 | $83,814 | $10,323 | $16,428 | 0.91 |
| Other vascular procedures with CCMS-DRG 253, surgical | 30 | $122,809 | $29,121 | $24,071 | 2.55 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 27 | $515,702 | $78,223 | $101,078 | 5.06 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 26 | $375,951 | $43,197 | $73,686 | 3.35 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 26 | $179,924 | $43,384 | $35,265 | 3.46 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 26 | $146,776 | $31,460 | $28,768 | 2.87 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 25 | $186,780 | $23,047 | $36,609 | 2.09 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 24 | $90,902 | $20,407 | $17,817 | 1.82 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 23 | $278,155 | $66,723 | $54,518 | 5.88 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 19 | $203,276 | $22,833 | $39,842 | 2.16 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 19 | $70,095 | $12,318 | $13,739 | 1.08 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 19 | $41,488 | $5,738 | $8,132 | 0.55 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 19 | $60,028 | $10,900 | $11,765 | 0.97 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $97,818 | $26,184 | $19,172 | 2.28 |
| Chest painMS-DRG 313, medical | 17 | $50,605 | $7,945 | $9,919 | 0.72 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 16 | $80,711 | $11,724 | $15,819 | 1.07 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 15 | $341,466 | $44,081 | $66,927 | 3.46 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 15 | $274,585 | $40,214 | $53,819 | 3.27 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 14 | $227,764 | $57,518 | $44,642 | 4.88 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $54,197 | $7,077 | $10,623 | 0.72 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 14 | $177,057 | $16,578 | $34,703 | 1.58 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 13 | $149,701 | $49,340 | $29,341 | 4.16 |
| Hypertension without MCCMS-DRG 305, medical | 13 | $62,824 | $7,823 | $12,314 | 0.75 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 12 | $235,826 | $51,702 | $46,222 | 3.90 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 11 | $160,775 | $27,942 | $31,512 | 2.81 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 11 | $100,883 | $21,533 | $19,773 | 1.83 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 11 | $250,599 | $28,102 | $49,117 | 1.97 |
Infectious and parasitic diseases750 discharges in 4 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 | 559 | $176,977 | $23,997 | $34,688 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 84 | $410,752 | $63,987 | $80,507 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 68 | $88,346 | $11,663 | $17,316 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 39 | $638,863 | $92,504 | $125,217 | 6.96 |
Musculoskeletal system and connective tissue633 discharges in 22 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 | 99 | $74,061 | $20,776 | $14,516 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 64 | $156,009 | $23,753 | $30,578 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 61 | $87,314 | $10,121 | $17,114 | 0.97 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 58 | $199,217 | $34,645 | $39,046 | 2.95 |
| Medical back problems with MCCMS-DRG 551, medical | 42 | $138,751 | $19,033 | $27,195 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 35 | $134,149 | $23,264 | $26,293 | 2.11 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 30 | $182,091 | $43,876 | $35,690 | 3.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 29 | $67,536 | $9,694 | $13,237 | 0.90 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 26 | $117,013 | $29,095 | $22,935 | 2.48 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 22 | $169,055 | $27,923 | $33,135 | 2.40 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 20 | $180,758 | $33,401 | $35,429 | 2.99 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 18 | $58,310 | $8,060 | $11,429 | 0.79 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 16 | $235,119 | $68,056 | $46,083 | 6.12 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 15 | $106,145 | $16,592 | $20,804 | 1.52 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 14 | $121,751 | $18,049 | $23,863 | 1.59 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 14 | $61,320 | $9,196 | $12,019 | 0.82 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 13 | $57,504 | $9,586 | $11,271 | 0.82 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 12 | $120,323 | $31,472 | $23,583 | 2.96 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 12 | $177,762 | $19,792 | $34,841 | 1.56 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 11 | $101,000 | $31,061 | $19,796 | 2.67 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $144,676 | $19,507 | $28,356 | 1.87 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 11 | $107,010 | $15,048 | $20,974 | 1.30 |
Nervous system572 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 73 | $228,475 | $28,382 | $44,781 | 2.00 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 53 | $86,395 | $26,917 | $16,933 | 2.43 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 50 | $191,808 | $30,668 | $37,594 | 2.39 |
| Seizures with MCCMS-DRG 100, medical | 41 | $221,862 | $28,512 | $43,485 | 1.98 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 39 | $333,584 | $51,500 | $65,382 | 4.42 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 38 | $135,915 | $20,317 | $26,639 | 1.79 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 38 | $78,535 | $11,754 | $15,393 | 1.03 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 35 | $101,372 | $11,424 | $19,869 | 1.02 |
| Seizures without MCCMS-DRG 101, medical | 35 | $83,671 | $9,686 | $16,400 | 0.91 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 32 | $155,270 | $20,999 | $30,433 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 31 | $510,455 | $77,905 | $100,049 | 5.67 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 20 | $54,175 | $8,132 | $10,618 | 0.80 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 18 | $238,468 | $30,067 | $46,740 | 2.28 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 15 | $86,248 | $8,437 | $16,905 | 0.69 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 15 | $182,948 | $25,413 | $35,858 | 2.27 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 14 | $87,842 | $14,675 | $17,217 | 1.32 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 13 | $273,001 | $24,705 | $53,508 | 1.79 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 12 | $48,363 | $7,762 | $9,479 | 0.77 |
Respiratory system456 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 110 | $128,209 | $19,183 | $25,129 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 83 | $107,587 | $15,081 | $21,087 | 1.33 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 38 | $146,827 | $16,296 | $28,778 | 1.40 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 36 | $97,491 | $11,965 | $19,108 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 32 | $109,858 | $14,508 | $21,532 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 21 | $93,244 | $10,940 | $18,276 | 0.99 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 20 | $62,506 | $10,016 | $12,251 | 0.96 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 19 | $61,629 | $8,647 | $12,079 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 18 | $202,976 | $31,548 | $39,783 | 2.70 |
| Major chest trauma with MCCMS-DRG 183, medical | 16 | $100,277 | $18,474 | $19,654 | 1.57 |
| Major chest trauma with CCMS-DRG 184, medical | 15 | $85,217 | $12,042 | $16,703 | 1.05 |
| Major chest procedures with MCCMS-DRG 163, surgical | 13 | $212,982 | $51,742 | $41,744 | 4.71 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 13 | $64,922 | $8,665 | $12,725 | 0.82 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 11 | $140,249 | $19,274 | $27,489 | 1.74 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 11 | $81,818 | $10,145 | $16,036 | 0.91 |
Kidney and urinary tract421 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 101 | $131,991 | $14,944 | $25,870 | 1.17 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 80 | $147,657 | $20,029 | $28,941 | 1.65 |
| Renal failure with MCCMS-DRG 682, medical | 72 | $143,098 | $17,108 | $28,047 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 53 | $68,738 | $8,421 | $13,473 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 39 | $86,341 | $10,171 | $16,923 | 0.90 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 23 | $83,941 | $11,306 | $16,453 | 1.02 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 15 | $50,626 | $10,286 | $9,923 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $228,105 | $31,184 | $44,709 | 2.59 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 12 | $83,343 | $14,282 | $16,335 | 1.35 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 12 | $434,195 | $40,525 | $85,102 | 3.70 |
Digestive system333 discharges in 10 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 | 73 | $99,804 | $10,738 | $19,562 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 45 | $94,070 | $10,904 | $18,438 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 45 | $98,801 | $14,492 | $19,365 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 43 | $178,476 | $22,569 | $34,981 | 1.79 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 28 | $140,119 | $18,954 | $27,463 | 1.62 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 25 | $80,790 | $10,315 | $15,835 | 0.94 |
| Digestive malignancy with MCCMS-DRG 374, medical | 23 | $167,795 | $26,084 | $32,888 | 2.10 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 20 | $143,909 | $27,449 | $28,206 | 2.37 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 19 | $317,094 | $55,844 | $62,150 | 4.52 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $136,380 | $49,232 | $26,730 | 5.08 |
Endocrine, nutritional and metabolic219 discharges in 7 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 | 96 | $124,297 | $16,549 | $24,362 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 32 | $56,159 | $8,706 | $11,007 | 0.78 |
| Diabetes with MCCMS-DRG 637, medical | 31 | $148,010 | $18,886 | $29,010 | 1.45 |
| Diabetes with CCMS-DRG 638, medical | 18 | $97,412 | $9,714 | $19,093 | 0.90 |
| Endocrine disorders with CCMS-DRG 644, medical | 15 | $75,566 | $12,066 | $14,811 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 14 | $139,569 | $20,137 | $27,356 | 1.65 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $151,323 | $22,944 | $29,659 | 1.98 |
Alcohol and drug use100 discharges in 4 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 | 52 | $78,728 | $9,070 | $15,431 | 0.86 |
| Alcohol, drug abuse or dependence, left amaMS-DRG 894, medical | 20 | $30,606 | $6,850 | $5,999 | 0.57 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 17 | $142,103 | $19,928 | $27,852 | 1.78 |
| Alcohol, drug abuse or dependence with rehabilitation therapyMS-DRG 895, medical | 11 | $151,945 | $17,706 | $29,781 | 1.61 |
Blood and immune system81 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders with MCCMS-DRG 811, medical | 40 | $126,444 | $16,487 | $24,783 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 24 | $86,807 | $10,100 | $17,014 | 0.90 |
| Coagulation disordersMS-DRG 813, medical | 17 | $116,454 | $18,280 | $22,825 | 1.56 |
Skin, subcutaneous tissue and breast74 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 52 | $70,851 | $9,851 | $13,887 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 22 | $172,402 | $18,450 | $33,791 | 1.49 |
Mental diseases and disorders36 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 | 36 | $146,242 | $22,057 | $28,663 | 1.76 |
Liver, gallbladder and pancreas36 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 14 | $87,639 | $12,542 | $17,177 | 1.09 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 11 | $185,488 | $19,521 | $36,356 | 1.92 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 11 | $194,048 | $24,718 | $38,033 | 1.76 |
Ear, nose, mouth and throat28 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 28 | $65,870 | $7,781 | $12,911 | 0.74 |
HIV infections27 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| HIV with major related condition with MCCMS-DRG 974, medical | 27 | $238,279 | $42,456 | $46,703 | 2.92 |
Factors influencing health status21 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 | 21 | $67,819 | $8,865 | $13,293 | 0.80 |
Transplants, ECMO and tracheostomy (pre-MDC)20 discharges in 1 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 | 20 | $1,590,286 | $248,298 | $311,696 | 14.70 |
Injuries, poisonings and toxic effects of drugs18 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 18 | $175,915 | $20,360 | $34,479 | 1.60 |
Other18 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 | 18 | $349,574 | $59,674 | $68,517 | 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 3 Endovascular ProceduresAPC 5193 | 252 | 240 | $44,491 | $10,740 | $8,874 |
| Level 1 Endovascular ProceduresAPC 5191 | 230 | 228 | $16,776 | $2,591 | $2,208 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 215 | 211 | $96,439 | $24,926 | $21,117 |
| Level 6 Urology and Related ServicesAPC 5376 | 164 | 154 | $27,206 | $8,629 | $7,291 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 138 | 135 | $35,714 | $6,380 | $5,339 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 129 | 126 | $41,998 | $12,655 | $10,772 |
| Level 3 Vascular ProceduresAPC 5183 | 120 | 99 | $13,953 | $2,847 | $2,405 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 119 | 118 | $27,016 | $5,135 | $4,358 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 115 | 111 | $11,712 | $1,441 | $1,196 |
| Level 2 Upper GI ProceduresAPC 5302 | 113 | 99 | $12,889 | $1,696 | $1,445 |
| Level 2 Endovascular ProceduresAPC 5192 | 104 | 89 | $22,538 | $5,078 | $4,338 |
| Level 5 Urology and Related ServicesAPC 5375 | 104 | 99 | $26,069 | $4,621 | $3,918 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 87 | 81 | $13,099 | $1,451 | $1,220 |
| Level 4 Urology and Related ServicesAPC 5374 | 83 | 71 | $20,038 | $3,129 | $2,629 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 81 | 76 | $18,326 | $2,905 | $2,373 |
| Level 5 ENT ProceduresAPC 5165 | 81 | 80 | $29,019 | $5,191 | $4,436 |
| Level 4 Endovascular ProceduresAPC 5194 | 81 | 75 | $56,084 | $17,625 | $14,606 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 80 | 80 | $29,537 | $7,828 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 72 | 69 | $27,797 | $4,861 | $3,946 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 67 | 67 | $40,338 | $10,221 | $8,569 |
| Level 3 Lower GI ProceduresAPC 5313 | 63 | 62 | $13,917 | $2,031 | $2,176 |
| Level 4 Gynecologic ProceduresAPC 5414 | 63 | 61 | $17,014 | $2,803 | $2,389 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 59 | 55 | $21,316 | $3,363 | $2,930 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 53 | 52 | $39,876 | $9,854 | $8,164 |
| Level 3 Urology and Related ServicesAPC 5373 | 50 | 33 | $14,642 | $1,828 | $1,516 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 49 | 40 | $19,815 | $3,105 | $2,636 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 45 | 45 | $101,687 | $22,941 | $18,465 |
| Level 4 Airway EndoscopyAPC 5154 | 39 | 39 | $20,228 | $3,318 | $2,833 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 37 | 37 | $18,470 | $2,550 | $2,141 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 34 | 34 | $29,697 | $5,680 | $4,982 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 33 | 32 | $102,678 | $33,235 | $26,719 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 30 | 30 | $119,265 | $34,123 | $29,375 |
| Level 5 Gynecologic ProceduresAPC 5415 | 26 | 26 | $24,903 | $4,285 | $3,792 |
| Level 3 Upper GI ProceduresAPC 5303 | 25 | $15,878 | $3,437 | $2,888 | |
| Level 5 Airway EndoscopyAPC 5155 | 21 | 21 | $30,044 | $6,142 | $5,183 |
| Level 2 Vascular ProceduresAPC 5182 | 21 | 20 | $9,495 | $1,437 | $1,204 |
| Level 1 Nerve ProceduresAPC 5431 | 21 | 20 | $16,686 | $1,650 | $1,407 |
| Level 8 Urology and Related ServicesAPC 5378 | 20 | 19 | $64,700 | $20,094 | $17,428 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 18 | 18 | $59,973 | $18,234 | $15,763 |
| Level 3 Airway EndoscopyAPC 5153 | 17 | 17 | $16,532 | $1,432 | $1,264 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 17 | 17 | $86,961 | $20,259 | $17,052 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 16 | 16 | $26,170 | $6,138 | $4,524 |
| Level 4 ENT ProceduresAPC 5164 | 14 | 14 | $24,230 | $2,889 | $2,217 |
| Comprehensive Observation ServicesAPC 8011 | 13 | 13 | $25,082 | $2,457 | $2,090 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 12 | 12 | $100,299 | $30,998 | $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.