New Hanover Regional Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for New Hanover Regional Medical Center, Wilmington, NC in 2024, from traditional Medicare claims. Back to the New Hanover Regional Medical Center profile, with quality ratings, finances and negotiated rates.
9,682
Medicare inpatient discharges
In 216 published DRGs
2.09
Case mix index
IPPS FY 2027
33%
Surgical stays
67%
Stays with complications
In DRGs with a CC or MCC
9,035
Medicare outpatient services
In 53 service groups
Inpatient stays by major diagnostic category
Circulatory system2,228 discharges in 41 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 457 | $35,212 | $9,392 | $10,071 | 1.28 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 141 | $65,925 | $13,092 | $18,855 | 1.82 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 126 | $18,797 | $4,875 | $5,376 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 119 | $87,938 | $21,744 | $25,150 | 2.87 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 105 | $41,207 | $8,682 | $11,785 | 1.20 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 89 | $94,730 | $25,143 | $27,093 | 3.24 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 81 | $73,013 | $17,145 | $20,882 | 2.28 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 80 | $68,458 | $16,590 | $19,579 | 2.16 |
| Syncope and collapseMS-DRG 312, medical | 78 | $29,621 | $5,879 | $8,472 | 0.86 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 73 | $14,898 | $3,120 | $4,261 | 0.55 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 71 | $151,024 | $38,617 | $43,193 | 4.88 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 70 | $40,420 | $7,267 | $11,560 | 1.08 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 56 | $44,457 | $12,064 | $12,715 | 1.59 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 49 | $190,492 | $55,587 | $54,481 | 6.25 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 42 | $60,104 | $13,831 | $17,190 | 1.83 |
| Other vascular procedures with CCMS-DRG 253, surgical | 40 | $82,400 | $19,769 | $23,566 | 2.55 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 39 | $147,473 | $31,275 | $42,177 | 4.04 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 39 | $95,986 | $28,037 | $27,452 | 3.35 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 35 | $107,594 | $27,513 | $30,772 | 3.46 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 35 | $34,958 | $6,153 | $9,998 | 0.91 |
| Coronary bypass with cardiac catheterization or open ablation without MCCMS-DRG 234, surgical | 31 | $193,808 | $40,219 | $55,429 | 5.20 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 31 | $49,917 | $16,091 | $14,276 | 2.09 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 29 | $95,955 | $26,330 | $27,443 | 3.46 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 28 | $140,162 | $31,656 | $40,086 | 4.16 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 22 | $26,826 | $6,359 | $7,672 | 0.97 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 20 | $75,784 | $21,311 | $21,674 | 2.81 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 20 | $133,197 | $36,648 | $38,094 | 5.06 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 20 | $47,647 | $7,490 | $13,627 | 1.07 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 18 | $224,493 | $41,843 | $64,205 | 5.24 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 18 | $259,925 | $61,933 | $74,338 | 7.80 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 18 | $143,916 | $38,254 | $41,160 | 4.78 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 18 | $32,691 | $4,646 | $9,350 | 0.72 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 17 | $105,004 | $23,369 | $30,031 | 3.18 |
| Hypertension without MCCMS-DRG 305, medical | 17 | $21,606 | $4,730 | $6,179 | 0.75 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 16 | $227,523 | $50,523 | $65,071 | 5.88 |
| Heart failure and shock with CCMS-DRG 292, medical | 15 | $18,142 | $5,981 | $5,189 | 0.86 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 15 | $46,372 | $12,101 | $13,262 | 1.58 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 14 | $63,189 | $12,708 | $18,072 | 1.74 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 13 | $84,154 | $33,395 | $24,068 | 4.81 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 12 | $138,494 | $42,224 | $39,609 | 5.04 |
| Hypertension with MCCMS-DRG 304, medical | 11 | $31,669 | $8,248 | $9,057 | 1.15 |
Musculoskeletal system and connective tissue1,259 discharges in 30 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 | 210 | $66,792 | $14,038 | $19,103 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 146 | $76,207 | $15,520 | $21,795 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 101 | $27,662 | $6,480 | $7,911 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 69 | $76,620 | $16,011 | $21,913 | 2.11 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 53 | $89,786 | $22,987 | $25,679 | 2.95 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 52 | $170,768 | $36,390 | $48,840 | 4.61 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 52 | $117,236 | $22,841 | $33,530 | 2.96 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 47 | $79,564 | $18,594 | $22,755 | 2.40 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 47 | $24,325 | $4,997 | $6,957 | 0.79 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 43 | $102,433 | $26,040 | $29,296 | 3.49 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 43 | $89,025 | $21,169 | $25,461 | 2.99 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 40 | $200,805 | $49,276 | $57,430 | 6.12 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 36 | $132,356 | $28,499 | $37,854 | 3.66 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 33 | $26,777 | $5,804 | $7,658 | 0.90 |
| Medical back problems with MCCMS-DRG 551, medical | 30 | $42,082 | $13,021 | $12,036 | 1.70 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 26 | $98,768 | $19,222 | $28,248 | 2.48 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 21 | $86,738 | $26,156 | $24,807 | 3.33 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 21 | $52,721 | $11,753 | $15,078 | 1.59 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 20 | $100,694 | $17,743 | $28,798 | 2.46 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 20 | $74,020 | $15,529 | $21,170 | 2.04 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 19 | $110,957 | $20,458 | $31,734 | 2.67 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 19 | $32,913 | $7,495 | $9,413 | 1.09 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 18 | $22,134 | $5,796 | $6,330 | 0.82 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 17 | $40,982 | $9,970 | $11,721 | 1.30 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 16 | $62,339 | $14,846 | $17,829 | 1.97 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 14 | $68,226 | $13,864 | $19,513 | 1.87 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 13 | $49,520 | $10,400 | $14,163 | 1.43 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 11 | $78,053 | $23,325 | $22,323 | 3.00 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 11 | $38,684 | $10,829 | $11,064 | 1.49 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 11 | $34,883 | $5,771 | $9,977 | 0.88 |
Nervous system1,096 discharges in 30 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 | 141 | $39,407 | $6,945 | $11,270 | 1.02 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 113 | $67,882 | $15,225 | $19,414 | 2.00 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 77 | $33,780 | $9,562 | $9,661 | 1.36 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 53 | $32,112 | $7,095 | $9,184 | 1.03 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 47 | $31,029 | $5,161 | $8,874 | 0.80 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 46 | $42,290 | $10,179 | $12,095 | 1.32 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 40 | $164,687 | $37,589 | $47,101 | 4.42 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 40 | $52,480 | $18,502 | $15,009 | 2.39 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 39 | $65,806 | $13,343 | $18,821 | 1.81 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 38 | $166,746 | $44,340 | $47,689 | 5.67 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 37 | $33,014 | $9,144 | $9,442 | 1.36 |
| Seizures without MCCMS-DRG 101, medical | 37 | $30,751 | $5,926 | $8,795 | 0.91 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 35 | $31,750 | $4,115 | $9,080 | 0.69 |
| Seizures with MCCMS-DRG 100, medical | 33 | $94,570 | $18,677 | $27,047 | 1.98 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 32 | $46,786 | $7,605 | $13,381 | 1.14 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 32 | $32,042 | $7,007 | $9,164 | 1.06 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 30 | $90,700 | $18,091 | $25,940 | 2.28 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 29 | $46,935 | $13,227 | $13,423 | 1.79 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 23 | $25,109 | $6,005 | $7,181 | 0.89 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 22 | $35,608 | $11,312 | $10,184 | 1.47 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 19 | $42,448 | $13,536 | $12,140 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 18 | $134,780 | $28,363 | $38,547 | 3.79 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 18 | $117,032 | $25,192 | $33,471 | 2.95 |
| Extracranial procedures with CCMS-DRG 038, surgical | 17 | $60,649 | $12,942 | $17,346 | 1.60 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 15 | $85,887 | $21,557 | $24,564 | 2.80 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 14 | $86,773 | $19,010 | $24,817 | 2.43 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 14 | $65,355 | $12,862 | $18,691 | 1.87 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 14 | $62,429 | $17,228 | $17,855 | 2.27 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 12 | $87,925 | $17,507 | $25,146 | 2.30 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 11 | $25,988 | $6,180 | $7,433 | 0.87 |
Respiratory system1,092 discharges in 22 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 211 | $35,254 | $9,410 | $10,083 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 198 | $43,322 | $12,437 | $12,390 | 1.70 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 112 | $35,856 | $7,958 | $10,255 | 1.10 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 103 | $37,822 | $8,701 | $10,817 | 1.23 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 60 | $26,412 | $5,278 | $7,554 | 0.82 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 49 | $34,888 | $10,208 | $9,978 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 41 | $88,992 | $20,093 | $25,452 | 2.70 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 34 | $50,492 | $12,921 | $14,441 | 1.74 |
| Major chest procedures with CCMS-DRG 164, surgical | 29 | $91,717 | $18,933 | $26,231 | 2.55 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 25 | $80,798 | $13,882 | $23,108 | 1.88 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 24 | $25,086 | $6,411 | $7,175 | 0.99 |
| Pleural effusion with MCCMS-DRG 186, medical | 24 | $42,301 | $11,886 | $12,098 | 1.55 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 22 | $120,331 | $32,942 | $34,415 | 4.06 |
| Major chest procedures with MCCMS-DRG 163, surgical | 21 | $114,006 | $33,606 | $32,606 | 4.71 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 21 | $23,688 | $5,369 | $6,775 | 0.82 |
| Major chest trauma with CCMS-DRG 184, medical | 21 | $27,737 | $7,312 | $7,933 | 1.05 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 19 | $67,540 | $15,468 | $19,316 | 1.90 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 19 | $27,996 | $6,290 | $8,007 | 0.96 |
| Major chest trauma with MCCMS-DRG 183, medical | 18 | $39,907 | $11,564 | $11,413 | 1.57 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $251,875 | $59,206 | $72,036 | 6.91 |
| Pneumothorax with CCMS-DRG 200, medical | 14 | $29,262 | $7,687 | $8,369 | 1.08 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 12 | $49,637 | $13,927 | $14,196 | 1.81 |
Digestive system1,078 discharges in 24 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 206 | $26,204 | $6,854 | $7,494 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 113 | $22,842 | $5,115 | $6,533 | 0.79 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 107 | $45,747 | $13,649 | $13,084 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 77 | $152,250 | $38,023 | $43,544 | 4.52 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 77 | $95,126 | $18,018 | $27,206 | 2.37 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 60 | $35,927 | $9,134 | $10,275 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 50 | $25,351 | $5,351 | $7,250 | 0.80 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 45 | $31,094 | $6,452 | $8,893 | 0.94 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 43 | $67,529 | $12,074 | $19,313 | 1.67 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 40 | $46,666 | $12,764 | $13,347 | 1.62 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 33 | $30,853 | $7,282 | $8,824 | 1.04 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 33 | $16,475 | $3,102 | $4,712 | 0.56 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 21 | $132,618 | $32,547 | $37,929 | 4.28 |
| Digestive malignancy with MCCMS-DRG 374, medical | 20 | $50,086 | $16,076 | $14,325 | 2.10 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 20 | $32,316 | $11,137 | $9,242 | 1.45 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 19 | $61,585 | $11,798 | $17,613 | 1.60 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 18 | $43,273 | $13,538 | $12,376 | 1.75 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 17 | $92,112 | $17,777 | $26,344 | 2.50 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 17 | $55,783 | $13,181 | $15,954 | 2.11 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 16 | $74,253 | $18,630 | $21,236 | 2.20 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 12 | $152,182 | $39,523 | $43,524 | 5.08 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 12 | $38,055 | $6,905 | $10,884 | 0.97 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 11 | $52,182 | $12,491 | $14,924 | 1.72 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 11 | $46,083 | $9,600 | $13,180 | 1.36 |
Infectious and parasitic diseases773 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 553 | $62,003 | $15,011 | $17,733 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 113 | $174,369 | $44,932 | $49,870 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 66 | $35,157 | $7,151 | $10,055 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 29 | $211,548 | $52,382 | $60,503 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 12 | $81,194 | $15,916 | $23,222 | 2.04 |
Kidney and urinary tract590 discharges in 12 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 134 | $28,754 | $8,557 | $8,224 | 1.17 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 111 | $25,552 | $5,358 | $7,308 | 0.81 |
| Renal failure with MCCMS-DRG 682, medical | 88 | $47,179 | $11,391 | $13,493 | 1.50 |
| Renal failure with CCMS-DRG 683, medical | 75 | $23,281 | $6,116 | $6,658 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 55 | $43,644 | $11,684 | $12,482 | 1.65 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 34 | $46,016 | $9,463 | $13,161 | 1.35 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 23 | $24,509 | $7,530 | $7,010 | 1.02 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 17 | $114,004 | $31,094 | $32,605 | 3.70 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 15 | $50,143 | $7,237 | $14,341 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 14 | $82,663 | $19,992 | $23,642 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 12 | $101,213 | $13,661 | $28,947 | 1.84 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 12 | $96,939 | $10,773 | $27,725 | 1.48 |
Endocrine, nutritional and metabolic387 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 with MCCMS-DRG 640, medical | 127 | $38,612 | $10,128 | $11,043 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 127 | $23,441 | $5,240 | $6,704 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 55 | $23,552 | $6,070 | $6,736 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 22 | $44,121 | $9,627 | $12,619 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 19 | $58,906 | $15,079 | $16,847 | 1.98 |
| Endocrine disorders with CCMS-DRG 644, medical | 14 | $23,056 | $7,568 | $6,594 | 1.06 |
| Endocrine disorders with MCCMS-DRG 643, medical | 12 | $26,659 | $12,073 | $7,625 | 1.65 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 11 | $75,155 | $10,816 | $21,494 | 1.52 |
Liver, gallbladder and pancreas302 discharges in 13 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 38 | $77,723 | $12,090 | $22,229 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 38 | $57,042 | $14,869 | $16,314 | 1.92 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 31 | $40,628 | $7,206 | $11,620 | 1.09 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 29 | $52,010 | $12,631 | $14,875 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 27 | $28,324 | $5,438 | $8,101 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 26 | $90,338 | $18,059 | $25,837 | 2.32 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 24 | $47,424 | $14,215 | $13,563 | 1.83 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 22 | $37,954 | $12,531 | $10,855 | 1.67 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 17 | $30,816 | $6,838 | $8,814 | 0.95 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 14 | $60,816 | $8,521 | $17,393 | 1.31 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 13 | $32,558 | $7,835 | $9,312 | 1.10 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 12 | $58,672 | $14,302 | $16,780 | 1.76 |
| Hepatobiliary diagnostic procedures with MCCMS-DRG 420, surgical | 11 | $74,709 | $23,522 | $21,367 | 3.20 |
Mental diseases and disorders183 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| PsychosesMS-DRG 885, medical | 147 | $39,204 | $9,242 | $11,212 | 1.37 |
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 36 | $40,169 | $12,023 | $11,488 | 1.76 |
Blood and immune system159 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 | 65 | $27,948 | $5,398 | $7,993 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 46 | $39,156 | $10,388 | $11,199 | 1.40 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 23 | $28,473 | $8,960 | $8,143 | 1.20 |
| Coagulation disordersMS-DRG 813, medical | 14 | $66,204 | $10,796 | $18,934 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 11 | $68,083 | $18,012 | $19,472 | 2.19 |
Skin, subcutaneous tissue and breast151 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 72 | $22,803 | $5,956 | $6,522 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 29 | $35,577 | $10,891 | $10,175 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 24 | $26,474 | $5,948 | $7,572 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 13 | $59,144 | $11,941 | $16,915 | 1.75 |
| Trauma to the skin, subcutaneous tissue and breast with MCCMS-DRG 604, medical | 13 | $47,592 | $10,320 | $13,611 | 1.51 |
Other105 discharges in 5 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 | 38 | $132,687 | $37,703 | $37,949 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 22 | $76,091 | $19,089 | $21,762 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 21 | $95,231 | $26,107 | $27,236 | 3.38 |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 12 | $144,701 | $31,544 | $41,384 | |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 12 | $72,408 | $12,188 | $20,709 | 1.70 |
Factors influencing health status77 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 | 43 | $23,829 | $5,453 | $6,815 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 18 | $34,094 | $9,466 | $9,751 | 1.25 |
| Other factors influencing health statusMS-DRG 951, medical | 16 | $11,020 | $4,039 | $3,152 | 0.59 |
Injuries, poisonings and toxic effects of drugs60 discharges in 3 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 | 25 | $59,406 | $12,075 | $16,990 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 21 | $26,282 | $7,349 | $7,517 | 1.03 |
| Complications of treatment with MCCMS-DRG 919, medical | 14 | $48,212 | $14,258 | $13,789 | 1.82 |
Alcohol and drug use47 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 without MCCMS-DRG 897, medical | 30 | $24,807 | $5,274 | $7,095 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 17 | $63,033 | $12,895 | $18,027 | 1.78 |
Transplants, ECMO and tracheostomy (pre-MDC)46 discharges in 3 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 | 17 | $633,460 | $184,111 | $181,170 | 21.32 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 15 | $705,776 | $216,306 | $201,852 | 27.10 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 14 | $365,027 | $102,009 | $104,398 | 14.70 |
Multiple significant trauma27 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 14 | $128,406 | $33,629 | $36,724 | 3.88 |
| Other o.r. procedures for multiple significant trauma with CCMS-DRG 958, surgical | 13 | $89,654 | $30,094 | $25,641 | 4.04 |
Ear, nose, mouth and throat22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 22 | $24,636 | $4,524 | $7,046 | 0.74 |
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 1 Endovascular ProceduresAPC 5191 | 774 | 764 | $23,286 | $2,150 | $2,208 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 730 | 707 | $59,683 | $10,530 | $10,772 |
| Level 2 Upper GI ProceduresAPC 5302 | 626 | 540 | $8,290 | $1,402 | $1,445 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 541 | 507 | $10,255 | $1,180 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 447 | 426 | $15,924 | $1,990 | $2,090 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 442 | 432 | $34,717 | $5,271 | $5,339 |
| Level 3 Endovascular ProceduresAPC 5193 | 374 | 349 | $46,079 | $8,565 | $8,874 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 360 | 356 | $33,225 | $4,260 | $4,358 |
| Level 4 Urology and Related ServicesAPC 5374 | 360 | 291 | $15,999 | $2,555 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 299 | 271 | $22,225 | $3,823 | $3,918 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 284 | 279 | $88,301 | $20,186 | $21,117 |
| Level 3 Vascular ProceduresAPC 5183 | 267 | 250 | $15,245 | $2,357 | $2,405 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 228 | 228 | $38,845 | $8,312 | $8,569 |
| Level 2 Intraocular ProceduresAPC 5492 | 213 | 199 | $18,686 | $2,960 | $3,116 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 188 | 186 | $87,508 | $15,532 | $15,763 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 180 | 178 | $17,979 | $2,376 | $2,373 |
| Level 3 Urology and Related ServicesAPC 5373 | 177 | 150 | $13,975 | $1,512 | $1,516 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 175 | 175 | $59,291 | $7,749 | $8,164 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 159 | 159 | $29,080 | $6,269 | $6,514 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 154 | 151 | $14,470 | $2,032 | $2,141 |
| Level 4 Vascular ProceduresAPC 5184 | 139 | 126 | $25,293 | $3,959 | $3,946 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 138 | 135 | $8,867 | $1,185 | $1,196 |
| Level 4 Airway EndoscopyAPC 5154 | 136 | 132 | $19,601 | $2,781 | $2,833 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 112 | 111 | $18,735 | $2,474 | $2,636 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 99 | 98 | $31,713 | $4,745 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 97 | 94 | $11,494 | $1,260 | $1,264 |
| Level 4 Gynecologic ProceduresAPC 5414 | 92 | 90 | $14,964 | $2,295 | $2,389 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 91 | 91 | $99,629 | $28,620 | $29,375 |
| Level 1 Nerve ProceduresAPC 5431 | 86 | 80 | $9,792 | $1,417 | $1,407 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 85 | 83 | $16,811 | $2,810 | $2,930 |
| Level 4 Endovascular ProceduresAPC 5194 | 83 | 78 | $55,359 | $14,146 | $14,606 |
| Level 2 Endovascular ProceduresAPC 5192 | 77 | 76 | $30,869 | $4,244 | $4,338 |
| Level 5 Airway EndoscopyAPC 5155 | 70 | 68 | $38,471 | $5,009 | $5,183 |
| Level 3 Upper GI ProceduresAPC 5303 | 63 | 60 | $17,578 | $2,799 | $2,888 |
| Level 5 ENT ProceduresAPC 5165 | 62 | 62 | $29,281 | $4,349 | $4,436 |
| Level 2 Vascular ProceduresAPC 5182 | 61 | 58 | $7,230 | $1,186 | $1,204 |
| Complex GI ProceduresAPC 5331 | 60 | 49 | $30,699 | $4,162 | $4,263 |
| Level 3 Lower GI ProceduresAPC 5313 | 52 | 50 | $15,252 | $2,052 | $2,176 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 50 | 50 | $62,155 | $16,487 | $17,052 |
| Level 1 Intraocular ProceduresAPC 5491 | 50 | 36 | $13,890 | $1,730 | $1,752 |
| Level 5 Gynecologic ProceduresAPC 5415 | 47 | 47 | $19,186 | $3,693 | $3,792 |
| Level 3 Intraocular ProceduresAPC 5493 | 47 | 42 | $28,320 | $3,877 | $4,004 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 40 | 40 | $25,327 | $5,546 | $5,682 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 40 | 40 | $85,039 | $26,543 | $26,719 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 31 | 29 | $11,285 | $1,735 | $1,780 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 28 | 28 | $60,493 | $18,706 | $18,465 |
| Level 4 ENT ProceduresAPC 5164 | 25 | 24 | $14,231 | $2,331 | $2,217 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 24 | 23 | $67,483 | $7,151 | $7,546 |
| Level 7 Radiation TherapyAPC 5627 | 21 | 20 | $38,314 | $2,160 | $6,121 |
| Level 8 Urology and Related ServicesAPC 5378 | 17 | 17 | $74,299 | $17,124 | $17,428 |
| Level 2 Urology and Related ServicesAPC 5372 | 12 | 12 | $7,265 | $507 | $502 |
| Cochlear Implant ProcedureAPC 5166 | 11 | 11 | $91,260 | $29,528 | $29,489 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 11 | 11 | $64,789 | $20,269 | $21,011 |
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.