Newyork-Presbyterian Weill Cornell Medical Center Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Newyork-Presbyterian Weill Cornell Medical Center, New York, NY in 2024, from traditional Medicare claims. Back to the Newyork-Presbyterian Weill Cornell Medical Center profile, with quality ratings, finances and negotiated rates.
27,689
Medicare inpatient discharges
In 373 published DRGs
2.41
Case mix index
IPPS FY 2027
31%
Surgical stays
70%
Stays with complications
In DRGs with a CC or MCC
19,818
Medicare outpatient services
In 59 service groups
Inpatient stays by major diagnostic category
Circulatory system5,907 discharges in 60 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 958 | $152,227 | $15,537 | $29,075 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 361 | $195,658 | $54,222 | $37,371 | 4.88 |
| Syncope and collapseMS-DRG 312, medical | 317 | $75,649 | $9,376 | $14,449 | 0.86 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 289 | $188,319 | $19,969 | $35,969 | 1.59 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 257 | $140,650 | $35,112 | $26,864 | 3.24 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 244 | $398,966 | $76,824 | $76,202 | 6.25 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 218 | $294,007 | $31,852 | $56,155 | 2.16 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 213 | $492,117 | $88,125 | $93,994 | 7.71 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 204 | $213,424 | $26,583 | $40,764 | 2.09 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 174 | $74,298 | $7,683 | $14,191 | 0.74 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 156 | $119,904 | $19,395 | $22,902 | 1.82 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 154 | $600,446 | $115,740 | $114,685 | 9.71 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 115 | $114,428 | $12,993 | $21,856 | 1.20 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 108 | $500,350 | $76,745 | $95,567 | 5.06 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 106 | $102,147 | $11,546 | $19,510 | 1.07 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 102 | $118,198 | $12,651 | $22,576 | 1.08 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 101 | $103,027 | $9,453 | $19,678 | 0.91 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 100 | $383,217 | $61,755 | $73,194 | 5.88 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 100 | $288,835 | $52,967 | $55,167 | 3.90 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 99 | $139,900 | $18,412 | $26,721 | 1.58 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 98 | $241,716 | $33,587 | $46,168 | 2.87 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 90 | $297,545 | $44,290 | $56,831 | 3.35 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 83 | $233,982 | $37,878 | $44,691 | 3.46 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 79 | $119,185 | $10,923 | $22,764 | 0.97 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 74 | $170,508 | $24,913 | $32,567 | 2.28 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 71 | $360,195 | $53,848 | $68,797 | 3.27 |
| Other vascular procedures with CCMS-DRG 253, surgical | 70 | $213,812 | $30,735 | $40,838 | 2.55 |
| Chest painMS-DRG 313, medical | 62 | $54,200 | $7,539 | $10,352 | 0.72 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 60 | $607,284 | $86,498 | $115,991 | 7.80 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 55 | $60,911 | $5,093 | $11,634 | 0.55 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 52 | $336,230 | $46,863 | $64,220 | 3.46 |
| Hypertension without MCCMS-DRG 305, medical | 47 | $72,500 | $7,572 | $13,847 | 0.75 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 45 | $438,386 | $67,704 | $83,732 | 5.04 |
| Amputation for circulatory system disorders except upper limb and toe with MCCMS-DRG 239, surgical | 42 | $381,286 | $56,489 | $72,826 | 4.81 |
| Heart failure and shock with CCMS-DRG 292, medical | 41 | $102,624 | $9,194 | $19,601 | 0.86 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 40 | $223,352 | $48,405 | $42,660 | 4.16 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 34 | $286,560 | $30,601 | $54,733 | 1.97 |
| Atherosclerosis without MCCMS-DRG 303, medical | 33 | $66,454 | $7,056 | $12,693 | 0.66 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 32 | $376,940 | $59,024 | $71,996 | 5.24 |
| Acute myocardial infarction, discharged alive without cc/mccMS-DRG 282, medical | 32 | $79,331 | $6,987 | $15,152 | 0.72 |
| Cardiac defibrillator implant with cardiac catheterization and MCCMS-DRG 275, surgical | 29 | $645,857 | $99,651 | $123,359 | 7.04 |
| Amputation for circulatory system disorders except upper limb and toe with CCMS-DRG 240, surgical | 28 | $208,585 | $31,140 | $39,840 | 2.81 |
| Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorMS-DRG 276, surgical | 26 | $460,361 | $80,232 | $87,929 | 6.21 |
| Cardiac congenital and valvular disorders without MCCMS-DRG 307, medical | 26 | $119,735 | $9,824 | $22,869 | 0.94 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 25 | $208,583 | $38,351 | $39,839 | 3.18 |
| Cardiac pacemaker revision except device replacement with CCMS-DRG 261, surgical | 22 | $150,042 | $18,326 | $28,658 | 1.88 |
| Hypertension with MCCMS-DRG 304, medical | 21 | $124,937 | $13,058 | $23,863 | 1.15 |
| Cardiac congenital and valvular disorders with MCCMS-DRG 306, medical | 21 | $187,043 | $20,447 | $35,725 | 1.54 |
| Cardiac defibrillator implant without MCCMS-DRG 277, surgical | 20 | $205,953 | $52,005 | $39,337 | 4.78 |
| Coronary intravascular lithotripsy with intraluminal device with MCCMS-DRG 323, surgical | 19 | $306,162 | $47,503 | $58,477 | 4.14 |
| Permanent cardiac pacemaker implant without cc/mccMS-DRG 244, surgical | 18 | $151,582 | $20,257 | $28,952 | 1.83 |
| Other vascular procedures without cc/mccMS-DRG 254, surgical | 18 | $127,560 | $19,108 | $24,364 | 1.74 |
| Coronary intravascular lithotripsy with intraluminal device without MCCMS-DRG 324, surgical | 18 | $140,144 | $34,312 | $26,767 | 2.97 |
| Other heart assist system implantMS-DRG 215, surgical | 17 | $646,698 | $141,612 | $123,519 | 10.21 |
| Aortic and heart assist procedures except pulsation balloon with MCCMS-DRG 268, surgical | 17 | $490,355 | $86,497 | $93,658 | 6.85 |
| Other endovascular cardiac valve procedures with MCCMS-DRG 319, surgical | 15 | $438,102 | $67,208 | $83,678 | 4.36 |
| Concomitant aortic and mitral valve proceduresMS-DRG 212, surgical | 14 | $933,166 | $144,378 | $178,235 | 10.77 |
| Percutaneous cardiovascular procedures without intraluminal device with MCCMS-DRG 250, surgical | 14 | $183,622 | $25,958 | $35,072 | 2.35 |
| Other circulatory system diagnoses without cc/mccMS-DRG 316, medical | 12 | $56,028 | $7,145 | $10,701 | 0.69 |
| Cardiac pacemaker revision except device replacement with MCCMS-DRG 260, surgical | 11 | $231,212 | $38,235 | $44,162 | 3.32 |
Infectious and parasitic diseases3,914 discharges in 13 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 | 2,607 | $218,019 | $25,941 | $41,642 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 418 | $543,207 | $73,399 | $103,753 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 374 | $100,615 | $10,744 | $19,217 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 261 | $651,438 | $98,682 | $124,425 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 53 | $203,438 | $24,141 | $38,857 | 2.04 |
| Postoperative and post-traumatic infections with MCCMS-DRG 862, medical | 39 | $183,191 | $22,082 | $34,989 | 1.84 |
| Viral illness without MCCMS-DRG 866, medical | 29 | $75,079 | $9,482 | $14,340 | 0.92 |
| Viral illness with MCCMS-DRG 865, medical | 27 | $114,657 | $17,561 | $21,900 | 1.64 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 25 | $483,726 | $65,379 | $92,392 | 4.43 |
| Postoperative and post-traumatic infections without MCCMS-DRG 863, medical | 25 | $84,996 | $10,377 | $16,234 | 1.01 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 24 | $183,492 | $23,911 | $35,047 | 2.14 |
| Fever and inflammatory conditionsMS-DRG 864, medical | 16 | $76,450 | $9,786 | $14,602 | 0.88 |
| Other infectious and parasitic diseases diagnoses with MCCMS-DRG 867, medical | 16 | $204,545 | $28,812 | $39,068 | 2.09 |
Respiratory system2,896 discharges in 32 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 528 | $166,761 | $20,547 | $31,851 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 371 | $143,424 | $15,186 | $27,394 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 172 | $74,386 | $8,319 | $14,208 | 0.82 |
| Major chest procedures with CCMS-DRG 164, surgical | 163 | $139,041 | $27,608 | $26,557 | 2.55 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 160 | $158,887 | $16,530 | $30,347 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 149 | $95,760 | $10,304 | $18,290 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 144 | $114,624 | $11,569 | $21,893 | 1.10 |
| Other respiratory system diagnoses with MCCMS-DRG 205, medical | 121 | $257,958 | $31,157 | $49,270 | 1.81 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 94 | $147,115 | $14,796 | $28,099 | 1.40 |
| Major chest procedures with MCCMS-DRG 163, surgical | 92 | $364,166 | $58,980 | $69,556 | 4.71 |
| Bronchitis and asthma with cc/mccMS-DRG 202, medical | 91 | $93,592 | $10,080 | $17,876 | 0.96 |
| Major chest trauma with CCMS-DRG 184, medical | 66 | $97,627 | $10,741 | $18,647 | 1.05 |
| Respiratory neoplasms with MCCMS-DRG 180, medical | 63 | $251,224 | $23,265 | $47,984 | 1.74 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 62 | $84,492 | $8,414 | $16,138 | 0.82 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 61 | $298,087 | $34,588 | $56,935 | 2.70 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 56 | $97,218 | $20,694 | $18,569 | 1.88 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 50 | $325,406 | $54,045 | $62,152 | 4.06 |
| Interstitial lung disease with MCCMS-DRG 196, medical | 47 | $171,395 | $21,297 | $32,736 | 1.90 |
| Chronic obstructive pulmonary disease with CCMS-DRG 191, medical | 46 | $68,944 | $8,410 | $13,168 | 0.85 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 46 | $607,098 | $94,792 | $115,956 | 6.91 |
| Other respiratory system diagnoses without MCCMS-DRG 206, medical | 45 | $147,877 | $13,300 | $28,244 | 0.91 |
| Other respiratory system o.r. procedures with CCMS-DRG 167, surgical | 44 | $159,110 | $20,902 | $30,390 | 1.82 |
| Major chest trauma with MCCMS-DRG 183, medical | 39 | $167,788 | $18,443 | $32,047 | 1.57 |
| Pleural effusion with MCCMS-DRG 186, medical | 33 | $190,702 | $17,409 | $36,424 | 1.55 |
| Pneumothorax with CCMS-DRG 200, medical | 27 | $164,230 | $17,290 | $31,368 | 1.08 |
| Pleural effusion with CCMS-DRG 187, medical | 24 | $116,389 | $11,270 | $22,230 | 1.00 |
| Respiratory infections and inflammations without cc/mccMS-DRG 179, medical | 21 | $56,184 | $7,312 | $10,731 | 0.76 |
| Respiratory neoplasms with CCMS-DRG 181, medical | 21 | $109,081 | $12,907 | $20,834 | 1.10 |
| Simple pneumonia and pleurisy without cc/mccMS-DRG 195, medical | 19 | $52,448 | $6,116 | $10,018 | 0.63 |
| Respiratory signs and symptomsMS-DRG 204, medical | 19 | $97,027 | $7,184 | $18,532 | 0.82 |
| Interstitial lung disease with CCMS-DRG 197, medical | 11 | $86,879 | $10,751 | $16,594 | 1.00 |
| Pneumothorax with MCCMS-DRG 199, medical | 11 | $198,623 | $16,549 | $37,937 | 1.77 |
Musculoskeletal system and connective tissue2,843 discharges in 55 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 | 304 | $98,544 | $20,753 | $18,822 | 1.88 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 214 | $156,488 | $22,359 | $29,889 | 2.07 |
| Medical back problems without MCCMS-DRG 552, medical | 211 | $91,924 | $10,301 | $17,557 | 0.97 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 143 | $146,795 | $22,984 | $28,038 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 127 | $94,680 | $9,368 | $18,084 | 0.90 |
| Combined anterior and posterior spinal fusion with CCMS-DRG 454, surgical | 106 | $289,835 | $67,821 | $55,358 | 6.12 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 90 | $237,066 | $33,702 | $45,280 | 2.95 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 84 | $162,255 | $36,751 | $30,991 | 3.49 |
| Bone diseases and arthropathies without MCCMS-DRG 554, medical | 82 | $88,952 | $8,733 | $16,990 | 0.82 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 77 | $96,205 | $11,125 | $18,375 | 1.09 |
| Medical back problems with MCCMS-DRG 551, medical | 72 | $136,823 | $18,344 | $26,133 | 1.70 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 70 | $140,941 | $21,487 | $26,920 | 1.97 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 68 | $130,401 | $28,381 | $24,907 | 2.48 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 67 | $165,359 | $31,266 | $31,584 | 2.96 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with MCCMS-DRG 542, medical | 59 | $220,427 | $23,185 | $42,102 | 1.82 |
| Fractures of hip and pelvis without MCCMS-DRG 536, medical | 58 | $80,578 | $8,488 | $15,390 | 0.79 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 56 | $126,602 | $21,494 | $24,181 | 2.04 |
| Connective tissue disorders with MCCMS-DRG 545, medical | 56 | $219,765 | $29,624 | $41,975 | 2.49 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 55 | $227,511 | $32,145 | $43,455 | 2.99 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 54 | $219,307 | $40,486 | $41,888 | 3.66 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 46 | $158,614 | $26,181 | $30,295 | 2.40 |
| Fractures of hip and pelvis with MCCMS-DRG 535, medical | 43 | $121,788 | $14,848 | $23,262 | 1.30 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCMS-DRG 562, medical | 36 | $117,092 | $16,366 | $22,365 | 1.52 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 35 | $218,853 | $33,612 | $41,801 | 3.00 |
| Signs and symptoms of musculoskeletal system and connective tissue without MCCMS-DRG 556, medical | 35 | $77,304 | $8,662 | $14,765 | 0.82 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 32 | $170,649 | $50,996 | $32,594 | 4.61 |
| Other musculoskeletal system and connective tissue o.r. procedures without cc/mccMS-DRG 517, surgical | 31 | $90,707 | $16,400 | $17,325 | 1.49 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 463, surgical | 30 | $473,596 | $57,788 | $90,457 | 5.66 |
| Connective tissue disorders with CCMS-DRG 546, medical | 28 | $126,719 | $12,682 | $24,203 | 1.20 |
| Tendonitis, myositis and bursitis without MCCMS-DRG 558, medical | 27 | $94,434 | $8,689 | $18,037 | 0.88 |
| Revision of hip or knee replacement without cc/mccMS-DRG 468, surgical | 25 | $102,731 | $28,731 | $19,622 | 2.67 |
| Biopsies of musculoskeletal system and connective tissue with CCMS-DRG 478, surgical | 25 | $216,902 | $27,563 | $41,428 | 2.38 |
| Back and neck procedures except spinal fusion without cc/mccMS-DRG 520, surgical | 24 | $99,263 | $14,570 | $18,959 | 1.43 |
| Biopsies of musculoskeletal system and connective tissue with MCCMS-DRG 477, surgical | 22 | $261,163 | $38,036 | $49,882 | 3.37 |
| Aftercare, musculoskeletal system and connective tissue with CCMS-DRG 560, medical | 22 | $102,572 | $13,104 | $19,591 | 1.13 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 457, surgical | 21 | $355,362 | $66,038 | $67,874 | 6.08 |
| Bone diseases and arthropathies with MCCMS-DRG 553, medical | 21 | $113,843 | $14,557 | $21,744 | 1.35 |
| Other musculoskeletal system and connective tissue diagnoses with MCCMS-DRG 564, medical | 21 | $193,507 | $19,795 | $36,960 | 1.56 |
| Other musculoskeletal system and connective tissue diagnoses with CCMS-DRG 565, medical | 21 | $98,866 | $10,940 | $18,883 | 1.00 |
| Amputation for musculoskeletal system and connective tissue disorders with MCCMS-DRG 474, surgical | 19 | $447,614 | $67,573 | $85,494 | 4.30 |
| Tendonitis, myositis and bursitis with MCCMS-DRG 557, medical | 19 | $170,716 | $19,239 | $32,607 | 1.56 |
| Hip and femur procedures except major joint without cc/mccMS-DRG 482, surgical | 18 | $102,793 | $17,177 | $19,633 | 1.59 |
| Spinal fusion except cervical with spinal curvature, malignancy, infection or extensiveMS-DRG 456, surgical | 17 | $477,235 | $88,911 | $91,152 | 8.43 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 17 | $106,234 | $20,682 | $20,291 | 1.87 |
| Soft tissue procedures with CCMS-DRG 501, surgical | 16 | $197,781 | $24,450 | $37,776 | 1.74 |
| Back and neck procedures except spinal fusion with MCC or disc device or neurostimulatorMS-DRG 518, surgical | 16 | $283,981 | $44,950 | $54,240 | 3.65 |
| Major hip and knee joint replacement or reattachment of lower extremity with MCC or totaMS-DRG 469, surgical | 15 | $186,207 | $36,812 | $35,566 | 3.33 |
| Cervical spinal fusion without cc/mccMS-DRG 473, surgical | 15 | $111,460 | $27,399 | $21,289 | 2.46 |
| Lower extremity and humerus procedures except hip, foot and femur with MCCMS-DRG 492, surgical | 15 | $254,463 | $35,343 | $48,602 | 3.46 |
| Combined anterior and posterior spinal fusion with MCCMS-DRG 453, surgical | 14 | $591,324 | $100,697 | $112,943 | 8.86 |
| Signs and symptoms of musculoskeletal system and connective tissue with MCCMS-DRG 555, medical | 14 | $134,075 | $15,428 | $25,608 | 1.40 |
| Aftercare, musculoskeletal system and connective tissue with MCCMS-DRG 559, medical | 14 | $289,907 | $30,356 | $55,372 | 1.85 |
| Other musculoskeletal system and connective tissue o.r. procedures with MCCMS-DRG 515, surgical | 13 | $221,666 | $36,924 | $42,338 | 3.16 |
| Cervical spinal fusion with MCCMS-DRG 471, surgical | 12 | $383,468 | $55,552 | $73,242 | 4.92 |
| Amputation for musculoskeletal system and connective tissue disorders with CCMS-DRG 475, surgical | 11 | $218,088 | $22,436 | $41,655 | 2.14 |
Nervous system2,543 discharges in 44 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 227 | $127,014 | $15,881 | $24,260 | 1.36 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 226 | $218,445 | $25,079 | $41,723 | 2.00 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 213 | $323,742 | $50,270 | $61,835 | 4.42 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 174 | $115,878 | $10,724 | $22,133 | 1.02 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 148 | $236,410 | $25,795 | $45,154 | 2.39 |
| Seizures without MCCMS-DRG 101, medical | 136 | $84,295 | $9,548 | $16,100 | 0.91 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 112 | $104,846 | $10,883 | $20,026 | 1.03 |
| Transient ischemia without thrombolyticMS-DRG 069, medical | 108 | $78,996 | $8,068 | $15,088 | 0.80 |
| Other disorders of nervous system with MCCMS-DRG 091, medical | 89 | $219,742 | $28,230 | $41,971 | 1.79 |
| Seizures with MCCMS-DRG 100, medical | 89 | $229,596 | $27,477 | $43,853 | 1.98 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 81 | $117,091 | $27,260 | $22,364 | 2.43 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 68 | $205,534 | $24,723 | $39,257 | 1.79 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 63 | $107,316 | $11,362 | $20,497 | 1.06 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 61 | $247,664 | $24,860 | $47,304 | 1.47 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 60 | $106,594 | $11,487 | $20,359 | 1.03 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 57 | $141,862 | $32,352 | $27,096 | 2.95 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 55 | $119,461 | $15,459 | $22,817 | 1.36 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 49 | $525,412 | $72,427 | $100,354 | 5.67 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 48 | $215,433 | $30,901 | $41,148 | 2.28 |
| Headaches without MCCMS-DRG 103, medical | 31 | $75,866 | $8,671 | $14,490 | 0.84 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 30 | $75,463 | $6,707 | $14,414 | 0.69 |
| Extracranial procedures with CCMS-DRG 038, surgical | 27 | $123,389 | $18,070 | $23,567 | 1.60 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 27 | $253,530 | $36,963 | $48,424 | 2.27 |
| Peripheral, cranial nerve and other nervous system procedures with MCCMS-DRG 040, surgical | 26 | $350,878 | $51,278 | $67,018 | 3.85 |
| Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurMS-DRG 041, surgical | 25 | $185,930 | $25,515 | $35,513 | 2.23 |
| Extracranial procedures without cc/mccMS-DRG 039, surgical | 24 | $92,891 | $11,193 | $17,742 | 1.14 |
| Other disorders of nervous system without cc/mccMS-DRG 093, medical | 24 | $59,103 | $7,824 | $11,289 | 0.77 |
| Spinal procedures with CC or spinal neurostimulatorsMS-DRG 029, surgical | 23 | $182,128 | $36,309 | $34,786 | 3.43 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 20 | $138,655 | $25,838 | $26,483 | 2.30 |
| Cranial and peripheral nerve disorders with MCCMS-DRG 073, medical | 20 | $166,761 | $18,376 | $31,851 | 1.51 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 061, medical | 19 | $267,223 | $32,406 | $51,040 | 2.80 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 18 | $435,805 | $95,370 | $83,239 | 8.45 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 18 | $92,325 | $13,549 | $17,634 | 1.32 |
| Spinal procedures with MCCMS-DRG 028, surgical | 17 | $335,566 | $74,289 | $64,093 | 6.03 |
| Ventricular shunt procedures with CCMS-DRG 032, surgical | 17 | $163,404 | $24,108 | $31,210 | 2.15 |
| Ventricular shunt procedures without cc/mccMS-DRG 033, surgical | 16 | $81,510 | $17,991 | $15,568 | 1.62 |
| Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent witMS-DRG 062, medical | 15 | $167,956 | $19,013 | $32,080 | 1.87 |
| Extracranial procedures with MCCMS-DRG 037, surgical | 13 | $277,051 | $40,614 | $52,917 | 3.38 |
| Traumatic stupor and coma >1 hour without cc/mccMS-DRG 084, medical | 13 | $72,198 | $9,946 | $13,790 | 0.92 |
| Non-bacterial infection of nervous system except viral meningitis with MCCMS-DRG 097, medical | 12 | $222,383 | $40,850 | $42,475 | 3.64 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 11 | $224,779 | $43,261 | $42,933 | 3.79 |
| Nervous system neoplasms without MCCMS-DRG 055, medical | 11 | $125,149 | $11,977 | $23,903 | 1.07 |
| Precerebral occlusion without infarction without MCCMS-DRG 068, medical | 11 | $82,856 | $9,622 | $15,825 | 0.87 |
| Bacterial and tuberculous infections of nervous system with MCCMS-DRG 094, medical | 11 | $349,402 | $55,308 | $66,736 | 3.62 |
Digestive system2,500 discharges in 35 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 | 308 | $76,033 | $8,235 | $14,522 | 0.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 224 | $91,638 | $10,373 | $17,503 | 0.98 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 209 | $181,623 | $21,921 | $34,690 | 1.79 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 172 | $129,330 | $15,357 | $24,702 | 1.28 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 158 | $154,588 | $26,008 | $29,526 | 2.37 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 144 | $100,252 | $11,147 | $19,148 | 0.94 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 131 | $413,382 | $61,018 | $78,956 | 4.52 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 112 | $184,861 | $24,032 | $35,308 | 1.62 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 110 | $86,661 | $8,515 | $16,552 | 0.80 |
| Digestive malignancy with MCCMS-DRG 374, medical | 103 | $246,387 | $27,136 | $47,060 | 2.10 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 70 | $167,439 | $27,503 | $31,981 | 2.50 |
| Gastrointestinal obstruction with MCCMS-DRG 388, medical | 64 | $143,356 | $18,242 | $27,381 | 1.45 |
| Major gastrointestinal disorders and peritoneal infections with CCMS-DRG 372, medical | 63 | $77,066 | $10,249 | $14,720 | 1.04 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 58 | $95,550 | $18,174 | $18,250 | 1.67 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 57 | $489,745 | $75,200 | $93,541 | 5.08 |
| Hernia procedures except inguinal and femoral with CCMS-DRG 354, surgical | 55 | $127,103 | $17,605 | $24,277 | 1.72 |
| Digestive malignancy with CCMS-DRG 375, medical | 53 | $135,394 | $14,036 | $25,860 | 1.20 |
| Hernia procedures except inguinal and femoral without cc/mccMS-DRG 355, surgical | 43 | $81,165 | $14,337 | $15,503 | 1.36 |
| Major gastrointestinal disorders and peritoneal infections with MCCMS-DRG 371, medical | 43 | $160,984 | $21,083 | $30,748 | 1.75 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 39 | $63,173 | $5,188 | $12,066 | 0.56 |
| Inflammatory bowel disease with CCMS-DRG 386, medical | 28 | $103,059 | $10,673 | $19,684 | 0.97 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 27 | $80,579 | $16,846 | $15,391 | 1.60 |
| Peritoneal adhesiolysis with CCMS-DRG 336, surgical | 25 | $127,837 | $22,320 | $24,417 | 2.11 |
| Complicated peptic ulcer with MCCMS-DRG 380, medical | 24 | $146,123 | $21,155 | $27,910 | 1.95 |
| Peritoneal adhesiolysis with MCCMS-DRG 335, surgical | 23 | $244,890 | $39,890 | $46,774 | 3.58 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 21 | $339,432 | $47,165 | $64,832 | 4.28 |
| Major esophageal disorders with MCCMS-DRG 368, medical | 21 | $152,554 | $18,968 | $29,138 | 1.65 |
| Inguinal and femoral hernia procedures with CCMS-DRG 351, surgical | 18 | $116,596 | $14,348 | $22,270 | 1.46 |
| Complicated peptic ulcer with CCMS-DRG 381, medical | 16 | $140,714 | $10,645 | $26,876 | 1.07 |
| Hernia procedures except inguinal and femoral with MCCMS-DRG 353, surgical | 15 | $218,029 | $33,899 | $41,643 | 2.92 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 15 | $48,265 | $5,701 | $9,219 | 0.65 |
| Other digestive system o.r. procedures with CCMS-DRG 357, surgical | 13 | $145,389 | $23,004 | $27,769 | 2.20 |
| Major esophageal disorders with CCMS-DRG 369, medical | 13 | $106,446 | $10,122 | $20,331 | 0.99 |
| Major gastrointestinal disorders and peritoneal infections without cc/mccMS-DRG 373, medical | 13 | $82,982 | $7,962 | $15,850 | 0.72 |
| Gastrointestinal hemorrhage without cc/mccMS-DRG 379, medical | 12 | $55,844 | $6,130 | $10,666 | 0.63 |
Kidney and urinary tract2,271 discharges in 23 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 381 | $165,036 | $19,583 | $31,522 | 1.65 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 314 | $86,253 | $9,057 | $16,474 | 0.81 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 303 | $124,504 | $13,182 | $23,780 | 1.17 |
| Renal failure with MCCMS-DRG 682, medical | 238 | $177,615 | $19,505 | $33,924 | 1.50 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 220 | $107,504 | $13,042 | $20,533 | 1.02 |
| Renal failure with CCMS-DRG 683, medical | 214 | $91,181 | $9,533 | $17,415 | 0.90 |
| Kidney transplantMS-DRG 652, surgical | 113 | $339,916 | $31,460 | $64,924 | 3.00 |
| Kidney transplant with hemodialysis with MCCMS-DRG 650, surgical | 78 | $385,506 | $49,920 | $73,632 | 4.50 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 64 | $371,279 | $51,122 | $70,914 | 3.70 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 50 | $112,479 | $15,130 | $21,483 | 1.35 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 44 | $198,339 | $28,637 | $37,883 | 2.59 |
| Kidney and ureter procedures for neoplasm with CCMS-DRG 657, surgical | 42 | $126,520 | $18,970 | $24,165 | 1.84 |
| Major bladder procedures with CCMS-DRG 654, surgical | 31 | $178,505 | $30,012 | $34,095 | 2.74 |
| Urinary stones without MCCMS-DRG 694, medical | 28 | $82,976 | $9,034 | $15,848 | 0.78 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 23 | $73,652 | $11,241 | $14,068 | 1.05 |
| Other kidney and urinary tract procedures with CCMS-DRG 674, surgical | 23 | $215,484 | $26,170 | $41,157 | 2.38 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 19 | $89,031 | $15,490 | $17,005 | 1.48 |
| Transurethral procedures with CCMS-DRG 669, surgical | 19 | $148,396 | $17,916 | $28,344 | 1.53 |
| Kidney and ureter procedures for neoplasm with MCCMS-DRG 656, surgical | 18 | $374,680 | $51,705 | $71,564 | 3.14 |
| Kidney and urinary tract neoplasms with MCCMS-DRG 686, medical | 14 | $250,546 | $25,627 | $47,854 | 1.84 |
| Kidney transplant with hemodialysis without MCCMS-DRG 651, surgical | 12 | $403,602 | $33,806 | $77,088 | 3.46 |
| Kidney and urinary tract signs and symptoms without MCCMS-DRG 696, medical | 12 | $60,309 | $7,327 | $11,519 | 0.69 |
| Renal failure without cc/mccMS-DRG 684, medical | 11 | $73,010 | $5,294 | $13,945 | 0.61 |
Endocrine, nutritional and metabolic949 discharges in 12 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 | 293 | $133,831 | $15,492 | $25,562 | 1.32 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 201 | $72,546 | $8,200 | $13,856 | 0.78 |
| Diabetes with CCMS-DRG 638, medical | 133 | $113,812 | $9,946 | $21,738 | 0.90 |
| Diabetes with MCCMS-DRG 637, medical | 85 | $137,200 | $16,027 | $26,205 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 76 | $190,807 | $20,815 | $36,444 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 60 | $108,484 | $11,671 | $20,720 | 1.06 |
| Adrenal and pituitary procedures with cc/mccMS-DRG 614, surgical | 22 | $136,652 | $24,155 | $26,101 | 2.25 |
| Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCMS-DRG 617, surgical | 20 | $173,270 | $20,635 | $33,095 | 1.98 |
| Adrenal and pituitary procedures without cc/mccMS-DRG 615, surgical | 19 | $79,312 | $14,444 | $15,149 | 1.47 |
| Other endocrine, nutritional and metabolic o.r. procedures with CCMS-DRG 629, surgical | 15 | $132,801 | $23,218 | $25,365 | 2.26 |
| Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders witMS-DRG 623, surgical | 13 | $128,740 | $17,566 | $24,589 | 1.86 |
| Diabetes without cc/mccMS-DRG 639, medical | 12 | $59,005 | $6,126 | $11,270 | 0.62 |
Liver, gallbladder and pancreas648 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 75 | $202,939 | $25,822 | $38,761 | 1.76 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 73 | $98,430 | $12,083 | $18,800 | 1.09 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCMS-DRG 441, medical | 59 | $288,988 | $33,222 | $55,197 | 1.83 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 55 | $186,316 | $29,860 | $35,586 | 2.89 |
| Pancreas, liver and shunt procedures with MCCMS-DRG 405, surgical | 50 | $296,714 | $59,661 | $56,672 | 5.51 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 47 | $133,249 | $16,503 | $25,451 | 1.63 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 46 | $271,130 | $26,064 | $51,786 | 1.92 |
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 41 | $202,020 | $22,392 | $38,586 | 1.63 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 39 | $103,229 | $8,810 | $19,717 | 0.86 |
| Laparoscopic cholecystectomy without C.D.E. with MCCMS-DRG 417, surgical | 33 | $218,677 | $32,527 | $41,767 | 2.32 |
| Laparoscopic cholecystectomy without C.D.E. without cc/mccMS-DRG 419, surgical | 29 | $92,875 | $12,853 | $17,739 | 1.31 |
| Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCMS-DRG 442, medical | 28 | $126,076 | $9,242 | $24,080 | 0.95 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 27 | $106,584 | $11,559 | $20,357 | 1.03 |
| Disorders of pancreas except malignancy with MCCMS-DRG 438, medical | 26 | $194,419 | $25,110 | $37,134 | 1.67 |
| Malignancy of hepatobiliary system or pancreas with CCMS-DRG 436, medical | 20 | $126,930 | $13,034 | $24,244 | 1.10 |
Blood and immune system485 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 172 | $90,401 | $9,955 | $17,267 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 150 | $158,814 | $17,511 | $30,334 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 71 | $127,217 | $18,139 | $24,298 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 808, medical | 34 | $235,744 | $28,546 | $45,027 | 2.19 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 34 | $103,306 | $11,856 | $19,731 | 1.20 |
| Reticuloendothelial and immunity disorders with MCCMS-DRG 814, medical | 24 | $339,029 | $54,417 | $64,754 | 2.13 |
Blood cancers and poorly differentiated neoplasms465 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 100 | $389,217 | $48,470 | $74,341 | 3.13 |
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 85 | $115,993 | $14,345 | $22,155 | 1.21 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 62 | $213,046 | $23,825 | $40,692 | 1.57 |
| Acute leukemia with MCCMS-DRG 834, medical | 52 | $607,115 | $80,091 | $115,959 | 5.60 |
| Chemotherapy without acute leukemia as secondary diagnosis with MCCMS-DRG 846, medical | 45 | $229,929 | $35,228 | $43,916 | 2.44 |
| Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy aMS-DRG 837, medical | 32 | $389,018 | $71,464 | $74,303 | 4.84 |
| Lymphoma and non-acute leukemia with other procedures with MCCMS-DRG 823, surgical | 25 | $454,116 | $62,882 | $86,736 | 4.50 |
| Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mcMS-DRG 843, medical | 18 | $271,741 | $28,512 | $51,903 | 1.86 |
| Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapMS-DRG 838, medical | 17 | $112,737 | $22,865 | $21,533 | 2.00 |
| Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedurMS-DRG 827, surgical | 16 | $136,237 | $26,154 | $26,021 | 2.32 |
| Lymphoma and non-acute leukemia with other procedures with CCMS-DRG 824, surgical | 13 | $187,216 | $27,461 | $35,758 | 2.23 |
Skin, subcutaneous tissue and breast457 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 183 | $85,350 | $9,192 | $16,302 | 0.88 |
| Cellulitis with MCCMS-DRG 602, medical | 69 | $189,343 | $20,635 | $36,165 | 1.49 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 63 | $74,647 | $9,919 | $14,258 | 0.91 |
| Other skin, subcutaneous tissue and breast procedures with CCMS-DRG 580, surgical | 26 | $143,033 | $17,820 | $27,319 | 1.75 |
| Minor skin disorders without MCCMS-DRG 607, medical | 23 | $136,266 | $14,874 | $26,027 | 0.89 |
| Skin ulcers with MCCMS-DRG 592, medical | 22 | $260,731 | $31,661 | $49,800 | 2.09 |
| Trauma to the skin, subcutaneous tissue and breast with MCCMS-DRG 604, medical | 17 | $97,295 | $16,787 | $18,583 | 1.51 |
| Skin ulcers with CCMS-DRG 593, medical | 14 | $80,542 | $11,951 | $15,384 | 1.21 |
| Major skin disorders without MCCMS-DRG 596, medical | 14 | $105,547 | $10,945 | $20,159 | 1.01 |
| Skin debridement with MCCMS-DRG 570, surgical | 13 | $198,685 | $32,200 | $37,949 | 2.92 |
| Other skin, subcutaneous tissue and breast procedures with MCCMS-DRG 579, surgical | 13 | $246,713 | $35,542 | $47,122 | 3.34 |
Other334 discharges in 9 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 | 138 | $434,541 | $67,504 | $82,997 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 57 | $192,000 | $28,985 | $36,672 | 2.49 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 987, surgical | 37 | $404,355 | $55,718 | $77,232 | 3.38 |
| Non-extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 988, surgical | 25 | $142,970 | $17,901 | $27,307 | 1.70 |
| Multiple level combined anterior and posterior spinal fusion except cervical with CCMS-DRG 427 | 23 | $385,193 | $81,992 | $73,572 | |
| Single level combined anterior and posterior spinal fusion except cervicalMS-DRG 402 | 19 | $182,581 | $41,838 | $34,873 | |
| Multiple level spinal fusion except cervical without MCCMS-DRG 448 | 12 | $235,756 | $43,288 | $45,029 | |
| Extensive o.r. procedures unrelated to principal diagnosis without cc/mccMS-DRG 983, surgical | 12 | $110,144 | $18,145 | $21,037 | 1.64 |
| Multiple level combined anterior and posterior spinal fusion except cervical with MCC orMS-DRG 426 | 11 | $679,328 | $128,826 | $129,752 |
Transplants, ECMO and tracheostomy (pre-MDC)300 discharges in 7 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 | 114 | $2,247,115 | $362,278 | $429,199 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 56 | $1,667,320 | $245,728 | $318,458 | 14.70 |
| Heart transplant or implant of heart assist system with MCCMS-DRG 001, surgical | 51 | $2,905,979 | $472,695 | $555,042 | 27.10 |
| Chimeric antigen receptor (car) t-cell and other immunotherapiesMS-DRG 018, medical | 26 | $1,942,978 | $387,660 | $371,109 | 36.84 |
| Liver transplant with MCC or intestinal transplantMS-DRG 005, surgical | 25 | $951,204 | $133,426 | $181,680 | 10.35 |
| Lung transplantMS-DRG 007, surgical | 15 | $963,241 | $162,198 | $183,979 | 12.27 |
| Allogeneic bone marrow transplantMS-DRG 014, medical | 13 | $1,211,007 | $192,779 | $231,302 | 11.46 |
Injuries, poisonings and toxic effects of drugs267 discharges in 8 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with MCCMS-DRG 919, medical | 59 | $180,122 | $22,881 | $34,403 | 1.82 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 58 | $160,888 | $20,413 | $30,730 | 1.60 |
| Complications of treatment with CCMS-DRG 920, medical | 45 | $98,314 | $11,759 | $18,778 | 1.03 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 32 | $364,183 | $46,577 | $69,559 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 26 | $146,497 | $22,382 | $27,981 | 2.00 |
| Poisoning and toxic effects of drugs without MCCMS-DRG 918, medical | 25 | $82,656 | $8,722 | $15,787 | 0.86 |
| Skin grafts for injuries with cc/mccMS-DRG 904, surgical | 11 | $547,246 | $47,828 | $104,524 | 3.26 |
| Other injury, poisoning and toxic effect diagnoses without MCCMS-DRG 923, medical | 11 | $96,675 | $10,890 | $18,465 | 1.01 |
Mental diseases and disorders186 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 | 143 | $221,000 | $25,731 | $42,211 | 1.76 |
| PsychosesMS-DRG 885, medical | 25 | $106,560 | $17,998 | $20,353 | 1.37 |
| Acute adjustment reaction and psychosocial dysfunctionMS-DRG 880, medical | 18 | $86,868 | $10,092 | $16,592 | 0.95 |
Ear, nose, mouth and throat177 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 74 | $69,113 | $7,596 | $13,201 | 0.74 |
| Otitis media and uri without MCCMS-DRG 153, medical | 28 | $69,989 | $7,655 | $13,368 | 0.73 |
| Otitis media and uri with MCCMS-DRG 152, medical | 18 | $119,132 | $14,301 | $22,754 | 1.19 |
| Other ear, nose, mouth and throat diagnoses with CCMS-DRG 155, medical | 18 | $66,442 | $9,654 | $12,690 | 0.95 |
| Major head and neck procedures with CCMS-DRG 141, surgical | 16 | $183,179 | $21,716 | $34,987 | 2.07 |
| Other ear, nose, mouth and throat o.r. procedures with CCMS-DRG 144, surgical | 12 | $107,101 | $19,212 | $20,456 | 1.73 |
| Dental and oral diseases with MCCMS-DRG 157, medical | 11 | $174,224 | $22,349 | $33,277 | 1.71 |
Factors influencing health status147 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 | 101 | $80,379 | $8,540 | $15,352 | 0.80 |
| Signs and symptoms with MCCMS-DRG 947, medical | 26 | $111,359 | $15,139 | $21,270 | 1.25 |
| Other factors influencing health statusMS-DRG 951, medical | 20 | $92,357 | $7,062 | $17,640 | 0.59 |
Male reproductive system105 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Transurethral prostatectomy with cc/mccMS-DRG 713, surgical | 63 | $70,272 | $16,054 | $13,422 | 1.45 |
| Major male pelvic procedures with cc/mccMS-DRG 707, surgical | 17 | $227,552 | $34,909 | $43,462 | 1.96 |
| Benign prostatic hypertrophy without MCCMS-DRG 726, medical | 14 | $58,126 | $7,281 | $11,102 | 0.73 |
| Malignancy, male reproductive system with MCCMS-DRG 722, medical | 11 | $237,981 | $28,555 | $45,454 | 1.87 |
Female reproductive system103 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Uterine and adnexa procedures for non-malignancy with cc/mccMS-DRG 742, surgical | 35 | $85,481 | $19,876 | $16,327 | 1.78 |
| Uterine and adnexa procedures for ovarian or adnexal malignancy with CCMS-DRG 737, surgical | 15 | $126,171 | $21,899 | $24,099 | 1.97 |
| Uterine and adnexa procedures for non-malignancy without cc/mccMS-DRG 743, surgical | 15 | $71,919 | $12,593 | $13,737 | 1.16 |
| Malignancy, female reproductive system with MCCMS-DRG 754, medical | 14 | $203,001 | $18,706 | $38,773 | 1.85 |
| Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with CCMS-DRG 740, surgical | 13 | $103,872 | $18,695 | $19,840 | 1.79 |
| Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy without cc/mccMS-DRG 741, surgical | 11 | $87,983 | $14,095 | $16,805 | 1.30 |
Alcohol and drug use61 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 | 38 | $70,477 | $9,359 | $13,461 | 0.86 |
| Alcohol, drug abuse or dependence without rehabilitation therapy with MCCMS-DRG 896, medical | 23 | $201,508 | $20,468 | $38,488 | 1.78 |
HIV infections57 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| HIV with major related condition with MCCMS-DRG 974, medical | 39 | $316,589 | $37,206 | $60,469 | 2.92 |
| HIV with major related condition with CCMS-DRG 975, medical | 18 | $114,035 | $15,685 | $21,781 | 1.36 |
Multiple significant trauma42 discharges in 3 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 | 17 | $302,167 | $37,807 | $57,714 | 3.88 |
| Other multiple significant trauma with CCMS-DRG 964, medical | 14 | $125,024 | $16,550 | $23,880 | 1.50 |
| Other multiple significant trauma with MCCMS-DRG 963, medical | 11 | $143,369 | $31,006 | $27,383 | 2.73 |
Burns32 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Non-extensive burnsMS-DRG 935, medical | 17 | $205,960 | $28,612 | $39,338 | 2.04 |
| Full thickness burn with skin graft or inhalation injury with cc/mccMS-DRG 928, surgical | 15 | $639,858 | $86,120 | $122,213 | 6.92 |
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 Intraocular ProceduresAPC 5491 | 2,406 | 1,594 | $19,019 | $2,095 | $1,752 |
| Level 1 Endovascular ProceduresAPC 5191 | 1,405 | 1,384 | $32,221 | $2,631 | $2,208 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 1,050 | 1,000 | $15,495 | $1,452 | $1,220 |
| Level 2 Upper GI ProceduresAPC 5302 | 973 | 852 | $16,537 | $1,707 | $1,445 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 808 | 797 | $34,219 | $5,172 | $4,358 |
| Level 3 Endovascular ProceduresAPC 5193 | 793 | 717 | $49,745 | $10,853 | $8,874 |
| Level 4 Urology and Related ServicesAPC 5374 | 633 | 543 | $20,724 | $3,154 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 615 | 563 | $23,838 | $4,649 | $3,918 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 596 | 563 | $52,852 | $13,271 | $10,772 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 556 | 542 | $39,359 | $6,502 | $5,339 |
| Level 4 Airway EndoscopyAPC 5154 | 534 | 421 | $25,166 | $3,382 | $2,833 |
| Level 3 Urology and Related ServicesAPC 5373 | 495 | 369 | $19,672 | $1,831 | $1,516 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 481 | 405 | $15,088 | $2,561 | $2,141 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 479 | 464 | $113,179 | $25,112 | $21,117 |
| Level 2 Intraocular ProceduresAPC 5492 | 469 | 410 | $31,555 | $3,678 | $3,116 |
| Level 3 Vascular ProceduresAPC 5183 | 464 | 422 | $26,572 | $2,852 | $2,405 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 434 | 399 | $26,264 | $3,085 | $2,636 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 356 | 356 | $50,282 | $10,009 | $8,164 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 341 | 321 | $24,937 | $3,435 | $2,930 |
| Level 2 Endovascular ProceduresAPC 5192 | 335 | 312 | $36,799 | $5,103 | $4,338 |
| Level 5 ENT ProceduresAPC 5165 | 323 | 319 | $39,378 | $5,276 | $4,436 |
| Level 4 Endovascular ProceduresAPC 5194 | 305 | 293 | $66,194 | $18,272 | $14,606 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 302 | 292 | $14,355 | $1,450 | $1,196 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 291 | 290 | $64,792 | $10,329 | $8,569 |
| Level 4 Gynecologic ProceduresAPC 5414 | 285 | 273 | $24,683 | $2,778 | $2,389 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 282 | 282 | $39,416 | $8,010 | $6,514 |
| Level 4 Vascular ProceduresAPC 5184 | 260 | 238 | $35,420 | $4,700 | $3,946 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 254 | 241 | $25,298 | $2,886 | $2,373 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 244 | 237 | $21,696 | $2,101 | $1,780 |
| Level 3 Lower GI ProceduresAPC 5313 | 243 | 230 | $19,767 | $2,584 | $2,176 |
| Level 5 Airway EndoscopyAPC 5155 | 232 | 228 | $31,024 | $6,205 | $5,183 |
| Level 1 Nerve ProceduresAPC 5431 | 225 | 214 | $21,799 | $1,748 | $1,407 |
| Complex GI ProceduresAPC 5331 | 219 | 171 | $28,412 | $5,120 | $4,263 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 207 | 202 | $33,451 | $5,869 | $4,982 |
| Level 3 Airway EndoscopyAPC 5153 | 190 | 173 | $20,153 | $1,529 | $1,264 |
| Level 7 Radiation TherapyAPC 5627 | 164 | 140 | $78,478 | $7,182 | $6,121 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 151 | 150 | $117,265 | $35,685 | $29,375 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 147 | 145 | $70,216 | $19,521 | $15,763 |
| Level 3 Upper GI ProceduresAPC 5303 | 141 | 132 | $20,793 | $3,422 | $2,888 |
| Level 2 Vascular ProceduresAPC 5182 | 121 | 117 | $16,022 | $1,425 | $1,204 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 107 | 94 | $38,936 | $6,200 | $4,524 |
| Level 2 Urology and Related ServicesAPC 5372 | 92 | 54 | $8,481 | $617 | $502 |
| Level 3 Intraocular ProceduresAPC 5493 | 91 | 69 | $31,471 | $4,737 | $4,004 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 84 | 83 | $94,884 | $20,483 | $17,052 |
| Level 5 Gynecologic ProceduresAPC 5415 | 80 | 80 | $35,547 | $4,478 | $3,792 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 79 | 75 | $59,165 | $13,835 | $11,550 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 67 | 66 | $112,730 | $32,588 | $26,719 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 64 | 57 | $33,904 | $3,505 | $2,969 |
| Level 1 ICD and Similar ProceduresAPC 5231 | 56 | 56 | $93,848 | $25,113 | $21,011 |
| Implantation Wireless PA Pressure MonitorAPC 5200 | 49 | 49 | $81,135 | $31,339 | $26,955 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 48 | 48 | $81,357 | $22,708 | $18,465 |
| Level 4 ENT ProceduresAPC 5164 | 43 | 43 | $28,402 | $2,919 | $2,217 |
| Level 6 Gynecologic ProceduresAPC 5416 | 41 | 41 | $51,818 | $6,964 | $5,836 |
| Level 6 Urology and Related ServicesAPC 5376 | 27 | 26 | $33,080 | $8,841 | $7,291 |
| Level 3 Breast/Lymphatic Surgery and Related ProceduresAPC 5093 | 19 | 19 | $57,505 | $8,606 | $7,546 |
| Level 8 Urology and Related ServicesAPC 5378 | 17 | 15 | $76,250 | $21,261 | $17,428 |
| Level 1 Neurostimulator and Related ProceduresAPC 5461 | 17 | 16 | $38,468 | $3,085 | $2,547 |
| Level 4 Breast/Lymphatic Surgery and Related ProceduresAPC 5094 | 14 | 14 | $65,109 | $18,371 | $15,549 |
| Cochlear Implant ProcedureAPC 5166 | 14 | 13 | $97,952 | $36,405 | $29,489 |
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.