Newton Wellesley Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Newton Wellesley Hospital, Newton Lower Falls, MA in 2024, from traditional Medicare claims. Back to the Newton Wellesley Hospital profile, with quality ratings, finances and negotiated rates.
5,906
Medicare inpatient discharges
In 141 published DRGs
1.57
Case mix index
IPPS FY 2027
15%
Surgical stays
71%
Stays with complications
In DRGs with a CC or MCC
6,004
Medicare outpatient services
In 37 service groups
Inpatient stays by major diagnostic category
Circulatory system967 discharges in 18 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 420 | $37,872 | $9,996 | $14,846 | 1.28 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 103 | $47,624 | $12,603 | $18,668 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 82 | $20,712 | $5,072 | $8,119 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 60 | $23,540 | $6,401 | $9,228 | 0.86 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 53 | $34,397 | $8,935 | $13,484 | 1.20 |
| Hypertension without MCCMS-DRG 305, medical | 37 | $19,430 | $5,224 | $7,617 | 0.75 |
| Atherosclerosis without MCCMS-DRG 303, medical | 23 | $21,048 | $4,618 | $8,251 | 0.66 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 21 | $21,631 | $7,843 | $8,479 | 1.07 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 21 | $17,389 | $3,420 | $6,817 | 0.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 20 | $82,505 | $28,545 | $32,342 | 3.46 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 20 | $24,982 | $6,160 | $9,793 | 0.91 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 19 | $46,992 | $16,103 | $18,421 | 2.09 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 18 | $60,339 | $18,841 | $23,653 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 16 | $99,687 | $20,829 | $39,077 | 2.55 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 15 | $30,313 | $11,026 | $11,883 | 1.58 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 14 | $19,940 | $4,639 | $7,816 | 0.72 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 13 | $22,699 | $7,421 | $8,898 | 0.97 |
| Heart failure and shock with CCMS-DRG 292, medical | 12 | $28,937 | $6,596 | $11,343 | 0.86 |
Musculoskeletal system and connective tissue890 discharges in 26 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 | 132 | $46,608 | $14,610 | $18,270 | 1.88 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 88 | $27,440 | $7,734 | $10,757 | 1.09 |
| Medical back problems without MCCMS-DRG 552, medical | 88 | $25,675 | $7,054 | $10,065 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 54 | $55,995 | $16,496 | $21,950 | 2.07 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 50 | $64,151 | $16,504 | $25,147 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 38 | $26,314 | $6,181 | $10,315 | 0.90 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 37 | $39,179 | $13,366 | $15,358 | 1.82 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 35 | $69,066 | $21,835 | $27,074 | 2.96 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 33 | $76,281 | $26,995 | $29,902 | 3.49 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 30 | $82,766 | $28,475 | $32,444 | 3.66 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 30 | $48,588 | $19,900 | $19,047 | 2.67 |
| Medical back problems with MCCMS-DRG 551, medical | 29 | $31,043 | $12,403 | $12,169 | 1.70 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 28 | $76,564 | $22,847 | $30,013 | 2.95 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 25 | $23,858 | $5,318 | $9,352 | 0.79 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 23 | $97,475 | $33,644 | $38,210 | 4.61 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 21 | $105,951 | $47,094 | $41,533 | 6.12 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 20 | $77,111 | $23,672 | $30,228 | 2.99 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 20 | $21,411 | $5,695 | $8,393 | 0.82 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 18 | $67,808 | $19,926 | $26,581 | 2.48 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 14 | $45,147 | $11,317 | $17,698 | 1.59 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 14 | $53,805 | $16,298 | $21,092 | 2.04 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 14 | $48,371 | $14,743 | $18,962 | 1.97 |
| Pathological fractures and musculoskeletal and connective tissue malignancy without cc/mMS-DRG 544, medical | 13 | $22,101 | $4,893 | $8,664 | 0.77 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 12 | $24,567 | $7,746 | $9,630 | 1.30 |
| Connective tissue disorders with CCMS-DRG 546, medical | 12 | $40,248 | $8,586 | $15,777 | 1.20 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 12 | $40,825 | $9,090 | $16,003 | 1.52 |
Respiratory system876 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 228 | $38,629 | $12,381 | $15,142 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 136 | $36,018 | $10,042 | $14,119 | 1.33 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 89 | $29,427 | $7,209 | $11,536 | 0.99 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 68 | $21,808 | $5,507 | $8,549 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 53 | $25,436 | $8,504 | $9,971 | 1.10 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 38 | $25,311 | $7,229 | $9,922 | 0.96 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 32 | $22,360 | $6,204 | $8,765 | 0.85 |
| Major chest trauma with CCMS-DRG 184, medical | 29 | $27,496 | $8,001 | $10,778 | 1.05 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 26 | $39,075 | $9,731 | $15,318 | 1.40 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 25 | $23,631 | $6,035 | $9,263 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 24 | $42,493 | $19,645 | $16,657 | 2.55 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 18 | $42,865 | $15,365 | $16,803 | 1.90 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 17 | $41,219 | $13,463 | $16,158 | 1.74 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 17 | $36,361 | $13,207 | $14,254 | 1.81 |
| Major chest trauma with MCCMS-DRG 183, medical | 15 | $38,736 | $12,657 | $15,184 | 1.57 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 14 | $99,887 | $23,951 | $39,156 | 2.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 13 | $42,023 | $9,899 | $16,473 | 1.23 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 12 | $24,049 | $6,626 | $9,427 | 0.91 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 11 | $28,958 | $4,804 | $11,352 | 0.76 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 11 | $18,783 | $3,931 | $7,363 | 0.63 |
Digestive system675 discharges in 16 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 | 140 | $20,269 | $5,614 | $7,945 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 65 | $24,667 | $7,713 | $9,670 | 0.98 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 62 | $28,812 | $10,145 | $11,294 | 1.28 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 62 | $22,598 | $7,075 | $8,858 | 0.94 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 52 | $54,815 | $17,677 | $21,487 | 2.37 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 50 | $20,284 | $5,641 | $7,951 | 0.80 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 37 | $35,173 | $13,094 | $13,788 | 1.62 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 36 | $43,274 | $13,700 | $16,964 | 1.79 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 33 | $111,909 | $35,192 | $43,868 | 4.52 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 30 | $44,994 | $12,904 | $17,638 | 1.67 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 22 | $24,171 | $8,023 | $9,475 | 1.04 |
| Digestive malignancy with MCCMS-DRG 374, medical | 19 | $40,436 | $16,854 | $15,851 | 2.10 |
| Digestive malignancy with CCMS-DRG 375, medical | 18 | $28,837 | $8,794 | $11,304 | 1.20 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 18 | $16,712 | $2,984 | $6,551 | 0.56 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 17 | $55,263 | $14,695 | $21,663 | 1.75 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 14 | $42,600 | $11,722 | $16,699 | 1.45 |
Kidney and urinary tract652 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 145 | $22,361 | $5,810 | $8,766 | 0.81 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 123 | $37,533 | $12,834 | $14,713 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 118 | $27,758 | $8,814 | $10,881 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 72 | $23,551 | $6,516 | $9,232 | 0.90 |
| Renal failure with MCCMS-DRG 682, medical | 71 | $38,652 | $11,551 | $15,152 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 68 | $24,513 | $7,596 | $9,609 | 1.02 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 25 | $39,078 | $10,444 | $15,319 | 1.35 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 18 | $29,137 | $7,433 | $11,422 | 1.05 |
| Urinary stones without MCCMS-DRG 694, medical | 12 | $21,839 | $5,317 | $8,561 | 0.78 |
Infectious and parasitic diseases561 discharges in 6 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 | 426 | $49,339 | $15,450 | $19,341 | 1.98 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 53 | $27,067 | $7,384 | $10,610 | 1.03 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 45 | $116,572 | $39,507 | $45,696 | 5.00 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 15 | $25,430 | $7,123 | $9,968 | 1.01 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 11 | $41,617 | $13,396 | $16,314 | 1.84 |
| Viral illness with MCCMS-DRG 865, medical | 11 | $26,290 | $12,345 | $10,306 | 1.64 |
Endocrine, nutritional and metabolic289 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 | 69 | $38,703 | $10,218 | $15,171 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 61 | $19,925 | $5,527 | $7,811 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 46 | $24,957 | $6,482 | $9,783 | 0.90 |
| Endocrine disorders with MCCMS-DRG 643, medical | 42 | $36,929 | $12,263 | $14,476 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 34 | $22,452 | $7,690 | $8,801 | 1.06 |
| Diabetes with MCCMS-DRG 637, medical | 24 | $37,622 | $11,630 | $14,748 | 1.45 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 13 | $50,155 | $14,667 | $19,661 | 1.98 |
Nervous system268 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 56 | $26,413 | $9,817 | $10,354 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 37 | $47,189 | $14,693 | $18,498 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 37 | $37,775 | $7,256 | $14,808 | 1.02 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 37 | $35,187 | $7,852 | $13,793 | 1.03 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 29 | $60,752 | $16,955 | $23,815 | 2.39 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 19 | $30,789 | $7,907 | $12,069 | 1.03 |
| Seizures without MCCMS-DRG 101, medical | 16 | $28,198 | $6,930 | $11,054 | 0.91 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 15 | $70,067 | $14,776 | $27,466 | 1.79 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 11 | $67,614 | $13,567 | $26,505 | 1.51 |
| Seizures with MCCMS-DRG 100, medical | 11 | $38,752 | $16,631 | $15,191 | 1.98 |
Liver, gallbladder and pancreas167 discharges in 10 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with CCMS-DRG 445, medical | 26 | $31,523 | $8,293 | $12,357 | 1.09 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 23 | $59,876 | $12,007 | $23,471 | 1.63 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $42,716 | $13,349 | $16,745 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 19 | $30,755 | $15,589 | $12,056 | 1.92 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 15 | $50,328 | $13,013 | $19,729 | 1.67 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 14 | $49,127 | $8,643 | $19,258 | 1.31 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 14 | $50,598 | $12,990 | $19,835 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 12 | $21,785 | $5,887 | $8,540 | 0.86 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 11 | $33,511 | $13,474 | $13,136 | 1.83 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 11 | $27,539 | $6,707 | $10,795 | 0.95 |
Blood and immune system158 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Coagulation disordersMS-DRG 813, medical | 88 | $29,629 | $12,755 | $11,615 | 1.56 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 31 | $43,304 | $11,523 | $16,975 | 1.40 |
| Red blood cell disorders without MCCMS-DRG 812, medical | 27 | $23,776 | $6,739 | $9,320 | 0.90 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 12 | $23,065 | $9,895 | $9,042 | 1.20 |
Skin, subcutaneous tissue and breast145 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 99 | $20,185 | $6,245 | $7,912 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 33 | $32,901 | $10,774 | $12,897 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 13 | $29,313 | $6,204 | $11,491 | 0.91 |
Mental diseases and disorders109 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 82 | $42,206 | $13,567 | $16,545 | 1.76 |
| PsychosesMS-DRG 885, medical | 15 | $50,834 | $10,763 | $19,927 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 12 | $21,698 | $6,838 | $8,506 | 0.95 |
Injuries, poisonings and toxic effects of drugs44 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 | 22 | $50,128 | $12,134 | $19,650 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 11 | $45,136 | $15,512 | $17,693 | 1.82 |
| Complications of treatment with CCMS-DRG 920, medical | 11 | $24,739 | $8,342 | $9,698 | 1.03 |
Alcohol and drug use34 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 | 22 | $22,814 | $6,348 | $8,943 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 12 | $33,164 | $14,479 | $13,000 | 1.78 |
Factors influencing health status31 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 | 17 | $26,541 | $5,803 | $10,404 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 14 | $35,747 | $9,223 | $14,013 | 1.25 |
Ear, nose, mouth and throat29 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 29 | $24,761 | $5,293 | $9,706 | 0.74 |
Other11 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 | 11 | $150,066 | $37,904 | $58,826 | 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 |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 1,246 | 1,163 | $13,821 | $2,319 | $2,090 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 675 | 653 | $32,683 | $12,347 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 434 | 393 | $4,437 | $1,381 | $1,220 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 349 | 321 | $7,247 | $1,369 | $1,196 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 310 | 308 | $23,945 | $6,100 | $5,339 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 291 | 283 | $12,899 | $2,750 | $2,373 |
| Level 1 Nerve ProceduresAPC 5431 | 231 | 200 | $9,309 | $1,647 | $1,407 |
| Level 2 Upper GI ProceduresAPC 5302 | 221 | 172 | $7,139 | $1,634 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 208 | 148 | $6,915 | $1,725 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 163 | 153 | $15,380 | $4,398 | $3,918 |
| Level 4 Urology and Related ServicesAPC 5374 | 161 | 142 | $12,907 | $2,961 | $2,629 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 159 | 159 | $21,885 | $4,904 | $4,358 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 142 | 140 | $38,093 | $9,300 | $8,164 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 141 | 131 | $13,015 | $2,928 | $2,636 |
| Level 3 Vascular ProceduresAPC 5183 | 120 | 118 | $8,240 | $2,682 | $2,405 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 103 | 101 | $56,287 | $18,328 | $15,763 |
| Level 1 Intraocular ProceduresAPC 5491 | 95 | 79 | $9,970 | $1,992 | $1,752 |
| Level 4 Gynecologic ProceduresAPC 5414 | 93 | 90 | $9,567 | $2,617 | $2,389 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 87 | 87 | $20,858 | $7,440 | $6,514 |
| Level 5 Gynecologic ProceduresAPC 5415 | 82 | 82 | $20,598 | $4,251 | $3,792 |
| Level 1 Endovascular ProceduresAPC 5191 | 80 | 78 | $25,091 | $2,510 | $2,208 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 73 | 73 | $15,961 | $3,261 | $2,930 |
| Level 3 Lower GI ProceduresAPC 5313 | 70 | 70 | $8,615 | $2,490 | $2,176 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 67 | 66 | $10,490 | $2,431 | $2,141 |
| Level 5 ENT ProceduresAPC 5165 | 61 | 61 | $24,618 | $5,007 | $4,436 |
| Level 2 Vascular ProceduresAPC 5182 | 55 | 47 | $4,235 | $1,365 | $1,204 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 40 | 40 | $22,565 | $5,580 | $4,982 |
| Level 6 Gynecologic ProceduresAPC 5416 | 39 | 39 | $22,587 | $6,478 | $5,836 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 36 | 36 | $20,558 | $9,815 | $8,569 |
| Complex GI ProceduresAPC 5331 | 36 | 36 | $21,147 | $4,866 | $4,263 |
| Level 6 Urology and Related ServicesAPC 5376 | 34 | 33 | $23,893 | $8,254 | $7,291 |
| Level 5 Airway EndoscopyAPC 5155 | 23 | 23 | $18,324 | $5,602 | $5,183 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 22 | 22 | $21,896 | $5,852 | $4,524 |
| Level 3 Upper GI ProceduresAPC 5303 | 20 | 20 | $15,022 | $3,277 | $2,888 |
| Level 3 Endovascular ProceduresAPC 5193 | 13 | 12 | $45,574 | $9,385 | $8,874 |
| Level 2 Urology and Related ServicesAPC 5372 | 12 | 12 | $7,102 | $585 | $502 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 12 | 11 | $35,296 | $21,799 | $18,465 |
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.